جستجوی مقالات مرتبط با کلیدواژه « Child mortality » در نشریات گروه « پزشکی »

 The child mortality rate is one of the important indicators that is influenced by various factors such as the health, economic, political, and cultural status of societies.

 The purpose of this study is to determine the causes related to the death of children aged 1 to 59 months in Zahedan University of Medical Sciences (ZAUMS) in the years 2018 to 2020 using the 10th edition of the International Classification of Diseases.

 The population of this descriptive study was children aged 1 - 59 months who died in the population covered by ZAUMS from 2018 to 2020. The research data were collected from the mortality surveillance system for children aged 1 to 59 months of the Vice-Chancellors for Health and Treatment Affairs of ZAUMS. The data collection tool was a checklist. The collected data was analyzed using descriptive statistics.

 The death rates of children aged 1 to 59 months in 2018, 2019, and 2020 were 7.6, 7.9, and 6.9 per thousand live births, respectively. The highest percentage of deaths was related to boys ages 1 to 12 months. Most of the deceased were residents of urban areas. The most common causes of death were related to respiratory system diseases, injuries, poisonings, and other specific consequences of external causes, such as congenital malformations, deformations, and chromosomal abnormalities.

 Educating parents on timely treatment of respiratory system diseases in children, improving the knowledge of families to control accidents and take better care of children in high-risk environments where there is a possibility of burns, respiratory obstruction, poisoning, and drowning, reforming and promoting policies related to genetic screening plans to identify congenital abnormalities during pregnancy, and premarital counseling to prevent high-risk family marriages can improve children's health index.

Children mortality is considered as one of the main indicators of population development and health, while most of the children’s deaths are preventable. This study systematically reviewed the determinants of children mortality in Iran.

This systematic review was conducted to summarize all the factors associated with children mortality in three age groups; Neonate (0-28 d), Infant (28 d-1 yr old) and children (<5 yr old), based on the PRISMA guideline. Many of the electronic international and national databases, in addition to hand searching of reference of selected articles, grey literature, formal and informal reports and government documents were screened to identify potential records up to Jan 2022. We included all studies that identified determinants of child mortality in any province of Iran or the whole country, without any restriction.

Overall, 32 studies were included, published between 2000 and 2022, of which 23 were cross-sectional and 15 published in Farsi language. The associations between several risk factors (n=69) and the child mortality were examined. Among the identified factors, ‘birth weight’, ‘mother’s literacy’, ‘socioeconomic status’, ‘delivery type’, ‘gestational age’, ‘pregnancy interval’, ‘immaturity’, ‘type of nutrition’, and ‘stillbirth’ were the most important mentioned determinants of child mortality in Iran.

Appropriate interventions and policies should be developed and implemented in Iran, addressing the main identified associated factors, resulting from this review study, with the aim of minimizing preventable child deaths, based on their age categories.

 During the past three decades, neonate, infant, and child mortality declined in North Africa and Middle East. However, there is substantial heterogeneity in mortality rates across countries.

 This study is part of the Global Burden of Diseases study (GBD) 2019. We report the number as well as mortality rates for neonates, infants, and children by cause across 21 countries in the region since 1990.

 Between 1990 and 2019, the neonate mortality rate in the region declined from 31.9 (29.8, 34.0) to 12.2 (11.1, 13.3) per 1000 live births. Respective figures for under 5 mortality rates (U5MRs) were 79.1 (75.7, 82.7) in 1990 and 24.4 (22.3, 26.7) per 1000 live births in 2019. The majority of deaths among children under 5 years were due to under 1 year deaths: 75.9% in 1990 and 81.8% in 2019. Mortality rates in males were higher than females. The mortality rate among neonates ranged from 2.4 (2.1, 2.6) per 1000 live births in Bahrain to 25.0 (21.6, 28.4) in Afghanistan in 2019. Similarly, in 2019, the U5MR ranged from 5.0 (4.2–6.0) per 1000 live births in United Arab Emirates to 55.3 (47.9–63.5) in Afghanistan. Neonatal disorders, congenital birth defects, and lower respiratory infections were the three main causes of neonate, infant, and child mortality in almost all countries in the region.

 In 2019, most countries in this region have achieved the SDG targets for neonate and child mortality. However, there is still substantial heterogeneity across countries.

This study aimed to examine the impact of the human development index (HDI) and other key macroeconomic variables on under-five mortality rates in the select Middle East and North African (MENA) countries from 2003 to 2019.

