Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis

Liu, Lei; Oza, Shefali; Hogan, Daniel R; Perin, Jamie; Rudan, Igor; Lawn, Joy E; Cousens, Simon; Mathers, Colin; Black, Robert E.

doi:10.1016/s0140-6736(14)61698-6

Cited by 2,735 publications

(2,304 citation statements)

References 51 publications

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“…Pneumonia is the leading cause of under-5 mortality outside the neonatal period in low- and middle-income countries (LMICs) [1,2]. Asthma is the commonest chronic disease in children in high and LMIC settings [3].…”

Section: Introductionmentioning

confidence: 99%

The association between environmental tobacco smoke exposure and childhood respiratory disease: a review

Vanker

Gie

Zar

2017

Expert Review of Respiratory Medicine

151

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Introduction: Childhood respiratory illness is a major cause of morbidity and mortality particularly in low and middle-income countries. Environmental tobacco smoke (ETS) exposure is a recognised risk factor for both acute and chronic respiratory illness.Areas covered: The aim of this paper was to review the epidemiology of ETS exposure and impact on respiratory health in children. We conducted a search of 3 electronic databases of publications on ETS and childhood respiratory illness from 1990–2015. Key findings were that up to 70% of children are exposed to ETS globally, but under-reporting may mask the true prevalence. Maternal smoking and ETS exposure influence infant lung development and are associated with childhood upper and lower respiratory tract infection, wheezing or asthma. Further, exposure to ETS is associated with more severe respiratory disease. ETS exposure reduces lung function early in life, establishing an increased lifelong risk of poor lung health.Expert commentary: Urgent and effective strategies are needed to decrease ETS exposure in young children to improve child and long-term lung health in adults especially in low and middle income countries where ETS exposure is increasing.

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Section: Introductionmentioning

confidence: 99%

The association between environmental tobacco smoke exposure and childhood respiratory disease: a review

Vanker

Gie

Zar

2017

Expert Review of Respiratory Medicine

151

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“…Since that time, despite an increased birth rate, the annual number of child deaths has decreased. The World Health Organization (WHO) estimates deaths in children under five decreased from 9.9 million in 2000 to 6.3 million in 2013 [1]. However, the mortality rate in children aged 1–59 months declined more significantly than did mortality for neonates, with a resultant increase in the contribution of neonatal deaths to the under-five mortality rate.…”

Section: Introductionmentioning

confidence: 99%

“…However, the mortality rate in children aged 1–59 months declined more significantly than did mortality for neonates, with a resultant increase in the contribution of neonatal deaths to the under-five mortality rate. As of 2013, intrapartum-related neonatal death (birth asphyxia) remained the cause of at least 662,000 deaths per year [1]. …”

Section: Introductionmentioning

confidence: 99%

“…However, although some of these studies included low-volume rural clinics, the majority of births evaluated in these studies occurred in hospitals or larger clinics staffed full-time by physicians. Due to a higher relative birth rate and less direct involvement of physicians in the labor and delivery process, rural areas served only by small clinics suffer a greater burden of neonatal mortality from birth asphyxia [1,2]. …”

Section: Introductionmentioning

confidence: 99%

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Retention and use of newborn resuscitation skills following a series of helping babies breathe trainings for midwives in rural Ghana

Eblovi

Kelly

Afua

et al. 2017

Global Health Action

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Background: The Helping Babies Breathe (HBB) program teaches basic newborn resuscitation techniques to birth attendants in low-resource settings. Previous studies have demonstrated a decrease in mortality following training, mostly in large hospitals. However, low-volume clinics in rural regions with no physician immediately available likely experience a greater relative burden of newborn mortality. This study aimed to determine the impact of HBB trainings provided to rural Ghanaian midwives on their skills retention and on first 24 hour mortality of the newborns they serve. Methods: American Acadamy of Paediatrics (AAP)-trained Master Trainers conducted two 2-day HBB trainings and 2-day refresher courses one year later for 48 midwives from Ghanaian rural health clinics. Trainee skills were evaluated by Objective Structured Clinical Examination (OSCE) at three time points: immediately after training, four months after training, and four months after the refresher. Midwives recorded the single highest level of resuscitation performed on each newborn delivered for one year. Results: 48 midwives attended the two trainings, 32 recorded data from 2,383 deliveries, and 13 completed OSCE simulations at all three time points. The midwives’ OSCE scores decreased from immediately after training (94.9%) to four months later (81.2%, p < 0.00001). However, four months following the refresher course, scores improved to the same high level attained initially (92.7%, p = 0.0013). 5.0% of neonates required bag-mask ventilation and 0.71% did not survive, compared with a nationwide first 24 hour mortality estimate of 1.7%. Conclusions: The midwives’ performance on the simulation exercise indicates that an in-depth refresher course provided one year after the initial training likely slows the decay in skills that occurs after initial training. Our finding that 5.0% of newborns required bag-mask ventilation is consistent with global estimates. Our observed first 24 hour mortality rate of 0.71% is lower than nationwide estimates, indicating the training likely prevented deaths due to birth asphyxia.

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“…2 A major contributor to the reduction in under-5 mortality was acceleration in prevention of deaths from two vaccine-preventable diseases, particularly neonatal tetanus and measles for which the yearly decline between 2000 and 2013 were 8.9% and 12.8%, respectively. 3 The decreases in measles and neonatal tetanus deaths, were largely attributed to vaccination strategies being adopted aimed at increasing routine coverage with the measles vaccines among children, and tetanus vaccine in pregnant women, respectively. Furthermore, for both measles and neonatal tetanus, the immunization strategy was enhanced through the use of periodic supplementary immunization activities (SIA), to optimise the targeted population vaccine coverage.…”

mentioning

confidence: 99%

Experience and challenges on influenza and pertussis vaccination in pregnant women

Madhi

Nunes

2018

Human Vaccines & Immunotherapeutics

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Young infants contribute to relatively high burden of vaccine-preventable diseases, including infections by influenza virus and Bordetella pertussis. Vaccination of pregnant women can enhance transplacental transfer of protective antibody to the fetus and protect the infant against disease during the first few months of life.Pregnant women are a priority group for seasonal influenza vaccination, due to third-trimester pregnancy being a risk-factor for severe influenza illness. Furthermore, randomized controlled trials confirmed that influenza vaccination during pregnancy confers protection against influenza-confirmed illness in the women, and their infants up to 3 months of age; and is also associated with 20% reduction in all-cause pneumonia among young-infants. Maternal influenza vaccination might also reduce the risk of low-birth weight, preterm births, and stillbirths however, data on this is conflicting.Vaccination of pregnant women with acellular pertussis vaccines reduces pertussis in their young infants by up to 93%. The increase in specific pertussis antibody among the infants born to vaccinated women might, however, interfere with the active pertussis vaccination of the infant following the primary series of vaccines. The clinical implication of this is yet to be ascertained, particularly since immune responses following the booster vaccine are unaffected.Vaccination of pregnant women with inactivated influenza vaccine and acellular pertussis vaccine have been demonstrated to confer protection to their young infants, and warrants consideration for inclusion into public health immunization programs, including in low and middle income countries.

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Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis

Cited by 2,735 publications

References 51 publications

The association between environmental tobacco smoke exposure and childhood respiratory disease: a review

The association between environmental tobacco smoke exposure and childhood respiratory disease: a review

Retention and use of newborn resuscitation skills following a series of helping babies breathe trainings for midwives in rural Ghana

Experience and challenges on influenza and pertussis vaccination in pregnant women

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