Trends, causes, and risk factors of mortality among children under 5 in Ethiopia, 1990–2013: findings from the Global Burden of Disease Study 2013
Identifieur interne : 003B63 ( Ncbi/Merge ); précédent : 003B62; suivant : 003B64Trends, causes, and risk factors of mortality among children under 5 in Ethiopia, 1990–2013: findings from the Global Burden of Disease Study 2013
Auteurs : Amare Deribew [Kenya, Royaume-Uni, Éthiopie] ; Gizachew Assefa Tessema [Australie, Éthiopie] ; Kebede Deribe [Royaume-Uni, Éthiopie] ; Yohannes Adama Melaku [Éthiopie, Australie] ; Yihunie Lakew [Éthiopie] ; Azmeraw T. Amare [Australie, Éthiopie, Pays-Bas] ; Semaw F. Abera [Éthiopie, Allemagne] ; Mesoud Mohammed [Éthiopie] ; Abiy Hiruye [Éthiopie] ; Efrem Teklay [Éthiopie] ; Awoke Misganaw [États-Unis] ; Nicholas Kassebaum [États-Unis]Source :
- Population Health Metrics [ 1478-7954 ] ; 2016.
Abstract
Ethiopia has made remarkable progress in reducing child mortality over the last two decades. However, the under-5 mortality rate in Ethiopia is still higher than the under-5 mortality rates of several low- and middle-income countries (LMIC). On the other hand, the patterns and causes of child mortality have not been well investigated in Ethiopia. The objective of this study was to investigate the mortality trend, causes of death, and risk factors among children under 5 in Ethiopia during 1990–2013.
We used Global Burden of Disease (GBD) 2013 data. Spatiotemporal Gaussian Process Regression (GPR) was applied to generate best estimates of child mortality with 95% uncertainty intervals (UI). Causes of death by age groups, sex, and year were measured using Cause of Death Ensemble modeling (CODEm). For estimation of HIV/AIDS mortality rate, the modified UNAIDS EPP-SPECTRUM suite model was used.
Between 1990 and 2013 the under-5 mortality rate declined from 203.9 deaths/1000 live births to 74.4 deaths/1000 live births with an annual rate of change of 4.6%, yielding a total reduction of 64%. Similarly, child (1–4 years), post-neonatal, and neonatal mortality rates declined by 75%, 64%, and 52%, respectively, between 1990 and 2013. Lower respiratory tract infection (LRI), diarrheal diseases, and neonatal syndromes (preterm birth complications, neonatal encephalopathy, neonatal sepsis, and other neonatal disorders) accounted for 54% of the total under-5 deaths in 2013. Under-5 mortality rates due to measles, diarrhea, malaria, protein-energy malnutrition, and iron-deficiency anemia declined by more than two-thirds between 1990 and 2013. Among the causes of under-5 deaths, neonatal syndromes such as sepsis, preterm birth complications, and birth asphyxia ranked third to fifth in 2013.
Of all risk-attributable deaths in 1990, 25% of the total under-5 deaths (112,288/435,962) and 48% (112,288/232,199) of the deaths due to diarrhea, LRI, and other common infections were attributable to childhood wasting. Similarly, 19% (43,759/229,333) of the total under-5 deaths and 45% (43,759/97,963) of the deaths due to diarrhea and LRI were attributable to wasting in 2013. Of the total diarrheal disease- and LRI-related deaths (
LRI, diarrheal diseases, and neonatal syndromes remain the major causes of under-5 deaths in Ethiopia. These findings call for better-integrated newborn and child survival interventions focusing on the main risk factors.
