Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

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Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

アブストラクト	BACKGROUND: Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success. METHODS: We generated updated estimates of child mortality in early neonatal (age 0-6 days), late neonatal (7-28 days), postneonatal (29-364 days), childhood (1-4 years), and under-5 (0-4 years) age groups for 188 countries from 1970 to 2013, with more than 29,000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030. FINDINGS: We estimated that 6.3 million (95% UI 6.0-6.6) children under-5 died in 2013, a 64% reduction from 17.6 million (17.1-18.1) in 1970. In 2013, child mortality rates ranged from 152.5 per 1000 livebirths (130.6-177.4) in Guinea-Bissau to 2.3 (1.8-2.9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from -6.8% to 0.1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000-13 than during 1990-2000. In 2013, neonatal deaths accounted for 41.6% of under-5 deaths compared with 37.4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1.4 million more child deaths, and rising income per person and maternal education led to 0.9 million and 2.2 million fewer deaths, respectively. Changes in secular trends led to 4.2 million fewer deaths. Unexplained factors accounted for only -1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone. INTERPRETATION: Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 2030. FUNDING: Bill & Melinda Gates Foundation, US Agency for International Development.
ジャーナル名	Lancet (London, England)
Pubmed追加日	2014/5/7
投稿者	Wang, Haidong; Liddell, Chelsea A; Coates, Matthew M; Mooney, Meghan D; Levitz, Carly E; Schumacher, Austin E; Apfel, Henry; Iannarone, Marissa; Phillips, Bryan; Lofgren, Katherine T; Sandar, Logan; Dorrington, Rob E; Rakovac, Ivo; Jacobs, Troy A; Liang, Xiaofeng; Zhou, Maigeng; Zhu, Jun; Yang, Gonghuan; Wang, Yanping; Liu, Shiwei; Li, Yichong; Ozgoren, Ayse Abbasoglu; Abera, Semaw Ferede; Abubakar, Ibrahim; Achoki, Tom; Adelekan, Ademola; Ademi, Zanfina; Alemu, Zewdie Aderaw; Allen, Peter J; AlMazroa, Mohammad AbdulAziz; Alvarez, Elena; Amankwaa, Adansi A; Amare, Azmeraw T; Ammar, Walid; Anwari, Palwasha; Cunningham, Solveig Argeseanu; Asad, Majed Masoud; Assadi, Reza; Banerjee, Amitava; Basu, Sanjay; Bedi, Neeraj; Bekele, Tolesa; Bell, Michelle L; Bhutta, Zulfiqar; Blore, Jed D; Basara, Berrak Bora; Boufous, Soufiane; Breitborde, Nicholas; Bruce, Nigel G; Bui, Linh Ngoc; Carapetis, Jonathan R; Cardenas, Rosario; Carpenter, David O; Caso, Valeria; Castro, Ruben Estanislao; Catala-Lopez, Ferran; Cavlin, Alanur; Che, Xuan; Chiang, Peggy Pei-Chia; Chowdhury, Rajiv; Christophi, Costas A; Chuang, Ting-Wu; Cirillo, Massimo; da Costa Leite, Iuri; Courville, Karen J; Dandona, Lalit; Dandona, Rakhi; Davis, Adrian; Dayama, Anand; Deribe, Kebede; Dharmaratne, Samath D; Dherani, Mukesh K; Dilmen, Ugur; Ding, Eric L; Edmond, Karen M; Ermakov, Sergei Petrovich; Farzadfar, Farshad; Fereshtehnejad, Seyed-Mohammad; Fijabi, Daniel Obadare; Foigt, Nataliya; Forouzanfar, Mohammad H; Garcia, Ana C; Geleijnse, Johanna M; Gessner, Bradford D; Goginashvili, Ketevan; Gona, Philimon; Goto, Atsushi; Gouda, Hebe N; Green, Mark A; Greenwell, Karen Fern; Gugnani, Harish Chander; Gupta, Rahul; Hamadeh, Randah Ribhi; Hammami, Mouhanad; Harb, Hilda L; Hay, Simon; Hedayati, Mohammad T; Hosgood, H