The study used a panel data method to examine the impact of macroeconomic ‎variables, such as HDI, gross national income per capita ‎‎(GNI), urbanization rate, government health expenditure as a percentage of gross ‎domestic product (GDP), and income distribution inequality index (Gini) on under-five mortality rates in the select MENA countries.

The HDI, GNI, urbanization rate, and government health expenditure share to GDP, have decreasing effects on the under-five mortality rate, while inequality in income distribution worsens health status and increases the under-five mortality rate.

By strengthening the HDI and increasing economic growth, employment rate, and per capita income, people in the community will have access to health services, thereby reducing under-five mortality.

Depending on the level of care and the availability of pediatric intensive care unit (PICU) facilities, the mortality rate of acutely ill children varies in PICUs. Referral of patients from other medical centers, admission during working or off-work hours, and nosocomial infections are the most important risk factors for the high mortality rates in PICUs.

The present study aimed to investigate the characteristics and factors related to the risk of mortality in pediatric patients admitted to the PICU of a pediatric hospital in Qazvin, Iran.

This cross-sectional study was performed on children admitted to the PICU of a pediatric hospital in Qazvin, Iran, between June 2017 and June 2020. During this period, a total of 1504 children, aged one month to 13 years, were admitted to the PICU, and 106 cases expired. The patients’ clinical data (ie, demographic characteristics, underlying disease, cause of death, and length of hospital stay) was extracted from their medical records. A prolonged length of stay was defined as more than 28 days of PICU admission.

A total of 106 children, with a mean age of 3.89 ± 3.23 years, expired during the study, with 41 (38.7%) cases being male. Among the investigated cases, 61 (57%) were < 2 years, 18 (17%) were 2 - 5 years old, and 27 (26%) were≥ 6 years. In these patients, sepsis (13/82, 15.85%) and pneumonia (10/82, 12.19%) were the main causes of death. Other mortalities (14/106) were due to infectious diseases (gastroenteritis, influenza, and coronavirus disease) and non-infectious diseases (aspiration, anaphylaxis, and electrocution). The majority of children with a prolonged length of stay were < 2 years (17/23, 74%). The length of PICU stay was shorter in children with a lower weight percentile (P = 0.016).

Following infectious diseases, congenital abnormalities and genetic disorders were the most common causes of pediatric mortality. Chronically ill children were more likely to be underweight and develop nutritional disorders, leading to the deterioration of their condition.

To estimate under-five mortality rate (U5MR), as one of the sustainable development goals, in rural and urban areas of Iran from 1990 to 2015.

We used the data collected through two censuses and one Demographic and Health Surveys (DHS). We analyzed the Summary Birth History (SBH) data via 2 approaches including Maternal Age Cohort (MAC) and Maternal Age Period (MAP) methods, and then, Gaussian Process Regression (GPR) was used to combine the three trends and with 95% uncertainty. Finally, Ratio of U5MR in rural to urban was calculated.

At the national level and in urban areas, U5MR in 1990, 2000, 2010, and 2015 was 66, 34, 18, and 13 per 1000 live births, respectively. Corresponding values in rural areas in 1990, 2000, 2010, and 2015 was 129, 64, 31, and 21 per 1000 live births, respectively. Accordingly, the ratio of U5MR in rural to urban at the national level was 1.93, 1.86, 1.72 and 1.63 in the same years. At the sub-national level, U5MR in urban areas ranged from 11.2 per 1000 live births in Isfahan to 18.2 per 1000 live births in Hormuzagn. U5MR in rural areas ranged from 14.1 per 1000 live births in Isfahan to 29.5 per 1000 live births in Sistan and Baluchistan

There is still a gap between rural and urban areas, although it has decreased during the 25 years of the study. To alleviate this gap, health system authorities are advised to plan appropriate actions using multi-sectoral capacities.

Child mortality surveillance system (CMSS) for children aged 1–59 months is a critical issue in the prevention of mortality. This surveillance system like other health programs needs to be evaluated. Therefore, this study aims to evaluate CMSS in Iran.

This evaluation was performed from March 2015 to March 2016 based on selected criteria for assessing the public health surveillance system proposed by the Centers for Disease Control and Prevention. Selected criteria examined in this study included timeliness, simplicity, acceptability, and flexibility. These criteria were evaluated in two ways. First, it included the use of a researcher‑made questionnaire. The questionnaires were completed by 100 experts on CMSS. Second, to perform a more exact evaluation of these criteria, 24 of these experts were selected for the focus group.

