'Vast Majority' of Child and Adolescent Deaths Worldwide Are Preventable

This story is part of a partnership between MedPage Today and VICE News.

An estimated 7.7 million children and adolescents died worldwide in 2013, but the "vast majority" of their deaths were preventable, according to a new report.

Although some countries are making progress toward lower childhood mortality, others are failing to reduce preventable deaths from diarrheal disease, respiratory illnesses and neonatal conditions, to name a few, according to the report published this week in the medical journal JAMA Pediatrics.

"Some countries are being left behind," Dr. Paul Wise, of Stanford University School of Medicine, wrote in an editorial accompanying the report. "These countries have experienced stagnant or, in some arenas, worsening child health outcomes."

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The report is part of the Global Burden of Diseases Study, which is compiled by the Institute for Health Metrics and Evaluation based at the University of Washington. Researchers worked with more than 50,000 sources of information, including data from vital registrations, verbal autopsy studies, and child death surveillance, lead study author Theo Vos of the Institute for Health Metrics and Evaluation told VICE News.

Almost 6.3 million deaths occurred in children under 5 years old, and more than half of them were attributed to just five causes: lower respiratory tract infections, preterm birth complications , neonatal encephalopathy after birth trauma and asphyxia, malaria, and diarrheal diseases, according to the report.

Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center, who was not involved in the study, said he remembers learning that diarrheal disease was among the top causes of childhood mortality as a medical student 40 years ago.

"I almost fell off my chair," he said, explaining that a lack of medical care and dehydration can make diarrheal disease fatal.

"As I read these studies today, I was filled with an extremely overwhelming feeling of sadness. Although we've made huge progress here, still in many countries of the world we have diarrheal disease and lower respiratory tract infections… still with us as leading causes of death in children."

Protein-energy malnutrition was the eighth leading cause of death among children under five years old, killing more than 225,000 of them, according to study estimates.

"These are children who are dying of starvation in 2016," Schaffner said. "There are parents who can't feed their children and have to see them wither and die simply because they don't have something as elementary as enough food. That's an ache and a pain when you look at these numbers."

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Among older children between the ages of five and nine years old the leading cause of death was diarrheal disease. Lower respiratory tract infections, road injuries, intestinal infectious diseases, and malaria were the other top causes of deaths in this age group.

Adolescents — defined as children between 10 and 19 years old — were most likely to die from road injuries. The second top cause of death was HIV/AIDS, followed by self-harm, drowning, and intestinal infectious diseases.

Although the study shows that childhood deaths have declined three percent, 2.9 percent and 1.6 percent among young children, older children and adolescents each year since 1990, it also highlights shortcomings in some parts of the world, Vos said.

For instance, although Nigeria has only about four percent of the world's population of children and adolescents, it had 12 percent of the global deaths from respiratory tract infections and 38 percent of the global deaths from malaria in 2013.

And although India, the Democratic Republic of Congo, Pakistan, Nigeria, and Ethiopia only contain about 30 percent of the world's population of children and adolescents, the five countries were home to more than half of the world's pediatric diarrheal deaths in 2013.

"Still, a number of things aren't going well," Vos said, "[The report] is intended to be a public good. We want as many people possible to use it, particularly people making decisions — ministries of health making big decisions about health care."