Dean; Hoy, Damian G; Idrisov, Bulat T; Islami, Farhad; Ismayilova, Samaya; Jha, Vivekanand; Jiang, Guohong; Jonas, Jost B; Juel, Knud; Kabagambe, Edmond Kato; Kazi, Dhruv S; Kengne, Andre Pascal; Kereselidze, Maia; Khader, Yousef Saleh; Khalifa, Shams Eldin Ali Hassan; Khang, Young-Ho; Kim, Daniel; Kinfu, Yohannes; Kinge, Jonas M; Kokubo, Yoshihiro; Kosen, Soewarta; Defo, Barthelemy Kuate; Kumar, G Anil; Kumar, Kaushalendra; Kumar, Ravi B; Lai, Taavi; Lan, Qing; Larsson, Anders; Lee, Jong-Tae; Leinsalu, Mall; Lim, Stephen S; Lipshultz, Steven E; Logroscino, Giancarlo; Lotufo, Paulo A; Lunevicius, Raimundas; Lyons, Ronan Anthony; Ma, Stefan; Mahdi, Abbas Ali; Marzan, Melvin Barrientos; Mashal, Mohammad Taufiq; Mazorodze, Tasara T; McGrath, John J; Memish, Ziad A; Mendoza, Walter; Mensah, George A; Meretoja, Atte; Miller, Ted R; Mills, Edward J; Mohammad, Karzan Abdulmuhsin; Mokdad, Ali H; Monasta, Lorenzo; Montico, Marcella; Moore, Ami R; Moschandreas, Joanna; Msemburi, William T; Mueller, Ulrich O; Muszynska, Magdalena M; Naghavi, Mohsen; Naidoo, Kovin S; Narayan, K M Venkat; Nejjari, Chakib; Ng, Marie; de Dieu Ngirabega, Jean; Nieuwenhuijsen, Mark J; Nyakarahuka, Luke; Ohkubo, Takayoshi; Omer, Saad B; Caicedo, Angel J Paternina; Pillay-van Wyk, Victoria; Pope, Dan; Pourmalek, Farshad; Prabhakaran, Dorairaj; Rahman, Sajjad U R; Rana, Saleem M; Reilly, Robert Quentin; Rojas-Rueda, David; Ronfani, Luca; Rushton, Lesley; Saeedi, Mohammad Yahya; Salomon, Joshua A; Sampson, Uchechukwu; Santos, Itamar S; Sawhney, Monika; Schmidt, Jurgen C; Shakh-Nazarova, Marina; She, Jun; Sheikhbahaei, Sara; Shibuya, Kenji; Shin, Hwashin Hyun; Shishani, Kawkab; Shiue, Ivy; Sigfusdottir, Inga Dora; Singh, Jasvinder A; Skirbekk, Vegard; Sliwa, Karen; Soshnikov, Sergey S; Sposato, Luciano A; Stathopoulou, Vasiliki Kalliopi; Stroumpoulis, Konstantinos; Tabb, Karen M; Talongwa, Roberto Tchio; Teixeira, Carolina Maria; Terkawi, Abdullah Sulieman; Thomson, Alan J; Thorne-Lyman, Andrew L; Toyoshima, Hideaki; Dimbuene, Zacharie Tsala; Uwaliraye, Parfait; Uzun, Selen Begum; Vasankari, Tommi J; Vasconcelos, Ana Maria Nogales; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Waller, Stephen; Wan, Xia; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Westerman, Ronny; Wilkinson, James D; Williams, Hywel C; Yang, Yang C; Yentur, Gokalp Kadri; Yip, Paul; Yonemoto, Naohiro; Younis, Mustafa; Yu, Chuanhua; Jin, Kim Yun; El Sayed Zaki, Maysaa; Zhu, Shankuan; Vos, Theo; Lopez, Alan D; Murray, Christopher J L
組織名	Institute for Health Metrics and Evaluation, University of Washington, Seattle,;WA, USA. Electronic address: haidong@uw.edu.;WA, USA.;University of Cape Town, Cape Town, South Africa.;WHO Regional Office for Europe, Copenhagen, Denmark.;MCH Division, USAID - Global Health Bureau, HIDN, Washington, DC, USA.;National Center for Chronic and Non-Communicable Disease Control and Prevention,;Chinese Center for Disease Control and Prevention, Beijing, China.;National Office for Maternal and Child's Health Surveillance, Chengdu, China.;Peking Union Medical College, Beijing, China; Peking Union Medical College,;Beijing, China.;Hacettepe University Institute of Population Studies, Ankara, Turkey.;Mekelle University, Tigray, Ethiopia.;University College London, London, United Kingdom.;WA, USA; Ministry of Health, Gaborone, Botswana.;Public Health Promotion Alliance, Osogpb, Nigeria.;University of