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| LETTER TO EDITOR |
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| Year : 2017 | Volume
: 8
| Issue : 1 | Page : 58-59 |
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Deaths among above-five children: Still neglected
Manas Pratim Roy
Department of Pediatrics, Safdarjung Hospital, New Delhi, India
| Date of Web Publication | 2-Feb-2017 |
Correspondence Address:
Manas Pratim Roy
Department of Pediatrics, Safdarjung Hospital, New Delhi - 110 029
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0975-9727.199370
How to cite this article:
Roy MP. Deaths among above-five children: Still neglected. Muller J Med Sci Res 2017;8:58-9 |
Dear Editor,
An estimated eight million deaths occur globally in children aged between 5 and 12 years. Low- and middle-income countries contribute 93.7% of them.[1] One community-based study, conducted through verbal autopsy, estimated 341,500 annual deaths of children between 5 and 14 years in India.[2] It is surprising that we talk about under-five children and adolescents, but nobody cares about the bridging age group between these two.
As we are changing our gear from Millennium Development Goals to Sustainable Development Goals, the large chunk of above-five children still remains deserted. In the absence of any national registry, we are virtually clueless about the mortality patterns and respective etiology among these children. As a result, till now, very few studies have undertaken the aim of analyzing the deaths in this age group.
Morris et al. attributed 58% of death among this age group in their community-based study to infectious diseases. Overall, 18% was due to diarrheal diseases and 10% was due to pneumonia.[2] However, most of the hospital-based studies from our country cited meningitis/encephalitis as most common cause of death in similar group. Sepsis and hepatic coma have also been found to contribute to the pool of mortality.[3],[4],[5]
Such difference in findings between community- and hospital-based studies is striking. A lesser proportion of deaths due to diarrhea and pneumonia in health facility could have two reasons. First, most of the deaths due to these two diseases took place in the community, i.e. before reaching a hospital. Second, admission of such cases in the hospital reduces death among children drastically. This opens up new questions – whether community-based interventions are really successful in sending sick children to hospitals? If we go by District Level Household and Facility Survey 3 data, we found that nearly 71% of mothers sought treatment for diarrheal episode of the children, but for acute respiratory infection, the proportion is meager 11%.[6] The scope for improving health-seeking behavior among parents of the sick children is huge and waiting to be explored.
In fact, pinpointing our focus on under-five children makes our vision blurred about rest of the children. Lack of any universal indicator for assessing mortality in this age group is another reason for listless attitude of scientific society and apathy of the policymakers toward these children. There is clear need to conduct community- and hospital-based studies with emphasis on this age group to understand frequency and distribution of diseases. Future research should also explore the health-seeking behavior among parents of such children.
Financial Support and Sponsorship
Nil.
Conflicts of Interest
There are no conflicts of interest.
| References | |  |
| 1. | Jamison DT, Shahid-Salles SA, Jamison J, Lawn JE, Zupan J. Incorporating deaths near the time of birth into estimates of the global burden of disease. In: Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ, editors. Global Burden of Disease and Risk Factors. Washington, DC: World Bank; 2006.  |
| 2. | Morris SK, Bassani DG, Awasthi S, Kumar R, Shet A, Suraweera W, et al. Diarrhea, pneumonia, and infectious disease mortality in children aged 5 to 14 years in India. PLoS One 2011;6:e20119. |
| 3. | Roy RN, Nandy S, Shrivastava P, Chakraborty A, Dasgupta M, Kundu TK. Mortality pattern of hospitalized children in a tertiary care hospital of Kolkata. Indian J Community Med 2008;33:187-9. [ PUBMED]  |
| 4. | Patil SW, Godale LB. Mortality pattern of hospitalized children in a tertiary care hospital in Latur: A record based retrospective analysis. Natl J Community Med 2013;4:96-9. |
| 5. | Das PK, Sarkar GN, Mallick A, Sahoo S, Sarkar U. Mortality profile among children in a city based pediatric referral hospital in Eastern India. Indian J Prev Soc Med 2008;39:143-8. |
| 6. | International Institute for Population Sciences. District Level Household and Facility Survey (DLHS-3), 2007-08: India. Mumbai: IIPS; 2010. |
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