In this study, the response rate was 91% (42% hospital‑based and 49% primary care‑based). In the timeliness section, 49% of the experts believed that approvals of the child mortality committees have not been sent within the designated time frame; hardware, software, and questionnaires were reported as effective factors in this respect. The structural and administrative problems were effective in simplicity domain and the experts of mortality registration and mood of relatives were effective in acceptability domain. The flexibility of the system was high and appropriate.

The findings of the present study reveal that CMSS has some limitations and problems in the timeliness, simplicity, and acceptability criteria, which can be resolved. But this program has an appropriate situation in terms of flexibility.

In this study, we seek to evaluate the population health improvements during the previous four decades in Iran. We have estimated the levels and trends of child and adult mortality in addition to life expectancy from 1979 to 2019 at national and sub-national levels using all the available data.

In this study, we used data from National and Sub-National Burden of Diseases study and employed Bayesian Averaging Model (BAM) to predict mortality rates and life expectancy from 1979 to 2019. By including all available data sources of death information of Iran, including national level data from the Institute for Health Metrics and Evaluation (IHME), national censuses, Demographic and Health Survey (DHS), and Death Registration System (DRS) and using Spatio-Temporal and Gaussian Process Regression (ST-GPR) models, we estimated mortality rates and life expectancy from 1990 to 2015. We also used a BAM to project our desired indices until 2019.

Both child and adult mortality rates decreased dramatically over the period. At the national level in Iran, in 2019, child mortality rate (deaths per 1000 livebirths), was 16.0 (95%UI: 13.0–19.6), adult mortality rates [probability of death (%)] for females and males were 6.1 (5.4–6.8) and 11.5 (10.3–12.8), respectively. Also, life expectancy values for females and males were 81.6 (80.7–82.2) and 76.1 (75.3–76.6), respectively. The results were consistent for both sexes. Despite the total narrowing gaps among provinces, a difference can still be observed particularly for the border provinces regarding child mortality rates. However, the difference in the other measures are inconsiderable. From 1979 to 2019, the overall change percent in child mortality rate, adult mortality rate for females and males and life expectancy for females and males were -86.3% (-89.0% – -83.1%), -52.5% (-60.9% – -42.9%), -48.7% (-56.9% – -39.6%), 25.3% (20.8%–31.5%), and 31.3% (25.5%–41.3%), respectively.

This study provides an overview of the previous 40 years of mortality rates (child and adult) and life expectancy. The provided framework of national and sub-national evaluation can be used by researchers to continue the path of providing information for prioritization and evaluation of programs and also performing cost-effectiveness analysis for proposing efficient strategies to policy makers.

Under-five mortality is considered an indicator of population well-being and health equality in societies. Under-five mortality caused by nutritional deficiencies is a public health concern in developing countries. In this study, we aimed to report the trend and mortality rate of nutritional deficiencies from 1995 to 2015 in children aged under five years.

In this study, we used the death registration system (DRS) data to estimate age- and sex-specific nutritional deficiency mortality rates at national and sub-national levels in Iran from 1995 to 2015. The Iranian DRS used the 10th revision of International Classification of Diseases (ICD-10) but we report our results based on Global Burden of Diseases (GBD) study codes. We used the average annual percent change (AAPC) to quantify trend in under-five mortality rate attributable to nutritional deficiencies from 1995 to 2015.

At national level, mortality rates in both sexes were 8.53 (95% uncertainty interval [UI]: 7.69–9.47), 1.04 (0.86–1.36), and 0.37 (95% UI: 0.28–0.57) per 100,000 in 1995, 2005, and 2015, respectively. AAPC was estimated between 1995 and 2015. At sub-national level, the highest and lowest mortality rates across provinces ranged from 17.7 per 100 000 in 1995 to 1.1 per 100 000 in 2015. In the latest years, protein-energy malnutrition (PEM) was the most frequent cause of mortality among other nutritional deficiencies.

The results show a substantial reduction in terms of mortality caused by nutritional deficiencies at national, as well as provincial, level among children under-five years of age.