Melbourne, Melbourne, VIC, Australia.;Debre Markos Univerity, Debre Markos, Ethiopia.;Ministry of Health, Belmopan, Cayo, Belize.;Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia.;Government, Madrid, Spain.;Albany State University, Albany, GA, USA.;Department of Epidemiology, University of Groningen, Groningen, Netherlands.;Ministry of Public Health, Beirut, Lebanon.;UNFPA, Kabul, Afghanistan.;Emory University, Atlanta, GA, USA.;Ministry of Health, Amman, Jordan.;Mashhad University of Medical Sciences, Mashhad, Khorasan, Iran.;University of Birmingham, Birmingham, West Midlands, United Kingdom.;Stanford University, Stanford, CA, USA.;College of Public Health and Tropical Medicine, Jazan, Saudi Arabia.;Madawalabu University, Bale Goba, Oromia, Ethiopia.;Yale University, New Haven, CT, USA.;Aga Khan University Medical Center, Karachi, Pakistan.;Ministry of Health, General Directorate of Health Research, Ankara, Turkey.;Transport and Road Safety (TARS) Research, University of New South Wales, Sydney,;NSW, Australia.;University of Arizona, Tucson, AZ, USA.;University of Liverpool, Merseyside, United Kingdom.;Hanoi School of Public Health, Hanoi, Vietnam.;Telethon Institute for Child Health Research, Subiaco, WA, Australia.;Universidad Autonoma Metropolitana, Mexico, DF, Mexico.;University at Albany, Rensselaer, NY, USA.;Stroke Unit, University of Perugia, Perugia, Italy.;Universidad Diego Portales, Santiago, Chile.;Division of Pharmacology and Pharmacovigilance, Spanish Medicines and Healthcare;Products Agency (AEMPS), Ministry of Health, Madrid, Spain.;National Institutes of Health, Bethesda, MD, USA.;General Practice and Primary Health Care Academic Centre, Melbourne, VIC,;Australia.;University of Cambridge, Cambridge, United Kingdom.;Cyprus University of Technology, Limassol, Cyprus.;Taipei Medical University, Taipei, Taiwan.;University of Salerno, Baronissi, SA, Italy.;National School of Public Health (ENSP/Fiocruz), Rio De Janeiro, Brazil.;Hospital Dr. Gustavo N. Collado, Chitre, Herrera, Panama.;WA, USA; Public Health Foundation of India, New Delhi, India.;Public Health Foundation of India, New Delhi, India.;Public Health England, London, United Kingdom.;School of Medicine, Atlanta, GA, USA.;Addis Ababa University, Addis Ababa, Ethiopia.;University of Peradeniya, Peradeniya, Sri Lanka.;Harvard School of Public Health, Harvard University, Boston, MA, USA.;University of Western Australia, Perth, WA, Australia.;The Institute of Social and Economic Studies of Population at the Russian Academy;of Sciences, Moscow, Russia.;Non-Communicable Diseases Research Center, Endocrine and Metabolic Research;Institute, Tehran University of Medical Sciences, Tehran, Iran.;Karolinska Institutet, Stockholm, Sweden.;Heller Graduate School, Waltham, MA, USA.;Institute of Gerontology, Academy of Medical Sciences, Kyiv, Ukraine.;Public Health Unit of Primary Health Care Group of Almada-Seixal (region of;Lisbon), Almada, Portugal.;Wageningen University, Division of Human Nutrition, Wageningen, the Netherlands.;Agence de Medecine Preventive, Paris, France.;Ministry of Labour, Health, and Social Affairs, Tbilisi, Georgia.;University of Massachusetts Medical School, Worcester, MA, USA.;Department of Diabetes Research, National Center for Global Health and Medicine,;Tokyo, Japan.;University of Queensland, Brisbane, QLD, Australia.;University of Sheffield, Sheffield, South