Url:
DOI: 10.1186/s12963-016-0112-2
PubMed: 27891065
PubMed Central: 5109762
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Trends, causes, and risk factors of mortality among children under 5 in Ethiopia, 1990–2013: findings from the Global Burden of Disease Study 2013</title>
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<country xml:lang="fr">Éthiopie</country>
<wicri:regionArea>Federal Ministry of Health, Addis Ababa</wicri:regionArea>
<wicri:noRegion>Addis Ababa</wicri:noRegion>
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<author><name sortKey="Teklay, Efrem" sort="Teklay, Efrem" uniqKey="Teklay E" first="Efrem" last="Teklay">Efrem Teklay</name>
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<wicri:regionArea>Federal Ministry of Health, Addis Ababa</wicri:regionArea>
<wicri:noRegion>Addis Ababa</wicri:noRegion>
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<author><name sortKey="Misganaw, Awoke" sort="Misganaw, Awoke" uniqKey="Misganaw A" first="Awoke" last="Misganaw">Awoke Misganaw</name>
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<author><name sortKey="Kassebaum, Nicholas" sort="Kassebaum, Nicholas" uniqKey="Kassebaum N" first="Nicholas" last="Kassebaum">Nicholas Kassebaum</name>
<affiliation wicri:level="4"><nlm:aff id="Aff16">Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Institute for Health Metrics and Evaluation, University of Washington, Seattle</wicri:regionArea>
<orgName type="university">Université de Washington</orgName>
<placeName><settlement type="city">Seattle</settlement>
<region type="state">Washington (État)</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">Population Health Metrics</title>
<idno type="eISSN">1478-7954</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
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</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Ethiopia has made remarkable progress in reducing child mortality over the last two decades. However, the under-5 mortality rate in Ethiopia is still higher than the under-5 mortality rates of several low- and middle-income countries (LMIC). On the other hand, the patterns and causes of child mortality have not been well investigated in Ethiopia. The objective of this study was to investigate the mortality trend, causes of death, and risk factors among children under 5 in Ethiopia during 1990–2013.</p>
</sec>
<sec><title>Methods</title>
<p>We used Global Burden of Disease (GBD) 2013 data. Spatiotemporal Gaussian Process Regression (GPR) was applied to generate best estimates of child mortality with 95% uncertainty intervals (UI). Causes of death by age groups, sex, and year were measured using Cause of Death Ensemble modeling (CODEm). For estimation of HIV/AIDS mortality rate, the modified UNAIDS EPP-SPECTRUM suite model was used.</p>
</sec>
<sec><title>Results</title>
<p>Between 1990 and 2013 the under-5 mortality rate declined from 203.9 deaths/1000 live births to 74.4 deaths/1000 live births with an annual rate of change of 4.6%, yielding a total reduction of 64%. Similarly, child (1–4 years), post-neonatal, and neonatal mortality rates declined by 75%, 64%, and 52%, respectively, between 1990 and 2013. Lower respiratory tract infection (LRI), diarrheal diseases, and neonatal syndromes (preterm birth complications, neonatal encephalopathy, neonatal sepsis, and other neonatal disorders) accounted for 54% of the total under-5 deaths in 2013. Under-5 mortality rates due to measles, diarrhea, malaria, protein-energy malnutrition, and iron-deficiency anemia declined by more than two-thirds between 1990 and 2013. Among the causes of under-5 deaths, neonatal syndromes such as sepsis, preterm birth complications, and birth asphyxia ranked third to fifth in 2013.</p>
<p>Of all risk-attributable deaths in 1990, 25% of the total under-5 deaths (112,288/435,962) and 48% (112,288/232,199) of the deaths due to diarrhea, LRI, and other common infections were attributable to childhood wasting. Similarly, 19% (43,759/229,333) of the total under-5 deaths and 45% (43,759/97,963) of the deaths due to diarrhea and LRI were attributable to wasting in 2013. Of the total diarrheal disease- and LRI-related deaths (<italic>n</italic>
