Deprivation and mortality related to pediatric respiratory tract infection: a cohort study in 3 high-income jurisdictions

Abstract

T here have been great strides in reducing childhood mortality over the past century. Globally, the mortality rate among children less than 5 years of age declined by more than 50% during the period of the United Nations Millennium Development Goals, decreasing from 90 to 43 deaths per 1000 live births between 1990 and 2015. 1 However, there are still improvements to make, in both developing and developed nations. 2,3 Respiratory tract infections (RTIs), such as pneumonia and bronchiolitis, are avoidable causes of mortality and are the third most common cause of death worldwide in children less than 5 years. 4-6 It is well known that children born preterm or with certain congenital anomalies or other chronic conditions are at increased risk for both all-cause mortality and RTI-related mortality. 7-9 However, deaths from RTIs are considered to be readily preventable through timely access to appropriate public health or medical interventions, including vaccination, passive immunization through palivizumab administration and antibiotic treatment. 4,10 In this study, we aimed to assess whether socioeconomic disparities in mortality related to pediatric RTIs in jurisdictions with universal access to physician and hospital care persisted after health status at birth was accounted for. Methods We sought to compare the rates of RTI-related death using nationally representative birth cohorts from 3 jurisdictions-Ontario (Canada's most populous province), Scotland and England-to determine the contribution of socioeconomic risk factors to RTI-related deaths among children less than 5 years of age, taking clinical risk factors at birth into account. These jurisdictions, all generally comparable, high-income, English-speaking regions with publicly funded universal health care systems, have implemented prevention programs for bacterial and viral pathogens causing RTIs (e.g., pertussis, Hemophilus influenzae type B, influenza and pneumococcal)

Causes of infant deaths and patterns of associated factors in Eastern Ethiopia: Results of verbal autopsy (InterVA-4) study

“…This finding suggested as lower maternal age group has largely contributed to multiplying ARI-specific infant mortality risk than all other causes of death. Studies revealed that children having adolescent mother was a strong risk factor for ARI-related death [ 55 , 61 ]. This could be possibly due to the assumption that lower aged mothers tend to have lower experience in pneumonia-related health care of children and, therefore, greater susceptibility to severe forms of infections that could be drives to mortality.…”

Developing a national birth cohort for child health research using a hospital admissions database in England: The impact of changes to data collection practices

“…In several countries national birth cohorts for child health research are commonly derived from birth registers (with information about key risk factors at birth, covering all children born in a given jurisdiction), with follow-up from linked death registration and hospital admission records. Such cohorts are commonly used for child health research for example in the Nordic countries [6], Australia [7,8], Canada [9,10].…”

Temporal clustering of neuroblastic tumours in children and young adults from Ontario, Canada

“…There are similarities in the overall levels of deprivation between Ontario and the whole of the UK. However, there are distinct differences in the nature of deprivation between the two locations [26,27]. The population of Ontario is approximately 14.7 million, is ethnically diverse and covers a large geographical area of 917,741 km 2 .…”