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Leading causes of child mortality in Brazil, in 1990 and 2015: estimates from the Global Burden of Disease study

Thursday, 31st of August 2017

Leading causes of child mortality in Brazil, in 1990 and 2015: estimates from the Global Burden of Disease study

[Article in English, Portuguese]

França EB¹, Lansky S², Rego MAS³, Malta DC⁴, França JS⁵, Teixeira R¹, Porto D⁶, Almeida MF⁷, Souza MFM⁵, Szwarcwald CL⁸, Mooney M⁹, Naghavi M⁹, Vasconcelos AMN¹⁰.

1

Programa de Pós-graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.

2

Secretaria Municipal de Saúde de Belo Horizonte - Belo Horizonte (MG), Brasil.

3

Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.

4

Escola de Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.

5

Faculdade de Medicina, Universidade de Brasília - Brasília (DF), Brasil.

6

Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e Promoção da Saúde, Ministério da Saúde - Brasília (DF), Brasil.

7

Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil.

8

Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brasil.

9

Institute for Health Metrics and Evaluation, University of Washington - Seattle (WA), Estados Unidos.

10

Departamento de Estatística, Universidade de Brasília - Brasília (DF), Brasil.

Abstract

OBJECTIVE:

To analyze under-5 mortality rates and leading causes in Brazil and states in 1990 and 2015, using the Global Burden of Disease Study (GBD) 2015 estimates.

METHODS:

The main sources of data for all-causes under-5 mortality and live births estimates were the mortality information system, surveys, and censuses. Proportions and rates per 1,000 live births (LB) were calculated for total deaths and leading causes.

RESULTS:

Estimates of under-5 deaths in Brazil were 191,505 in 1990, and 51,226 in 2015, 90% of which were infant deaths. The rates per 1,000 LB showed a reduction of 67.6% from 1990 to 2015, achieving the proposed target established by the Millennium Development Goals (MDGs). The reduction generally was more than 60% in states, with a faster reduction in the poorest Northeast region. The ratio of the highest and lowest rates in the states decreased from 4.9 in 1990 to 2.3 in 2015, indicating a reduction in socioeconomic regional disparities. Although prematurity showed a 72% reduction, it still remains as the leading cause of death (COD), followed by diarrheal diseases in 1990, and congenital anomalies, birth asphyxia and septicemia neonatal in 2015.

CONCLUSION:

Under-5 mortality has decreased over the past 25 years, with reduction of regional disparities. However, pregnancy and childbirth-related causes remain as major causes of death, together with congenital anomalies. Intersectoral and specific public health policies must be continued to improve living conditions and health care in order to achieve further reduction of under-5 mortality rates in Brazil.