= 97,963) in 2013, 59% (57,923/97,963) of them were attributable to unsafe water supply, unsafe sanitation, household air pollution, and no handwashing with soap.</p>
</sec>
<sec><title>Conclusions</title>
<p>LRI, diarrheal diseases, and neonatal syndromes remain the major causes of under-5 deaths in Ethiopia. These findings call for better-integrated newborn and child survival interventions focusing on the main risk factors.</p>
</sec>
</div>
</front>
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</TEI>
<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Popul Health Metr</journal-id>
<journal-id journal-id-type="iso-abbrev">Popul Health Metr</journal-id>
<journal-title-group><journal-title>Population Health Metrics</journal-title>
</journal-title-group>
<issn pub-type="epub">1478-7954</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27891065</article-id>
<article-id pub-id-type="pmc">5109762</article-id>
<article-id pub-id-type="publisher-id">112</article-id>
<article-id pub-id-type="doi">10.1186/s12963-016-0112-2</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>Trends, causes, and risk factors of mortality among children under 5 in Ethiopia, 1990–2013: findings from the Global Burden of Disease Study 2013</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Deribew</surname>
<given-names>Amare</given-names>
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<address><email>amare.deribew@gmail.com</email>
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<given-names>Gizachew Assefa</given-names>
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<given-names>Kebede</given-names>
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<address><email>kebededeka@yahoo.com</email>
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<given-names>Yihunie</given-names>
</name>
<address><email>yihunierh@yahoo.com</email>
</address>
<xref ref-type="aff" rid="Aff10">10</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Amare</surname>
<given-names>Azmeraw T.</given-names>
</name>
<address><email>azmerawtayelgn3@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff9">9</xref>
<xref ref-type="aff" rid="Aff11">11</xref>
<xref ref-type="aff" rid="Aff12">12</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Abera</surname>
<given-names>Semaw F.</given-names>
</name>
<address><email>semawfer@yahoo.com</email>
</address>
<xref ref-type="aff" rid="Aff8">8</xref>
<xref ref-type="aff" rid="Aff13">13</xref>
<xref ref-type="aff" rid="Aff14">14</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mohammed</surname>
<given-names>Mesoud</given-names>
</name>
<address><email>mesoud.mohammed@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff15">15</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hiruye</surname>
<given-names>Abiy</given-names>
</name>
<address><email>abiyhiruy@yahoo.com</email>
</address>
<xref ref-type="aff" rid="Aff15">15</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Teklay</surname>
<given-names>Efrem</given-names>
</name>
<address><email>Mchdirector.fmoh@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff15">15</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Misganaw</surname>
<given-names>Awoke</given-names>
</name>
<address><email>awoket@uw.edu</email>
</address>
<xref ref-type="aff" rid="Aff16">16</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kassebaum</surname>
<given-names>Nicholas</given-names>
</name>
<address><email>nickjk@uw.edu</email>
</address>
<xref ref-type="aff" rid="Aff16">16</xref>
</contrib>
<aff id="Aff1"><label>1</label>
KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya</aff>
<aff id="Aff2"><label>2</label>
Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK</aff>
<aff id="Aff3"><label>3</label>
St. Paul Millennium Medical College, Addis Ababa, Ethiopia</aff>
<aff id="Aff4"><label>4</label>
School of Public Health, University of Adelaide, Adelaide, Australia</aff>
<aff id="Aff5"><label>5</label>
Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia</aff>
<aff id="Aff6"><label>6</label>
Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton & Sussex Medical School, Falmer, Brighton, UK</aff>
