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Deaths of children and adolescents fall by half, but deficiencies on the rise, according to a global study



Research published Monday in the journal JAMA Pediatrics found that from 1990 to 2017, overall child and adolescent deaths declined 51.7%, while disability increased 4.7%. In addition, there is a growing gap between the health outcomes of young people across different countries.

The study was part of the Global Burden of Disease report. By 2017, the most common killers of children and adolescents were diarrhea, acute malnutrition, and lower respiratory tract infections. However, deaths among children and adolescents fell from 13.77 million in 1990 to 6.64 million in 2017.

Among the countries with the greatest socioeconomic development, some of the main contributors to the deficiency were birth defects, neonatal disorders, headache, dermatitis and anxiety. In the less developed countries, lower respiratory infections, diarrhea and malaria, as well as congenital defects and neonatal disorders, contributed to disability.

When researchers looked at death and disability in people aged up to 19 years in 195 territories and countries, they found that the regions with the highest declines in infant deaths were Central, Eastern and Sub-Saharan Africa, while the fastest rates of deaths declined. Andean, South Asia and East Asia. The authors attribute these improvements to practices such as more widespread vaccinations, better sanitation and nutrition, and targeting of malaria and sexually transmitted infections.

In sub-Saharan Africa, reducing mortality from tropical diseases, infections and nutritional deficiencies has resulted in healthier children from 1990 to 2017, but other public health problems remain. "Although malaria has declined dramatically across the African continent, there are many countries, especially in sub-Saharan Africa, where transmission of parasites, acute diseases and malaria mortality remains high," the researchers noted.

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

Researchers also found that the largest reduction in mortality was in children aged 1 to 4 years – 61% – while adolescents, aged 10 to 19 years, had the slowest improvements.

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The well-being of a mother can contribute to the health of the child, they noted. Countries where maternal deaths were reduced also reduced the deaths of children and adolescents. Poor health outcomes are most likely when funding for education and family planning is declining, researchers said, and therefore authorities should prioritize the health of young women.

The authors say that in countries with low and medium socioeconomic development, the growing number of children surviving health problems will undermine already overburdened health and education systems. "The cost of sustaining progress in the health and well-being of children and adolescents is not insignificant."

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

As more children survive into adulthood, countries will have to meet the individual needs of their younger citizens, researchers say. "All countries should make strategic investments in education and health systems, including human resources for health, supply chains, infrastructure, governance and greater support for children with developmental disabilities."


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