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Top causes of under 5 death

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  • 1. Goal4.org Brief: Top Causes of Under-Five DeathEach year over 8 million children die before their 5th birthday and 500,000 women dieduring childbirth. Half of these deaths happen in Sub-Saharan Africa and almost all arepreventable. Babies who are left motherless are 10 times more likely to die within twoyears of their mothers death.Children often die from multiple causes. Determining the primary cause is difficult evenwith diagnostic equipment; near impossible without it. We do know, however, thatmalnutrition is associated with half the deaths.The below chart shows the top 5 causes of under-five deaths in Goal4’s pilot area, Sega,Kenya. The chart shows what is needed in order to prevent, diagnose, and treat each ofthese causes. The heart of Goal4’s approach is to build a connected, educated,engaged, supplied community – from medical professionals to mothers – that worktogether to do what is needed to stop these things from killing kids. This chart will be thecommunity’s North Star. Cause Prevent Diagnose TreatPneumonia Vaccine Radiograph Antibiotics Nutrition/Exclusive Breastfeeding to 6 Clinical Signs Oxygen months Indoor AirDiarrheal Safe drinking water Microscope Oral rehydrationDisease Personal hygiene IV rehydration Public sanitation Zinc Vaccine AntibioticsMalaria Insecticide treated bed net Microscope Anti-malarial med Vaccine (2011)Malnutrition Exclusive breastfeeding to 6 months Weighing Food supplements Age-appropriate food, sufficient quantity scale De-worming tablets Avoid persistent diarrhea, pneumonia, Measuring Check/treat for other malaria, measles tape diseases: malaria, Avoid worms via hygiene / regularly de- diarrhea, pneumonia wormDelivery + 2 Prenatal care & early detection of Equipped deliveryweeks complications facility Prenatal health – supplements, nutrition Delivery kits Deliver at health center and/or with skilled birth attendantJanuary 2012 For more about goal4.org visit: www.goal4.org
  • 2. Below is a bit of detail on each of the five causes with notes on the next most importantcause of death, mother to child transmission of HIV.Pneumonia / Acute Respiratory Infection (ARI)ARI is a leading cause of mortality in children under the age of five in developingcountries. Respiratory infections caused by viruses or bacteria, can manifest in any areaof the respiratory tract, including the nose, middle ear, throat, voice box, air passage,and lungs. Pneumonia, an infection of the lungs, is the most serious respiratory infectionand often can be treated with affordable oral antibiotics since the primary cause ofinfection is bacteria. Children suffering from other conditions, such as malnutrition ormeasles, are particularly susceptible to pneumonia. To prevent deaths when childrendevelop ARI, it is crucial that the signs are recognized - a cough accompanied by difficultor short, rapid breathing - and that appropriate health care is sought immediately. Moredetail on pneumonia at http://www.childinfo.org/pneumonia.htmlDiarrheal DiseaseDiarrhea remains one of the major causes of death among the worlds children. Most dieof dehydration - the loss of large quantities of water and salt from the body. Many ofthese deaths can be prevented with the use of oral rehydration therapy (ORT) at firstonset of diarrhea. Diarrhea is caused by ingesting certain bacteria, viruses or parasitesfound in fecal matter which may be spread through water, food, hands, eating anddrinking utensils, flies, and dirt under fingernails. Diarrhea may present in different formsand have various treatment protocols: persistent diarrhea (more than 14 days), acutewatery diarrhea, or dysentery (blood in stool). Other diseases that can occurconcurrently with diarrhea include measles and malaria. Malnutrition also oftenaccompanies diarrhea. More detail on diarrhea at http://www.childinfo.org/diarrhoea.htmlMalariaMalaria is caused by a parasite transmitted to humans by mosquitoes. Young childrenare particularly vulnerable because they have not developed the partial immunity thatresults from surviving repeated infections. The disease may occur year-round orseasonally. Symptoms of malaria include fever with shivering and sweating, headache,and pain in the back, joints, or body. There may also be loss of appetite, cough,vomiting, and diarrhea; however fever may be the only sign of malaria, making it difficultto distinguish. Malaria may cause several weeks or months of poor health due torepeated attacks of fever, anemia, and general weakness. Children can deterioraterapidly over 1-2 days, becoming very ill, going into coma (cerebral malaria) or shock, ormanifesting convulsions, severe anemia and acidosis. Malnutrition should be recognizedas possible co-existing condition. Prevention methods for malaria include the use ofinsecticide-impregnated bed nets in endemic areas. In most cases, children with malariacan be quickly and effectively treated with a course of inexpensive, oral anti-malarialtablets. More detail on malaria at http://www.childinfo.org/malaria.htmlMalnutritionMalnutrition contributes to about half of all childhood deaths. Poor feeding practices -inadequate breastfeeding, offering the wrong foods at the wrong age, and giving food ininsufficient quantities - contribute to malnutrition. Infection, frequent or persistentdiarrhea, pneumonia, measles and malaria, also undermine nutritional status, leavingmalnourished children even more vulnerable to disease. Efforts to prevent malnutritioninclude the promotion of breastfeeding, the improvement of feeding practices, and theprovision of routine micronutrient supplements for children who need them.January 2012 For more about goal4.org visit: www.goal4.org
  • 3. Safe delivery + 2 weeksSurviving delivery and the following two weeks are a significant challenge for bothmother and child. Babies who are left motherless are 10 times more likely to die withintwo years of their mothers death. Because so many mothers don’t get prenatal care,signs of potential birth complications go undetected, leaving them to be addressed as anemergency late in labor (if they can make it to a health facility) or end in death to bothmother and child at home. And finally, many newborns die of asphyxia because unskilledbirth attendants don’t know how to clear airways properly and monitor for distress.This chart shows that asphyxia,sepsis, and prematurity mayeach, alone actually cause moreunder-5 deaths in Kenya thanmalaria.Source: The World Health Organizationhttp://www.who.int/gho/countries/ken.pdfMother to child transmission of HIVThe transmission of HIV from an HIV-positive mother to her child during pregnancy,labor, delivery or breastfeeding is called mother-to-child transmission. In the absence ofany interventions, transmission rates range from 15-45% and about half of thosechildren will die before their 2 nd birthday. The transmission rate can be reduced to levelsbelow 5% with effective interventions.Interventions are: 1. Infant feeding – either the HIV-positive mother or their infant should take antiretroviral drugs (ARVs) during breastfeeding 2. Use of ARVs during pregnancyMore detail on preventing mother to child transmission athttp://aidsalliance.3cdn.net/c4448808bc953b94c7_3dm6vd8hq.pdfJanuary 2012 For more about goal4.org visit: www.goal4.org