Global study finds deaths in children and adolescents halved, but disability increases



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Research published Monday in the journal JAMA Pediatrics revealed that between 1990 and 2017, the number of deaths of children and adolescents in the world decreased by 51.7%, while disabilities rose 4.7%. In addition, there is a growing gap between the health outcomes of young people across countries.

The study was part of the Global Burden of Disease report. In 2017, the leading causes of death among children and adolescents were diarrhea, acute malnutrition and lower respiratory tract infections. However, the number of deaths of children and adolescents has fallen from 13.77 million in 1990 to 6.64 million in 2017.

Among the countries with higher socioeconomic development, some of the major factors of disability were congenital anomalies, neonatal disorders, headaches, dermatitis and anxiety. In low-developing countries, lower respiratory tract infections, diarrhea and malaria, as well as congenital anomalies and neonatal disorders contributed to disability.

When they examined mortality and disability among people under 19 years of age in 195 territories and countries, they found that the regions with the largest decline in child mortality were Central, East and Sub-Saharan Africa. , while Andean Latin America, South Asia and East Asia. The authors attribute these improvements to practices such as more widespread immunization, improving sanitation and nutrition, and targeting malaria and sexually transmitted infections.

In sub-Saharan Africa, the reduction of mortality due to tropical diseases, infections and nutritional deficiencies has allowed children to be healthier from 1990 to 2017, but other public health problems persist. "While malaria has dropped dramatically on the African continent, there are many countries, particularly in sub-Saharan Africa, where parasite transmission, severe diseases and malaria mortality remain high," said the researchers. .

There was also a 0.6% increase in the risk of death from HIV / AIDS or sexually transmitted infections among young people from 1990 to 2017 in southern sub-Saharan Africa. Fifty countries reported an increased risk of death from self-harm or interpersonal violence.

The researchers also found that the largest decrease in mortality occurred among children aged 1 to 4 – by 61% – while adolescents aged 10 to 19 experienced the slowest improvements.

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The well-being of the mother can contribute to the health of the child, they noted. Countries where maternal deaths have been reduced have also decreased deaths of children and adolescents. Health outcomes are more likely when funding for education and family planning is reduced, the researchers said. Leaders should therefore prioritize the health of young women.

The authors say that in low and middle socioeconomic countries, the growing number of children who survive with health problems will weigh heavily on already overburdened health and education systems. "The cost of sustainable progress in the health and well-being of children and adolescents is not negligible."

The authors noted some limitations of their research, including the influence of the results on the availability of data. Some data may be outdated or inaccurate due to delays in data communication or in conflict zones, such as Afghanistan, Syria and Iraq.

According to the researchers, as more children survive into adulthood, countries will have to respond to the individual needs of their youngest citizens. "All countries must make strategic investments in education and health systems, including human resources for health, supply chains, infrastructure, governance and increased support for children with disabilities. an intellectual disability. "

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