The pediatric risk of mortality (PRISM III), pediatric index of mortality (PIM3), and pediatric logistic organ dysfunction (PELOD-2) are of the most used predictive models in predicting the risk of mortality in the pediatric intensive care unit (PICU). The current study aimed at comparing the predictive ability of these three modes in medical/surgical ICUs (MICU/SICU). A total of 90 consecutive patients, aged ≤ 18 years, admitted to MICUs or SICUs were enrolled in the current observational, prospective study. The PRISM III, PIM3, and PELOD-2 as well as demographic characteristics of the subjects were recorded on admission. A receive operator characteristic (ROC) curve, logistic regression, and the Hosmer-Lemeshow goodness-of-fit test were used for statistical analyses [95% confidence interval (CI)]. Data analysis showed a significant difference in PRISM III, PIM3, and PELOD-2 scores between survivors and nonsurvivors (P < 0.001, P < 0.001, P < 0.001, respectively). The discrimination power was moderate for PRISM III (area under ROC curve (AUC): 77.3%; standard error (SE): 6.0%), and good for PIM3 and PELOD-2 (AUC: 82.4%, SE: 5.5% and AUC: 80.3%, SE: 4.9%, respectively). All the three models were well calibrated (χ2 = 4.73, P = 0.79; χ2 = 3.09, P = 0.93; and χ2 = 5.01, P = 0.66, respectively). PRISM III, PIM3, and PELOD-2 had good performance in predicting outcomes in children admitted to MICUs or SICUs. Further studies on different ICUs may provide more conclusive results with greater generalization of the validity of these predictive models.

Community health worker (CHW) interventions to manage childhood illness is a strategy promoted by the global health community which involves training and supporting CHW to assess, classify and treat sick children at home, using an algorithm adapted from the Integrated Management of Childhood Illness (IMCI). To inform CHW policy, the Government of Tanzania launched a program in 2011 to determine if community case management (CCM) of malaria, pneumonia and diarrhea could be implemented by CHW in that country. This paper reports the results of an observational study on the CCM service delivery quality of a trial cohort of CHW in Tanzania, called WAJA. In 2014, teams of data collectors, employees of the Ministry of Health and Social Welfare trained in IMCI, assessed the IMCI skills rendered by a sample of WAJA on sick children who presented to WAJA with illness signs and symptoms in their communities. The assessment included direct observations of WAJA IMCI episodes and expert re-assessment of the same children seen by WAJA to assess the congruence between the assessment, classification and treatment outcomes of WAJA cases and those from cases conducted by expert re-assessors. In the majority of cases, WAJA correctly assess sick children for CCM-treatable illnesses (malaria, pneumonia, and diarrhea) and general danger signs (90% and 89%, respectively), but too few correctly assess for physical danger signs (39%); on classification in the majority of cases (73%) WAJA correctly classified illness, though more for CCM-treatable illnesses (83%). In majority of cases (78%) WAJA treated children correctly (84% of malaria, 74% pneumonia, and 71% diarrhea cases). Errors were often associated with lapses in health systems support, mainly supervision and logistics. CCM is a feasible strategy for CHW in Tanzania, who, in the majority of cases, implemented the approach as well as IMCI expert re-assessors. Nevertheless, for CCM to be effective, in Tanzania, a strategy to implement it must be coordinated with efforts to strengthen local health systems.

We aimed to measure changes in socioeconomic inequality in child mortality in Iran.
A secondary data analysis of two Demographic and Health Surveys (DHS 2000 and 2010) was undertaken. Neonatal, infant and under-5 mortality rates were estimated directly from complete birth history. Economic quintiles were constructed using principal component analysis. Changes in inequality were measured using odds ratios, mortality rates, and concentration curves and indices.
Based on the compared measures, inequalities in neonatal, infant, and under-5 mortality declined between the two surveys. The poorest-to-richest neonatal, infant and under-5 mortality odds ratios in 2000 were 1.69 (95% CI= 1.3-2.07), 2.85 (95% CI= 1.96-4.1) and 1.98 (95% CI= 1.64-2.3), respectively. Whereas these mortality odds ratios in 2010 had fallen to 1.65 (95% CI= 0.95-2.9), 1.47 (95% CI=0.5-4) and 1.85 (95% CI=1.13-3), respectively. Moreover, mortality rates in all economic quintiles experienced a decreasing trend. Neonatal, infant, and under-5 mortality concentration indices in 2000 were -0.15, -0.26, and -0.17 respectively. Whereas concentration indices in 2010 had dropped to -0.13, -0.11, and -0.14, respectively. Concentration curves dominance test revealed that there was a statistically significant reduction in inequality in infant and under-5 mortalities.
Despite substantial reduction in child mortality rates and narrowing of the gap between poor and rich people, socioeconomic inequality in child mortalities disfavoring worse-off groups still exists. Combination of child health-related efforts that aim to reach to those children born in poor households alongside with pro-equity programs in other sectors of society may further reduce infant, under-5, and particularly neonatal mortality across economic quintiles in Iran.

