Infectious diseases were responsible for the largest global burden of premature death and disability until the end of the twentieth century. The World Health Organization (WHO) reported that in 2016, about three infectious diseases were ranked in the top ten causes of death globally; namely, lower respiratory infections, diarrheal diseases, and tuberculosis, which have cumulatively killed about 5.7 million people. It has been reported that in Africa, more than 70.0% of deaths among children under 5 are caused by infectious diseases. Malaria causes about 15.0% of deaths among under 5 years of age children in sub-Saharan Africa. Since 1970, the global under-five mortality has been decreasing. Smallpox was responsible for about 300-500 million deaths in the twentieth century and it was declared to be the first disease eradicated from the planet as a result of a global immunization campaign by the World Health Organization. Poliovirus has been eliminated from almost all countries.
Africa is a region in which the majority of children are living with HIV. Reports from many African countries reveal that AIDS is becoming an increasingly significant contributor to child mortality. In 2016, worldwide about 120,000 children died due to AIDS-related illnesses. This corresponds to about 328 deaths daily. In the African region, AIDS contributed to only 6% of the child mortality, and more than 30% of the AIDS-related deaths were found among Southern African countries. A study reveals that mother-to-child transmission of HIV ranges from 15 to 45%, with about 20% resulting from breastfeeding. A study conducted in Uganda reported 2-year mortality rates of 547,166 and 128 per 1000 among HIV-infected children, HIV-negative children of HIV-positive mothers, and HIV-negative children of HIV-negative mothers. Under 5 years children living with HIV are more likely to die than people of any age group living with HIV.
Many decades ago, Africa contributed to approximately 14% of the global child mortality burden. However now, sub-Saharan Africa alone accounts for more than 50% of child mortality. In Africa, the low coverage and poor performance of the health system contribute to a high mortality rate of otherwise preventable deaths. It was reported that about 25% of all deaths in children under five in Africa occur within the first month, and about 75% of these cases during the first week. In Africa, the child mortality rate has steadily declined. In the 1950s, child mortality was estimated to be about 300 deaths per 1000 births, this means that around one-third of the children born in those years did not make their fifth birthday. However, in 2020, this number has fallen significantly, to about 71 deaths per thousand births. The risk of death among the children is the highest in the neonatal period. Nevertheless, safe childbirth and effective neonatal care are essential to prevent these deaths. Infectious diseases are responsible for over 50% of childhood deaths and an even greater level of morbidity. Many serious challenges need to be overcome in order to reduce childhood mortality in Africa. The African governments should adopt strong policies to reach poor and marginalized communities as well. They should also improve coverage, quality, and use of skilled care in order to reduce childhood mortality.
Guest Editorial