No abstract

Background: This study analyzed the trends and seasonality in mortality among children aged 0-14 years in Guangzhou, China during 2008. Understanding the epidemiology of this public health problem can guide policy development for children mortality prevention. Methods:A population-based epidemiological retrospective study was conducted. 7,265 individual data of children mortality were obtained from the Guangzhou Centre for Disease Control and Prevention. The Poisson regression was used to quantify the annual average reduction rate and the difference in mortality rate between gender and age groups. Incidence ratios with 95% confidence intervals (CI) were calculated to determine the ratio of the observed number of deaths to the expected deaths (i.e. the average assuming no variations) by month, season, school term, weeks and holidays deaths.Results: Between 2008 and 2018, the children mortality rate in Guangzhou decreased from 54.0 to 34.3 per 100,000 children, with an annual reduction rate of 4.6% (95%CI:1.1%-8.1%), especially the under-5 mortality rate decreased by 8.3% (95%CI: 4.8%-11.6%) per year. The decline trend varied by causes of death, even with an upward trend for the mortality of asphyxia and neurological diseases. The risk of death among male children was 1.78 times (95%CI: 1.61-1.98) that of females. The distribution of causes of death differed by age groups. Maternal and perinatal, congenital and pneumonia were the top three causes of death in infants and cancer 3 accounted for 17% of deaths in children aged 1-14 years. Moreover, the injury-related mortality showed significant temporal variations with higher risk during the weekend. And there was a summer peak for drowning and a winter peak for asphyxia. Conclusions: Guangzhou has made considerable progress in reducing mortality over the last decade. The findings of characteristics of children mortality would provide important information for the development and implementation of integrated interventions targeted specific age groups and causes of death. mortality unchanged among the children aged 10-14 years. There children mortality rate was higher among males and those under five years. Significant temporal variations were observed for injury-related mortality from drowning, transport accidents and asphyxia. The upward trend of mortality due to asphyxia, neurological and cardiovascular diseases strengthens the importance of monitoring and management for specific causes of death. The findings provide important information for the development and implementation of interventions targeting specific causes, seasons and age groups to reduce children mortality.