Bengaluru Mar 18, 2019, (Research Matters):
Although the mortality rate among children in the age group of 5–14 years is lower than those below five years of age, an estimated one million kids in this age group still die around the world. In a recent study, researchers from Canada, Brazil, China, Mexico, India and Switzerland have tried to uncover the reasons behind this alarming statistic by analysing the causes of deaths in these children from India, China, Brazil, and Mexico. These countries have an estimated 40% of kids aged 5-14 years and report an estimated 200,000 deaths annually at these ages. The findings of their study were published in the journal The Lancet.
The researchers analysed 244,401 deaths of young children in the age group of 5-14 years between 2005 and 2016 in the four countries. They found that most of these deaths arose from preventable or treatable conditions. Among the common causes of death were communicable and non-communicable diseases, transport injuries, drowning and cancer.
India fares the worst
The analysis for India, where the researchers studied about 10,109 deaths from the Million Death Study, has some disturbing results. The findings show that India has the highest rate of death in every broad category among the four countries, except for non-communicable diseases among boys. “India was the only country where communicable diseases still account for nearly half of deaths”, says the study.
Percentage of deaths among children between 5-14 years in India. [Data Source]
In the eleven years considered in the study, from 2005 to 2016, the number of deaths of children in the 1-14 years age group had significantly reduced according to the findings. Although there were significant difference in the mortality rates between boys and girls during the initial years of the study, it had narrowed down towards 2016. “India had the fastest decline of any country for both sexes and with faster annual declines in communicable causes of death for girls than for boys”, the researchers say. However, there is much ground to cover as the age-standardised death rates from communicable diseases are about 17–19 times greater than in China and about 7–12 times greater than in Brazil or Mexico, depending on sex.
Age-standardised death rates per 100,000 population in India [Data Source]
The leading causes of death in India among girls were diarrhoea, followed by malaria and pneumonia. On the other hand, boys mostly died of drowning, diarrhoea and transport accidents. The study also found that the number of road traffic deaths were on the higher side in China and India. About 90% of the victims in India were vulnerable road users like pedestrians, pedal cyclists, or occupants of two-wheeled or three-wheeled vehicles. In China, about 57% of the victims of road accidents were pedestrians The study also found that in Brazil and Mexico a significant child homicide numbers were firearm related and suicide mortality was increasing for boys in Mexico.
Overall, transport accidents were in the top three causes for both sexes in all countries, except for Indian girls. Cancer is in the top three causes for both sexes in Mexico, Brazil, and China, but was the ninth and seventh leading cause of death for boys and girls, respectively, in India.
Number of deaths due to various causes in India in 2016 [Data Source]
Interestingly, the study points out the majority of these deaths among children in this age group are preventable. “In 2016, India had about 74,000 preventable or treatable deaths from communicable diseases, representing nearly half of all the annual Indian deaths and over a third of all deaths in the four countries at these ages”, says the study. In all the four countries studied, almost all of the deaths arose from preventable or treatable conditions.
The researchers are hopeful that these mortality rates can be reduced with suitable steps. “Substantial declines in deaths in this age group are possible in many countries with cost-effective, affordable, and feasible interventions”, they say. One such example is the strategy of vaccinations and antigens against communicable diseases, and primary care treatments, which are currently available for children under the age of five, to be extended to children aged 5-14 years. In India, a step towards this is the expansion of the government’s reproductive, maternal, newborn, and child health programme to include adolescents and establishment of adolescent-friendly clinics.
The mortality trends presented in this study would be useful for designing strategies to prevent and control such cases. “Analysis of direct cause-specific mortality among children aged 5–14 years provides clear targets for prevention and treatment of the conditions causing more than 200,000 deaths annually at these ages in India, China, Brazil, and Mexico”, say the authors, talking about the importance of such a study.