York, United Kingdom.;Stattis LLC, Chisinau, Moldova.;Saint James School of Medicine, Kralendijk, Bonaire, Netherlands Antilles.;Kanawha Charleston Health Department, Charleston, WV, USA.;Arabian Gulf University, Manama, Bahrain.;Wayne County Department of Health and Human Services, Detroit, MI, USA.;University of Oxford, Oxford, United Kingdom.;Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran.;Albert Einstein College of Medicine, Bronx, NY, USA.;School of Population Health, Brisbane, QLD, Australia; Public Health Division,;Secretariat of the Pacific Community, Noumea, New Caledonia.;Brandeis University, Waltham, MA, USA.;American Cancer Society, New York, NY, USA.;Self-Employed, Baku, Azerbaijan.;Postgraduate Institute of Medical Education and Research, Chandigarh, India.;Tianjin Centers for Disease Control and Prevention, Tianjin, China.;Department of Ophthalmology, Medical Faculty Mannheim, Mannheim, Germany.;The National Institute of Public Health, Copenhagen, Denmark.;Vanderbilt University, Nashville, TN, USA.;University of California San Francisco, San Francisco, CA, USA.;South African Medical Research Council, Cape Town, Western Cape, South Africa.;National Centre for Diseases Control and Public Health, Tbilisi, Georgia.;Jordan University of Science and Technology, AlRamtha, Irbid, Jordan.;Supreme Council of Health, Doha, Qatar.;Institute of Health Policy and Management, Seoul National University College of;Medicine, Seoul, South Korea.;Northeastern University, Boston, MA, USA.;University of Canberra, Canberra, ACT, Australia.;The Norwegian Institute of Public Health, Oslo, Norway.;Department of Preventive Cardiology, Department of Preventive Medicine and;Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita,;Osaka, Japan.;Center for Community Empowerment, Health Policy & Humanities, NIHRD, Jakarta,;Indonesia.;University of Montreal, Montreal, Quebec, Canada.;International Institute for Population Sciences, Mumbai, India.;Fourth View Consulting, Tallinn, Estonia.;National Cancer Institute, Bethesda, MD, USA.;Uppsala University, Uppsala, Sweden.;Korea University, Seoul, South Korea.;The National Institute for Health Development, Tallinn, Estonia.;Wayne State University, Miami, FL, USA.;University of Bari, Bari, Italy.;University of Sao Paulo, Sao Paulo, Brazil.;Aintree University Hospital NHS Foundation Trust, Liverpool, United Kingdom.;Swansea University, Swansea, United Kingdom.;Ministry of Health Singapore, Singapore.;King George's Medical University, Lucknow, Uttar Pradesh, India.;University of the East Ramon Magsaysay Medical Center, Quezon City, Metro Manila,;Philippines.;Ministry of Public Health, Kabul, Afghanistan.;AIDC EC, Port Elizabeth, Eastern Cape, South Africa.;UNFPA, Lima, Peru.;Center for Translation Research and Implementation Science (CTRIS), National;Heart, Lung, and Blood Institute, Bethesda, MD, USA.;Pacific Institute for Research & Evaluation, Calverton, MD, USA.;University of Ottawa, Ottawa, Ontario, Canada.;University of Salahaddin, Erbil, Iraq.;Institute for Maternal and Child Health - IRCCS "Burlo Garofolo," Trieste, Italy.;University of North Texas, Denton, TX, USA.;University of Crete, Crete, Greece.;Philipps-University Marburg, Marburg, Hessia, Germany.;Warsaw School of Economics, Warsaw, Poland.;University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.;Department of Epidemiology and Public Health, Faculty of