Masquelier B, et al. - Researchers analyzed empirical data to determine the levels and trends in mortality of children aged 5–14 years in 195 countries from 1990 to 2016. In 2016, the global death of 1 million (90% uncertainty interval: 0.9 million–1.1 million) children aged 5–14 years was reported. Sub-Saharan Africa and South Asia showed disproportionately high death rates. In sub-Saharan Africa, 55% (51–58) of deaths in this age group were reported, an increase from 36% (35–38) in 1990. In South Asia, 25% (22–28) of these deaths occurred, including 160,000 (142,000–178,000) deaths in India in that year.

Methods

• Researchers performed analysis of empirical data, and expanded the United Nations Inter-agency Group for Child Mortality Estimation database containing data on children aged < 5 years with 5,530 data points regarding children aged 5–14 years.
• Nationally representative birth histories, data on household deaths reported in population censuses, and nationwide systems of civil registration and vital statistics were used to obtain mortality rates from 1990 to 2016.
• In a Bayesian B-spline bias-reduction model, researchers used these data to generate smoothed trends with 90% uncertainty intervals in order to determine the probability of a child 5 years of age dying before reaching 15 years of age.

Results

• In 2016, the global probability of a child dying between ages 5 and 15 years was 7.5 deaths (90% uncertainty interval: 7.2–8.3) per 1,000 children, which was less than one-fifth of the risk of dying between birth and age 5 years (41 deaths [39–44] per 1000 children).
• In children aged 5–14 years, the mortality rate decreased by 51% (46–54) between 1990 and 2016, despite not being specifically targeted by health interventions.
• This age group showed a decrease in the annual number of deaths from 1.7 million (1.7 million–1.8 million) to 1 million (0.9 million–1.1 million) in 1990–2016.
• In, 1990-2000 there was a faster decrease in mortality rates in children aged 5–14 years vs children aged 0–4 years.
• However, since 2000, mortality rates in children aged < 5 years have decreased faster than mortality rates in children aged 5-14 years.
• Among children aged < 5 years, the annual rate of reduction in mortality has been 4.0% (3.6–4.3) since 2000 vs 2.7% (2.3–3.0) in children aged 5–14 years.
• In sub-Saharan Africa, older children and young adolescents showed disproportionately higher tendency to die than those in other regions.
• Despite having only 21% of the global population of children aged 5–14 years, sub-Saharan Africa accounted for 55% (51–58) of deaths of children of this age.
• In 2016, low-income and middle-income countries displayed 98% (98–99) of all deaths of children aged 5–14 years; seven countries alone accounted for more than one-half of the total number of deaths of these children.