Epidemiologic View and Spatial Analysis of the Mortality of Children under 5 Years of Age in Isfahan Province in 2011–2016 Original Article

Nafiseh Sadeghian, Mehri Rejali, Behzad Mahaki, Mostafa Saberi

Abstract


Background: Children’s mortality rate reflects the health level of the community. Therefore, accurate mapping of child mortality is one of the most important ways to reduce this rate. The purpose of this study was to investigate the mortality rate of children under 5 in Isfahan province in 2011–2016. Methods: In this analytical cross‑sectional study, all mortalities of children under 5 of Isfahan province related to Child Death Care System Program during 2011–2016 were studied. Mortality rate of children was calculated. Relationship between variables [demographic characteristics, place of death (urban/rural), and underlying cause of death] and child mortality was analyzed using Chi‑square test. Mortality rate in the cities of Isfahan province was plotted on a geographical map. Results: Whole number of mortalities of children under 5 was 5247 cases. Most of the mortalities (60.1%) were occurred in neonatal. Mortality rate was higher in boys than girls (12.6 vs. 11.1 per 1000 live births) (P < 0.001); “mortality rate in non‑Iranians who live in Iran was more than that of Iranians (21.4 vs. 11.5 per 1000 live birth) (P < 0.001) and rural areas more than urban areas (15.2 vs. 11.4 per thousand live births) (P < 0.001).” Certain conditions originating in the perinatal period were reported as the greatest causes of death (45.9%). Congenital malformations (27.4%) and external causes of morbidity and mortality (6.7%) were the second and third causes of death. Fereidun Shahr had the highest U5MR and Khansar had the lowest U5MR. Conclusions: Considering the major contribution of neonatal to the death of children under 5 and also the most important causes of death, interventions such as preventing early delivery, genetic counseling in high‑risk couples, and parent training for accident prevention can play an effective role in reducing child mortality.

Keywords


Cause of death; child; epidemiology; Iran; mortality; spatial analysis

Full Text:

PDF

References


De Looper M, Lafortune G. Measuring disparities in health

status and in access and use of health care in OECD countries.

OECD Health Working Papers 2009;43:1-55.

Assembly UG. United Nations Millennium Declaration.

New York: United Nations; 2000.

Rahmani K, Zokaei M, Bidarpoor F, Babahajiani S, Nessaei P,

Moradi G. Children mortality rate trend in Kurdistan Province

during 2007 to 2011. Iranian J Epidemiol 2014;10:65‑72.

Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global,

regional, and national causes of under‑5 mortality in 2000–15:

An updated systematic analysis with implications for the

Sustainable Development Goals. Lancet 2016;388:3027‑35.

Deribew A, Tessema GA, Deribe K, Melaku YA, Lakew Y,

Amare AT, et al. Trends, causes, and risk factors of mortality

among children under 5 in Ethiopia, 1990–2013: Findings from

the Global Burden of Disease Study 2013. Popul Health Metr

;14:42.

Abir T, Agho KE, Page AN, Milton AH, Dibley MJ. Risk factors

for under‑5 mortality: Evidence from Bangladesh demographic

and health survey, 2004–2011. BMJ Open 2015;5:e006722.

Nasrullah M, Zakar R, Zakar MZ, Krämer A. Girl‑child marriage

and its association with morbidity and mortality of children

under 5 years of age in a nationally‑representative sample of

Pakistan. J Pediatr 2014;164:639‑46.

Cui H, He C, Kang L, Li Q, Miao L, Shen L, et al. Under‑5‑years

child mortality due to congenital anomalies: A retrospective

study in urban and rural China in 1996 − 2013. Am J Prev Med

;50:663‑71.

Batailler P, Hours M, Maza M, Charnay P, Tardy H, Tournier C,

et al. Health status recovery at one year in children injured in a

road accident: A cohort study. Accid Anal Preve 2014;71:267‑72.

Khazaei Z, Khazaei S, Valizadeh R, Mazharmanesh S,

Mirmoeini R, Mamdohi S, et al. The epidemiology of injuries and

accidents in children under one year of age, during (2009‑2016)

in Hamadan Province, Iran. Int J Pediatr 2016;4:2213‑20.

Walker N, Yenokyan G, Friberg IK, Bryce J. Patterns in

coverage of maternal, newborn, and child health interventions:

Projections of neonatal and under‑5 mortality to 2035. Lancet

;382:1029‑38.

You D, Hug L, Ejdemyr S, Idele P, Hogan D, Mathers C, et al.

Global, regional, and national levels and trends in under‑5

mortality between 1990 and 2015, with scenario‑based projections

to 2030: A systematic analysis by the UN Inter‑agency Group for

child mortality estimation. Lancet 2015;386:2275‑86.