<aff id="Aff7"><label>7</label>
School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia</aff>
<aff id="Aff8"><label>8</label>
School of Public Health, Mekelle University, Mekelle, Ethiopia</aff>
<aff id="Aff9"><label>9</label>
School of Medicine, University of Adelaide, Adelaide, Australia</aff>
<aff id="Aff10"><label>10</label>
Ethiopian Public Health Association, Addis Ababa, Ethiopia</aff>
<aff id="Aff11"><label>11</label>
College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia</aff>
<aff id="Aff12"><label>12</label>
Department of Epidemiology, University of Groningen, Groningen, The Netherlands</aff>
<aff id="Aff13"><label>13</label>
Kilte Awlaelo-Health and Demographic Surveillance Site, Tigray, Ethiopia</aff>
<aff id="Aff14"><label>14</label>
Institute of Biological Chemistry and Nutrition, Hohenheim University, Stuttgart, Germany</aff>
<aff id="Aff15"><label>15</label>
Federal Ministry of Health, Addis Ababa, Ethiopia</aff>
<aff id="Aff16"><label>16</label>
Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA</aff>
</contrib-group>
<pub-date pub-type="epub"><day>14</day>
<month>11</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>14</day>
<month>11</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection"><year>2016</year>
</pub-date>
<volume>14</volume>
<elocation-id>42</elocation-id>
<history><date date-type="received"><day>9</day>
<month>7</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>8</day>
<month>11</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© The Author(s). 2016</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1"><sec><title>Background</title>
<p>Ethiopia has made remarkable progress in reducing child mortality over the last two decades. However, the under-5 mortality rate in Ethiopia is still higher than the under-5 mortality rates of several low- and middle-income countries (LMIC). On the other hand, the patterns and causes of child mortality have not been well investigated in Ethiopia. The objective of this study was to investigate the mortality trend, causes of death, and risk factors among children under 5 in Ethiopia during 1990–2013.</p>
</sec>
<sec><title>Methods</title>
<p>We used Global Burden of Disease (GBD) 2013 data. Spatiotemporal Gaussian Process Regression (GPR) was applied to generate best estimates of child mortality with 95% uncertainty intervals (UI). Causes of death by age groups, sex, and year were measured using Cause of Death Ensemble modeling (CODEm). For estimation of HIV/AIDS mortality rate, the modified UNAIDS EPP-SPECTRUM suite model was used.</p>
</sec>
<sec><title>Results</title>
<p>Between 1990 and 2013 the under-5 mortality rate declined from 203.9 deaths/1000 live births to 74.4 deaths/1000 live births with an annual rate of change of 4.6%, yielding a total reduction of 64%. Similarly, child (1–4 years), post-neonatal, and neonatal mortality rates declined by 75%, 64%, and 52%, respectively, between 1990 and 2013. Lower respiratory tract infection (LRI), diarrheal diseases, and neonatal syndromes (preterm birth complications, neonatal encephalopathy, neonatal sepsis, and other neonatal disorders) accounted for 54% of the total under-5 deaths in 2013. Under-5 mortality rates due to measles, diarrhea, malaria, protein-energy malnutrition, and iron-deficiency anemia declined by more than two-thirds between 1990 and 2013. Among the causes of under-5 deaths, neonatal syndromes such as sepsis, preterm birth complications, and birth asphyxia ranked third to fifth in 2013.</p>
<p>Of all risk-attributable deaths in 1990, 25% of the total under-5 deaths (112,288/435,962) and 48% (112,288/232,199) of the deaths due to diarrhea, LRI, and other common infections were attributable to childhood wasting. Similarly, 19% (43,759/229,333) of the total under-5 deaths and 45% (43,759/97,963) of the deaths due to diarrhea and LRI were attributable to wasting in 2013. Of the total diarrheal disease- and LRI-related deaths (<italic>n</italic>
= 97,963) in 2013, 59% (57,923/97,963) of them were attributable to unsafe water supply, unsafe sanitation, household air pollution, and no handwashing with soap.</p>
</sec>
<sec><title>Conclusions</title>
