Abstract
Until recently, the mortality of children 5 to 14 years old had not raised the same interest as that of children less than five years old. However, in the last few years, the health and mortality of the older child have grown in importance in the global scenario. The objective of this study is to describe the magnitude and trends of the mortality rates among children 5 to 14 years old, according to the main causes of death, age (5 to 9 and 10 to 14) and sex in the state of Rio de Janeiro, between 2000 and 2017. We have identified and analyzed trends for the top five causes of death: external causes of morbidity and mortality; neoplasms; certain infectious and parasitic diseases; diseases of the respiratory system and diseases of the nervous system. The symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified were also analyzed because they reflect, at least in part, the quality of the information on causes of death as coded in the death certificate. Data were obtained from the Brazilian Mortality Information System (SIM). Trend analysis were performedand the Annual Percent Changes (APC) were estimated by the Joinpoint Regression software (version 4.7.0.0). A total of 13,670 deaths occurred among children 5 to 14 years of age in the state of Rio de Janeiro in the period 2000 - 2017, 58% of which occurred among those 10 to 14 years and 61% among male children. The two top causes of death in each of the two age groups were the external causes of morbidity and mortality and neoplasms. There was a 30% decline in the number of deaths between 2000 and 2017; the greatest relative reductions being those for neoplasias (60%) and for the infectious and parasitic diseases (55%), both in the younger age group. The only increasing trend observed was that for diseases of the nervous system among female children 10 to 14 in the period 2000-2008. For all other causes, trends were either stable or of decline. These results are likely to contribute to the evaluation of the currently implemented programs aimed at the reduction of deaths among children 5-14, to the identification of gaps, and to a possible redefinition of priorities, in addition to supporting future analysis of the effectiveness of new health programs and policies.
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