Mohammadi Y, Parsaeian M, Mehdipour P, Khosravi A,

Larijani B, Sheidaei A, et al. Measuring Iran’s success in

achieving millennium development goal 4: A systematic analysis

of under‑5 mortality at national and subnational levels from 1990

to 2015. Lancet Global Health 2017;5:e537‑44.

Quattrochi J, Jasseh M, Mackenzie G, Castro MC. Spatial

analysis of under-5 mortality and potential risk factors in the

basse health and demographic surveillance system, the Gambia.

Trop Med Int Health 2015;20:941‑51.

Deihim Z, Aghababaeian H. evaluation of factors associated with

mortality in neonate’s and children aged 1‑59 months in Dezful

City (2009‑2014). Iran J Pediatr Nurs 2015.

Collaborators G, Wang H, Coates M, Coggeshall M, Dandona L,

Fraser M, et al. Global, regional, national, and selected

subnational levels of stillbirths, neonatal, infant, and under‑5

mortality, 1980–2015: A systematic analysis for the Global

Burden of Disease Study 2015. Lancet 2016;388:1725‑74.

Lee H‑Y, Do DV, Choi S, Trinh OTH, To KG. Trends and

determinants of infant and under‑five childhood mortality in

Vietnam, 1986–2011. Glob Health Action 2016;9:29312.

Ahmadi A, Javadi A. Trends and determinants of infant mortality

rate in Fars province during 2001‑2011. J Rafsanjan Univ Med

Sci 2015;14:37‑46.

Izadi N, Shetabi H, Bakhtiari S, Janat AM, Parabi M, Ahmadi K.

The rate and causes of infant mortaliry in the hospitals of

Kermanshah Province during 2011‑2014. J Rafsanjan Univ Med

Sci 2016;15:129‑38.

Ntuli ST, Malangu N, Alberts M. Causes of deaths in children

under‑five years old at a tertiary hospital in Limpopo province of

South Africa. Glob J Health Sci 2013;5:95‑100.

Pongou R. Why is infant mortality higher in boys than in

girls? A new hypothesis based on preconception environment

and evidence from a large sample of twins. Demography

;50:421‑44.

He C, Liu L, Chu Y, Perin J, Dai L, Li X, et al. National and

subnational all‑cause and cause‑specific child mortality in

China, 1996–2015: A systematic analysis with implications

for the Sustainable Development Goals. Lancet Glob Health

;5:e186‑97.

Naghibi SA, Moosazadeh M, Shojaee J. Epidemiological features

of under 5 year children mortality in Mazandaran. J Health Res

Community 2015;1:11‑9.

Rutherford ME, Dockerty JD, Jasseh M, Howie SR, Herbison P,

Jeffries DJ, et al. Access to health care and mortality of children

under 5 years of age in the Gambia: A case‑control study. Bull

World Health Organ 2009;87:216‑24.

Tesfaye B, Atique S, Elias N, Dibaba L, Shabbir S‑A,

Kebede M. Determinants and development of a web‑based

child mortality prediction model in resource‑limited settings:

A data mining approach. Comput Methods Programs Biomed

;140:45‑51.

Melli LC, Waldman EA. Temporal trends and inequality in

under‑5 mortality from diarrhea. J Pediatr 2009;85:21‑7.

Kliegman RM, Stanton BM, Geme JS. Nelson Textbook of

Pediatrics. 20th ed: Elsevier; 2015. p. 3880.

Callaghan WM, MacDorman MF, Rasmussen SA, Qin C,

Lackritz EM. The contribution of preterm birth to infant

mortality rates in the United States. Pediatrics 2006;118:1566‑73.

Tajedini F, Ehdaievand F, Farsar AR. Epidemiological features

of children mortality in the area covered by Shahid Beheshti

university of medical sciences in 2012. J Clin Nurs Midwifery

;3(1):62-71.

Safari H, Nooripour S, Emadi Z, Shakeri R, Jandaghi J,

Mirmohammadkhani M. Associated factors of mortality of

children aged 1 to 59 months in rural areas of Semnan: A nested

case‑control study based on 10 years of surveillance data.

Koomesh 2014;15:282-8.

Shahraki VA, Mardani HM, Arab M, Firouzkouhi Z. Infant

under 1‑59 month mortality causes in Zabol. Iran J Nurs Res

;5:6‑13.

Xu Y‑H, Huang X‑W, Yang R‑L. The under‑five mortality rate

and the causes of death in Zhejiang Province between 2000 and

Zhongguo Dang Dai Er Ke Za Zhi 2011;13:561‑4.

Soori H, Rafiei E, Entezami N, Hasani J, Hossaini SM.

A comparison study on rate and causes of under 5 years old

deaths in Iran, eastern Mediterranean region and the world. Saf

Promot Inj Prev 2016;4:1‑8.