Medicine and Pharmacy,;University sidi Mohamed Ben Abdellah, Fez, Morocco.;Rwanda Biomedical Center, Kigali, Rwanda.;Centre of Research in Environmental Epidemiology (CREAL), Barcelona, Spain.;Makerere University, Kampala, Uganda.;Teikyo University School of Medicine, Tokyo, Japan.;Universidad de Cartagena, Cartagena, Bolivar, Colombia.;University of British Columbia, Vancouver, BC, Canada.;Centre for Chronic Disease Control, New Delhi, Delhi, India.;Hamad Medical Corporation, Doha, Qatar.;Department of Public Health, University of the Punjab, Lahore, Punjab, Pakistan.;Private Consultant, Cairns, QLD, Australia.;Imperial College London, London, United Kingdom.;Marshall University, Huntington, WV, USA.;Zhongshan Hospital, Fudan, University, Shanghai, China.;University of Tokyo, Tokyo, Japan.;Health Canada, Ottawa, Ontario, Canada.;Washington State University, Spokane, WA, USA.;Heriot-Watt University, Edinburgh, Scotland, United Kingdom.;Reykjavik University, Reykjavik, Iceland.;University of Alabama at Birmingham, Birmingham, AL, USA.;Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in;Africa, University of Cape Town, Cape Town, South Africa.;Federal Research Institute for Health Organization and Informatics of Ministry of;Health of the Russian Federation, Moscow, Russia.;Department of Clinical Neurological Sciences, Western University, London,;Ontario, Canada.;Centre Hospitalier Nord Deux-Sevres, Bressuire, France.;KEELPNO (Center for Disease Control, Greece, dispatched to "Alexandra" General;Hospital of Athens), Athens, Greece.;University of Illinois, Champaign, IL, USA.;Ministry of Health, Yaounde, Centre, Cameroon.;ARS Norte, Porto, Portugal.;Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA;;Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia.;Adaptive Knowledge Management, Victoria, BC, Canada.;Columbia University and The Earth Institute, New York, NY, USA.;Health Care Center of Anjo Kosei Hospital, Anjo City, Aichi Prefecture, Japan.;Department of Population Sciences and Development, Faculty of Economics and;Management, University of Kinshasa, Kinshasa, Democratic Republic of the Congo,;Rwanda, Kigali City, Rwanda.;Ministry of Health, Rwanda, Kigali City, Rwanda.;UKK Institute for Health Promotion Research, Tampere, Finland.;Universidade de Brasilia, Brasilia, Distrito Federal, Brazil.;National Research University Higher School of Economics, Moscow, Russia.;Uniformed Services University of Health Sciences, Bethesda, MD, USA.;Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences,;Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden.;University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research;Institute, Royal Children's Hospital, Melbourne, VIC, Australia.;University of Miami, Miami, FL, USA.;University of Nottingham, Nottingham, United Kingdom.;University of North Carolina at Chapel Hill, Chapel Hill, NC. USA.;The University of Hong Kong, Hong Kong.;National Center of Neurology and Psychiatry, Kodira, Tokyo, Japan.;Jackson State University, Jackson, MS, USA.;Department of Epidemiology and Biostatistics, School of Public Health, and Global;Health Institute, Wuhan University, Wuhan, Hubei, China.;TCM MEDICAL TK SDN BHD, Nusajaya, Johor Bahru, Malaysia.;Mansoura Faculty of Medicine, Mansoura, Egypt.;Zhejiang University School of Public Health, Hangzhou, Zhejiang, China.
Pubmed リンク	https://www.ncbi.nlm.nih.gov/pubmed/24797572/