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. 2014 Nov 20:14:1191.
doi: 10.1186/1471-2458-14-1191.

Contribution of respiratory tract infections to child deaths: a data linkage study

Pia Hardelid  1 , Nirupa Dattani, Mario Cortina-Borja, Ruth Gilbert
Affiliations

Contribution of respiratory tract infections to child deaths: a data linkage study

Pia Hardelid et al. BMC Public Health. .

Abstract

Background: Respiratory tract infections (RTIs) are an important cause of death in children, and often contribute to the terminal decline in children with chronic conditions. RTIs are often underrecorded as the underlying cause of death; therefore the overall contribution of RTIs to child deaths and the potential preventability of RTI-related deaths have not been adequately quantified.

Methods: We analysed deaths in children resident in England who died of non-injury causes aged 28 days to 18 years between 2001 and 2010 using death certificates linked to a longitudinal hospital admission database. We defined deaths as RTI-related if RTIs or other respiratory conditions were recorded on death certificates or linked hospital records up to 30 days before death. We examined trends in mortality by age group, year and season (winter or summer) and determined the winter excess of RTI-related deaths using rate differencing techniques. We estimated the proportion of RTI-related deaths in children with chronic conditions.

Results: 22.4% (5039/22509) of child deaths were RTI-related. RTI-related deaths declined by 2.3% per year in infants aged 28 to 364 days between 2001 and 2010. No decline was observed for older children. On average there were 161 winter excess RTI-related deaths annually, accounting for 32% of all RTI-related deaths. 89.0% of children with RTI-related deaths had at least one chronic condition; neurological conditions were the most prevalent.

Conclusions: RTI-related deaths have not declined in the last decade except in infants. Targeted strategies to prevent the winter excess of RTIs and to treat RTIs in children, particularly children with chronic conditions, may reduce RTI-related deaths.

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Figures

Figure 1
Figure 1
Mortality rates (per 100,000 population) for RTIs, any respiratory condition and all non-injury causes by age group, 2001–2010. Note different y-axis scales for children aged less than one year.
Figure 2
Figure 2
Mortality rates (per 100,000 population) by week of the year, age group for deaths involving RTIs and any respiratory condition.
Figure 3
Figure 3
Circular plot of monthly RTI-related mortality rates by age group (per 100,000 population). The distance from the centre of the circle to the edge is proportional to the mortality rate.
Figure 4
Figure 4
Circular plot of monthly mortality rates for any respiratory condition by age group (per 100,000 population). The distance from the centre of the circle to the edge is proportional to the mortality rate.
See this image and copyright information in PMC

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Pre-publication history
    1. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2458/14/1191/prepub

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