title: Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000.
abstract: BACKGROUND
  Information about the distribution of causes of and time trends for child mortality should be periodically updated. We report the latest estimates of causes of child mortality in 2010 with time trends since 2000.
  
  
  METHODS
  Updated total numbers of deaths in children aged 0-27 days and 1-59 months were applied to the corresponding country-specific distribution of deaths by cause. We did the following to derive the number of deaths in children aged 1-59 months: we used vital registration data for countries with an adequate vital registration system; we applied a multinomial logistic regression model to vital registration data for low-mortality countries without adequate vital registration; we used a similar multinomial logistic regression with verbal autopsy data for high-mortality countries; for India and China, we developed national models. We aggregated country results to generate regional and global estimates.
  
  
  RESULTS
  Of 7·6 million deaths in children younger than 5 years in 2010, 64·0% (4·879 million) were attributable to infectious causes and 40·3% (3·072 million) occurred in neonates. Preterm birth complications (14·1%; 1·078 million, uncertainty range [UR] 0·916-1·325), intrapartum-related complications (9·4%; 0·717 million, 0·610-0·876), and sepsis or meningitis (5·2%; 0·393 million, 0·252-0·552) were the leading causes of neonatal death. In older children, pneumonia (14·1%; 1·071 million, 0·977-1·176), diarrhoea (9·9%; 0·751 million, 0·538-1·031), and malaria (7·4%; 0·564 million, 0·432-0·709) claimed the most lives. Despite tremendous efforts to identify relevant data, the causes of only 2·7% (0·205 million) of deaths in children younger than 5 years were medically certified in 2010. Between 2000 and 2010, the global burden of deaths in children younger than 5 years decreased by 2 million, of which pneumonia, measles, and diarrhoea contributed the most to the overall reduction (0·451 million [0·339-0·547], 0·363 million [0·283-0·419], and 0·359 million [0·215-0·476], respectively). However, only tetanus, measles, AIDS, and malaria (in Africa) decreased at an annual rate sufficient to attain the Millennium Development Goal 4.
  
  
  CONCLUSIONS
  Child survival strategies should direct resources toward the leading causes of child mortality, with attention focusing on infectious and neonatal causes. More rapid decreases from 2010-15 will need accelerated reduction for the most common causes of death, notably pneumonia and preterm birth complications. Continued efforts to gather high-quality data and enhance estimation methods are essential for the improvement of future estimates.
  
  
  BACKGROUND
  The Bill & Melinda Gates Foundation.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.forename: Hope L
authors.initials: HL
authors.lastname: Johnson
authors.forename: Simon
authors.initials: S
authors.lastname: Cousens
authors.forename: Jamie
authors.initials: J
authors.lastname: Perin
authors.forename: Susana
authors.initials: S
authors.lastname: Scott
authors.forename: Joy E
authors.initials: JE
authors.lastname: Lawn
authors.forename: Igor
authors.initials: I
authors.lastname: Rudan
authors.forename: Harry
authors.initials: H
authors.lastname: Campbell
authors.forename: Richard
authors.initials: R
authors.lastname: Cibulskis
authors.forename: Mengying
authors.initials: M
authors.lastname: Li
authors.forename: Colin
authors.initials: C
authors.lastname: Mathers
authors.forename: Robert E
authors.initials: RE
authors.lastname: Black
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000401:mortality; D001720:Birth Injuries / Q000401:mortality; D002423:Cause of Death / Q000639:trends*; D046688:Child Mortality / Q000639:trends*; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000401:mortality; D003967:Diarrhea / Q000401:mortality; D014943:Global Health; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality; D008288:Malaria / Q000401:mortality; D008581:Meningitis / Q000401:mortality; D011014:Pneumonia / Q000401:mortality; D012044:Regression Analysis