Under-5 Year Mortality: Result of In-Hospital Study, Tehran, Iran
In July 2003, the Bellagio Study Group on Child Survival estimated that the lives of 6 million children could be saved each year if 23 proven interventions were universally available in the 42 countries re-sponsible for 90% of child deaths in 2000. The aim of this study was to determine frequency of important causes of mortality among under-5 year old children in hospitals, Tehran, Iran. Information about Mortality data of under-5 year old children from 16 hospitals in the West of Tehran was collected. The study period was conducted from 1 October 2005 to 30 March 2006. Educated health personnel in each hospital interviewed parents of children who died in hospital and filled out a checklist. 142 under-5 year old children died over the course of study, of whom, 118 (83%) were neonates (under 28 days-old), 53.5% had low birth weights (< 2500 Kg), 62 (43%) were girls and 80 (57%) boys. The most common cause of under-5 year death was due to certain conditions originating in the perinatal period (ICD-10: P00-P96) (68%). Congenital abnormalities (12%) and pneumonia (5%) were the second and third most common causes respectively. Among 28-day to one-year old children, the leading cause of death was pneumonia (27.3%), while for children being 1 to 5 years of age, this included pneumonia and chronic hepatitis (about 30%). Overall, the most common causes of death were disorders related to short gestation and low birth weight. Therefore, achievement of the millennium development goal of reducing child mortality by two-thirds from 1990 rate will depend on renewed efforts to prevent and control low birth weight, preterm delivery, pneumonia, and infectious diseases in our setting.
A Better World For All. Infant and Child Mortality [Online]. 2007 Jan 1. Available from: URL:http://www.paris21.org/betterworld/infant.htm
Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every year? Lancet 2003; 361(9376): 2226-34.
Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS; Bellagio Child Survival Study Group. How many child deaths can we prevent this year? Lancet 2003; 362(9377): 65-71.
Lawn JE, Cousens S, Zupan J; Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: when? Where? Why? Lancet 2005; 365(9462): 891-900.
Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L; Lancet Neonatal Survival Steering Team. Evidence- based, cost-effective interventions: how many newborn babies can we save? Lancet 2005; 365(9463): 977-88.
The World Health Report 2005. Make every mother and child count [Online]. 2006 Jul 26. Available from:m URL:http://www.who.int/whr/2005/en/index.html
UN Millennium Project Task Force on Child Health andMaternal Health. Who's got the power? Transforming health systems for women and children. New York: UNDP, 2005.
Krug A, Pattinson RC, Power DJ. Why children die: an under-5 health care survey in Mafikeng region. S Afr Med J 2004; 94(3): 202-6.
Wang YP, Miao L, Qian YQ, Liang J, Wu YQ, Zhu J, et al. Analysis of under 5 years old children mortality and the leading death cause in China from 1996 to 2000. Zhonghua Yu Fang Yi Xue Za Zhi 2005; 39(4): 260-4.
Rutstein SO. Effects of preceding birth intervals on neonatal, infant and under-five years mortality and nutritional status in developing countries: evidence from the demographic and health surveys. Int J Gynaecol Obstet 2005; 89 Suppl 1: S7-24.
Chung H, Muntaner C. Political and welfare state determinants of infant and child health indicators: an analysis of wealthy countries. Soc Sci Med 2006; 63(3): 829-42.
Mohamed NS, Nofal LM, Hassan MH, Elkaffas SM. Timeseries analysis of under five mortality in Alexandria. J Egypt Public Health Assoc 2004; 79(3-4): 263-81.
Kalland M, Pensola TH, Meriläinen J, Sinkkonen J. Mortality in children registered in the Finnish child welfare registry: population based study. BMJ 2001; 323(7306): 207-8.
Grandesso F, Sanderson F, Kruijt J, Koene T, Brown V. Mortality and malnutrition among populations living in South Darfur, Sudan: results of 3 surveys, September 2004. JAMA 2005; 293(12): 1490-4.
Bryce J, Boschi-Pinto C, Shibuya K, Black RE; WHO Child Health Epidemiology Reference Group. WHO estimates of the causes of death in children. Lancet 2005; 365(9465): 1147-52.
Bhutta ZA, Belgaumi A, Abdur Rab M, Karrar Z, Khashaba M, Mouane N. Child health and survival in the Eastern Mediterranean region. BMJ 2006; 333(7573): 839-42.
Center for Health Network Development. Ministry of Health and Medical Education. Tehran: Islamic Republic of Iran, 2006.
Travis P, Bennett S, Haines A, Pang T, Bhutta Z, Hyder A, et al. Overcoming health-systems constraints to achieve the Millennium Development Goals. Lancet 2004; 364(9437): 900-6.
Zupan J, Aahman E. Perinatal mortality for the year 2000: estimates developed by WHO. Geneva: World Health Organization, 2005.
Bang A, Reddy MH, Deshmukh MD. Child mortality in Maharashtra. Economic Political Weekly 2002; 37: 4947-65.
Yasmin S, Osrin D, Paul E, Costello A. Neonatal mortality of low-birth-weight infants in Bangladesh. Bull World Health Organ 2001; 79(7): 608-14.
Aleman J, Brännström I, Liljestrand J, Peña R, PerssonLA, Steidinger J. Saving more neonates in hospital: an intervention towards a sustainable reduction in neonatal mortality in a Nicaraguan hospital. Trop Doct 1998; 28(2): 88-92.
Duke T, Willie L, Mgone JM. The effect of introduction of minimal standards of neonatal care on in-hospital mortality. P N G Med J 2000; 43(1-2): 127-36.
Conde-Agudelo A, Diaz-Rossello JL, Belizan JM. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev 2003; (2): CD002771.