A Systematic Review on The Leading Causes of Death Among Under-Five Children in Iran

Abstract

Background: Child mortality is one of the most important indicators of population health. No systematic review has explored the leading causes of death among under-five children in Iran. This study reviewed the causes of child death by different age groups on the basis of ICD-10. Methods: A systematic search in seven electronic databases and two search engines of all the studies that identified causes of child mortality in any part of Iran or in the whole country were included, without any restriction of time or language of studies. To identify the studies, a combination of hand searching, gray literatures and bibliographies was also conducted. These sources and citations yielded a total of 817 articles; nevertheless, finally 30 articles fulfilled the inclusion criteria, then were reviewed and analyzed. Results: Amongst the 30 studies published between 2000 and 2019 in Iran, 25 studies were cross-sectional and 19 published in Farsi language. Overall, 71244 child deaths in different age ranges were reviewed in this study. The most common causes of “neonatal mortality” were prenatal conditions (57.8%), congenital malformations, deformations, and chromosomal abnormalities (17%) and disorders of length of gestation and fetal growth (5.9%). “Infant mortalities” were also mainly happened as a result of congenital malformations (22.8%), remainder of prenatal condition (21.2%) and remainder of diseases of the respiratory system (9%). In the age range of 28 days to 5 years, transport accidents (21.1%), congenital malformations (18.1%) and neoplasms (9.3%) were common leading causes of’ deaths. Overall, certain conditions originating in the perinatal period (29.3%), all other disease (26.1%) and external diseases (5.6%) were the leading cause of death in under-five children. Conclusions: This study, provided an updated summary of evidences on the causes of child death in Iran, which is highly critical for the development of interventions and reduction of the burden of under 5 mortality and morbidities.