Peer-reviewed article
Exploring mortality patterns in Pakistani children and adolescents aged 5-19: evidence from a national verbal and social autopsy study.
Soofi SB, Chauhadry IA, Nausheen S, Mariam E, Umer M et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined the causes of death among 1,322 children and adolescents aged 5-19 in Pakistan using verbal and social autopsy interviews. The researchers found that infectious diseases, non-communicable diseases, and accidents or injuries were the leading causes of death, with patterns varying by age and gender. Deaths from infectious diseases declined with age while deaths from non-communicable diseases and injuries increased, and maternal complications were a significant cause of death among teenage girls. The findings highlight the need for age-specific health interventions beyond current under-five mortality reduction efforts.
Key points
- Overall mortality was higher among males (59%) than females (41%)
- 29.8% of deaths were among children aged 5-9, 24.4% among ages 10-14, and 45.8% among ages 15-19
- Infectious diseases, NCDs, and accidents/injuries were the three main causes of death
- The contribution of infectious diseases declined with age while NCDs and injuries increased
- Maternal causes, particularly obstetric complications, significantly contributed to mortality among female adolescents
Limitations
The study is based on retrospective verbal autopsy, which relies on caregiver recall and may not capture all details of circumstances surrounding death. The findings describe mortality patterns but do not establish causal relationships or evaluate interventions to prevent these deaths.
Abstract
Background While under-five mortality has declined by approximately 50% globally since 2000, mortality among older children and adolescents has fallen by only 31% since 1990. The age group 5-19-year-olds constitute over a third of Pakistan's population, yet estimates of mortality in this population, which are necessary for identifying preventable causes of death and developing interventions to improve health outcomes, have been limited. We aimed to investigate cause-specific mortality in children aged ≥5 years using verbal and social autopsy (VASA) to identify patterns and health risks across these age groups. Methods We used the multistage stratified cluster sampling frame of the Pakistan National Nutrition Survey 2018, which covered 115,600 households from urban and rural areas. Through retrospective mortality surveillance, we identified 1,322 deaths among 5-19-year-olds in these households in the preceding three years. We then obtained data on their deaths from the household members through VASA interviews, after which a trained paediatrician and two computerised methods assigned specific causes of death to each case. Results We completed VASA interviews for 1,322 deaths, out of which 29.8% were among children aged 5-9 years, 24.4% among young adolescents (10-14 years), and 45.8% among older adolescents (15-19 years). Overall mortality was higher among males (59%) than females (41%). Infectious diseases, non-communicable diseases (NCDs), and accidents/injuries were the three main causes of death, with the contribution of infectious diseases declining, and that of NCDs and injuries increasing with age. Maternal causes, particularly obstetric complications, contributed significantly to mortality among female adolescents. Conclusions We found age- and gender-based differences in mortality causes among the 5-19-year population in Pakistan. Targeted efforts are needed to sustain the gains achieved among the under-five population by extending mortality reduction strategies that focus on age-specific risks for older children and adolescents.