Abstract
BackgroundThis study analyzed the trends and seasonality in mortality among children aged 0–14 years in Guangzhou, China during 2008–2018. Understanding the epidemiology of this public health problem can guide policy development for children mortality prevention.MethodsA population-based epidemiological retrospective study was conducted. Seven thousand two hundred sixty-five individual data of children mortality were obtained from the Guangzhou Center for Disease Control and Prevention (CDC). The Poisson regression was used to quantify the annual average reduction rate and the difference in mortality rate between sex and age groups. Incidence ratio with 95% confidence interval (CI) was estimated to determine the temperaol variations in mortality by month, season, school term, day of the week and between holidays and other days.ResultsBetween 2008 and 2018, the children mortality rate in Guangzhou decreased from 54.0 to 34.3 per 100,000 children, with an annual reduction rate of 4.6% (95% CI: 1.1%–8.1%), especially the under-5 mortality rate decreased by 8.3% (95% CI: 4.8%–11.6%) per year. Decline trends varied by causes of death, even with an upward trend for the mortality of asphyxia and neurological diseases. The risk of death among males children was 1.33 times (95% CI: 1.20–1.47) of that of females. The distribution of causes of death differed by age group. Maternal and perinatal, congenital and pneumonia were the top three causes of death in infants and cancer accounted for 17% of deaths in children aged 1–14 years. Moreover, the injury-related mortality showed significant temporal variations with higher risk during the weekend. And there was a summer peak for drowning and a winter peak for asphyxia.ConclusionsGuangzhou has made considerable progress in reducing mortality over the last decade. The findings of characteristics of children mortality would provide important information for the development and implementation of integrated interventions targeted specific age groups and causes of death.
Highlights
This study analyzed the trends and seasonality in mortality among children aged 0–14 years in Guangzhou, China during 2008–2018
The United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) reported that the annual mortality reduction rate was lower among children aged 5–14 years compared with under-5 children since 2000 (2.7% vs 4.0%) [3]
We found the mortality of children aged 10–14 years was higher than that of those 5–9 years of age and almost remained unchanged over the study period, probably because most of the public health interventions aiming at improving the health of children under 5 years may be beneficial for those 5–9 years of age, with smaller spillover effects to 10–14 age group [22]
Summary
This study analyzed the trends and seasonality in mortality among children aged 0–14 years in Guangzhou, China during 2008–2018. The deaths at the age of 5–14 are predominantly from avoidable causes [3] but have largely been ignored by the global health community The children at this stage of life undergo rapid developments which have major health consequences over the lifetime. It is suggested that some relevant global health targets, including the 2030 UN Sustainable Development Goals (SDGs), need to consider children up to age 15 years and those younger than 5 years [4]. This consideration would require better understanding the characteristics of mortality in children aged 5–14 years. Most of the mortality data published were obtained from disease surveillance points or estimated from mathematical models rather than a whole population [3, 5, 6]
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