<p>LRI, diarrheal diseases, and neonatal syndromes remain the major causes of under-5 deaths in Ethiopia. These findings call for better-integrated newborn and child survival interventions focusing on the main risk factors.</p>
</sec>
</abstract>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2016</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Allemagne</li>
<li>Australie</li>
<li>Kenya</li>
<li>Pays-Bas</li>
<li>Royaume-Uni</li>
<li>États-Unis</li>
<li>Éthiopie</li>
</country>
<region><li>Angleterre</li>
<li>Bade-Wurtemberg</li>
<li>District de Stuttgart</li>
<li>Groningue (province)</li>
<li>Oxfordshire</li>
<li>Washington (État)</li>
</region>
<settlement><li>Groningue</li>
<li>Groningue (ville)</li>
<li>Oxford</li>
<li>Seattle</li>
<li>Stuttgart</li>
</settlement>
<orgName><li>Université d'Oxford</li>
<li>Université de Groningue</li>
<li>Université de Washington</li>
</orgName>
</list>
<tree><country name="Kenya"><noRegion><name sortKey="Deribew, Amare" sort="Deribew, Amare" uniqKey="Deribew A" first="Amare" last="Deribew">Amare Deribew</name>
</noRegion>
</country>
<country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Deribew, Amare" sort="Deribew, Amare" uniqKey="Deribew A" first="Amare" last="Deribew">Amare Deribew</name>
</region>
<name sortKey="Deribe, Kebede" sort="Deribe, Kebede" uniqKey="Deribe K" first="Kebede" last="Deribe">Kebede Deribe</name>
</country>
<country name="Éthiopie"><noRegion><name sortKey="Deribew, Amare" sort="Deribew, Amare" uniqKey="Deribew A" first="Amare" last="Deribew">Amare Deribew</name>
</noRegion>
<name sortKey="Abera, Semaw F" sort="Abera, Semaw F" uniqKey="Abera S" first="Semaw F." last="Abera">Semaw F. Abera</name>
<name sortKey="Abera, Semaw F" sort="Abera, Semaw F" uniqKey="Abera S" first="Semaw F." last="Abera">Semaw F. Abera</name>
<name sortKey="Amare, Azmeraw T" sort="Amare, Azmeraw T" uniqKey="Amare A" first="Azmeraw T." last="Amare">Azmeraw T. Amare</name>
<name sortKey="Deribe, Kebede" sort="Deribe, Kebede" uniqKey="Deribe K" first="Kebede" last="Deribe">Kebede Deribe</name>
<name sortKey="Hiruye, Abiy" sort="Hiruye, Abiy" uniqKey="Hiruye A" first="Abiy" last="Hiruye">Abiy Hiruye</name>
<name sortKey="Lakew, Yihunie" sort="Lakew, Yihunie" uniqKey="Lakew Y" first="Yihunie" last="Lakew">Yihunie Lakew</name>
<name sortKey="Melaku, Yohannes Adama" sort="Melaku, Yohannes Adama" uniqKey="Melaku Y" first="Yohannes Adama" last="Melaku">Yohannes Adama Melaku</name>
<name sortKey="Mohammed, Mesoud" sort="Mohammed, Mesoud" uniqKey="Mohammed M" first="Mesoud" last="Mohammed">Mesoud Mohammed</name>
<name sortKey="Teklay, Efrem" sort="Teklay, Efrem" uniqKey="Teklay E" first="Efrem" last="Teklay">Efrem Teklay</name>
<name sortKey="Tessema, Gizachew Assefa" sort="Tessema, Gizachew Assefa" uniqKey="Tessema G" first="Gizachew Assefa" last="Tessema">Gizachew Assefa Tessema</name>
</country>
<country name="Australie"><noRegion><name sortKey="Tessema, Gizachew Assefa" sort="Tessema, Gizachew Assefa" uniqKey="Tessema G" first="Gizachew Assefa" last="Tessema">Gizachew Assefa Tessema</name>
</noRegion>
<name sortKey="Amare, Azmeraw T" sort="Amare, Azmeraw T" uniqKey="Amare A" first="Azmeraw T." last="Amare">Azmeraw T. Amare</name>
<name sortKey="Melaku, Yohannes Adama" sort="Melaku, Yohannes Adama" uniqKey="Melaku Y" first="Yohannes Adama" last="Melaku">Yohannes Adama Melaku</name>
</country>
<country name="Pays-Bas"><region name="Groningue (province)"><name sortKey="Amare, Azmeraw T" sort="Amare, Azmeraw T" uniqKey="Amare A" first="Azmeraw T." last="Amare">Azmeraw T. Amare</name>
</region>
</country>
<country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Abera, Semaw F" sort="Abera, Semaw F" uniqKey="Abera S" first="Semaw F." last="Abera">Semaw F. Abera</name>
</region>
</country>
<country name="États-Unis"><region name="Washington (État)"><name sortKey="Misganaw, Awoke" sort="Misganaw, Awoke" uniqKey="Misganaw A" first="Awoke" last="Misganaw">Awoke Misganaw</name>
</region>
<name sortKey="Kassebaum, Nicholas" sort="Kassebaum, Nicholas" uniqKey="Kassebaum N" first="Nicholas" last="Kassebaum">Nicholas Kassebaum</name>
</country>
</tree>
</affiliations>
</record>
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