Child mortality is one of the major health indices and the main targets in sustainable development goals. This study aimed to estimate child mortality rate and assess the progress toward sustainable development goals in Hamadan Province, western Iran and its districts from 1990 to 2016.
Study design: A cross-sectional study.
We used two data sources including death registration system (DRS) and summary birth history data (SBH) of 2010 census for estimating child mortality rate. SBH data was analyzed by Maternal Age Cohort and Maternal age period methods. To obtain the final trend with 95% uncertainty, we used Bayesian Penalized B-Spline.
At provincial level, child mortality rate reduced by 82% from 1990 (97 per 1000 live births) to 2016 (16 per 1000 live births). At district level, in 2016, the highest child mortality rate belonged to Toyserkan and Kaboodarahang districts with 18 per 1000 live births, and the lowest child mortality rate belonged to Hamadan and Razan districts with 12 per 1000 live births. The highest and the lowest reduction rate from 1990 to 2016 belonged to Razan and Kaboodarahang districts, respectively.
The rate of child mortality has declined massively at both provincial and district levels. However, disparity existed among districts of Hamadan Province. The level of maternal education and income level was associated with disparity.

A secular milestone is approached by the world in line of reaching Millennium Development Goals (MDGs). After December 2015, a new of flexible and global Sustainable Development Goals (SDGs) were set, replace MDGs by SDGs. Infant mortality rate (IMR) is a pivotal indicator of development in a given country that embedded in Millennium Development Goal (MDG). After that in manner of strong clinical reasons, IMR has been replaced by the neonatal mortality rate (NMR); here, we were interested to write a concise chronological fantastic story about what had happened on IMR’s life span in Iran.

All nations are striving for development. Economic development is one of the main parts of development process, but not all of it. Populations health is one of the main factors of economic development, and child’s mortality is one of the main factors of population health status. The aim of this study is investigating the role of socioeconomic disparties in under 5 mortality in Eastern Mediterranean Regional Office (EMRO) countries. This study is a restropective and panel data type. Data used in this study inquired form the World Health Organization(WHO) and the World Bank database for 20 EMRO countries. In order to investigate socio-economic factors of under 5 mortality we used per capita income logarithm, health expenditure per capita, out-of-pocket health expenditure, access to improved sanitation and Measles vacination, literacy rate in 15 to 24 years old females, female unemployment rate, and birth rate. According to results, all variables (Per Capita National Income, Health Expenditure Per Capita, Access to Health Facilities, Out-of-Pocket Health Expenditure, and Measles Immunization, Female Literacy Rate for 15 to 24 year old, Female Unemployment Rate and Crude Birth Rate) showed significant relationship with under 5 mortality except per capita health expenditure. Per capita income logarithm also had the greatest impact in reducing the mortality of children under 5 year in comparison with other variables. Childs mortality is the symbol of development and have important role in population growth. Results of this study indicate that access to healthcare services have lower impact on childs mortality rather than economic variables.

Mortality indices are among the most important health indicators in every country. On the other hand, mortality has an unequal distribution in different socioeconomic levels.. We sought to evaluate the association between economic inequality and infant, under-5-year-old, maternal, and crude mortality rates in the world..Patients and In this ecological study, data on 196 countries were obtained from the World Bank to assess the relation between economic inequality and mortality in 2013. Per capita gross domestic product (GDP), gross national income (GNI), out-of-pocket index, and per capita health expenditure were extracted as economic variables. Data analysis was performed using STATA, version 12.. The results showed that poorer countries had higher rates of infant, under-5-year-old, and maternal mortality. Among the economic indicators, per capita health expenditure, per capita GDP, and GNI had an important role in creating disparities, whereas the out-of-pocket index had no impact.. Per capita GDP, GNI, and per capita health expenditure played a significant role in creating disparities. Since per capita GDP and GNI are less variable, an increase in health expenditure can reduce inequality in mortality rates..

The loss of a child is a tragedy - families suffer and human potential is wasted. 6.3 million children under the age of five died in 2013, nearly 17 000 every day. Most deaths among children aged one to five years are due to diseases that can be prevented, but that can also be easily treated at home or in health facilities. Leading causes of death in under-five children are preterm birth complications, pneumonia, birth asphyxia, diarrhea and malaria. About 45% of all child deaths are linked to malnutrition. Under-five deaths are increasingly concentrated in sub-Saharan Africa and Southern Asia, while the proportion in the rest of the world dropped from 32% in 1990 to 18% in 2013. Children in sub-Saharan Africa are more than 15 times more likely to die before the age of five than children in developed regions. About half of under-five deaths occur in only five countries: China, Democratic Republic of the Congo, India, Nigeria and Pakistan. India (21%) and Nigeria (13%) together account for more than a third of all under-five deaths.