6. Incorporating Deaths Near the Time of Birth into Estimates of the Global Burden of Disease

Sources: WHO 2005a for columns a-d, unreported estimates undertaken as part of the GBD study, reported in chapter 3 for columns f-g, and chapter 3 of this volume.

Note: The absence of an entry in columns a-d denotes either a value of less than 1,000 deaths or that no estimate was allocated to that entry. For columns f-k, a blank cell indicates that fewer than 1,000 deaths are attributable to the specific cause. Infant and child deaths in columns f and g are based on unreported estimates undertaken as part of the GBD study, reported in chapter 3, of the percentage of under-five deaths that were under age one. Because the sources used for neonatal deaths left a large number unallocated, it is not appropriate to calculate values of column e by subtracting column d from column f except where explicitly noted.

a. WHO 2005b and Bryce and others (2005) estimate that 395,000 deaths occur due to measles. Chapter 3 provides an estimate for measles deaths age zero to four of 763,000.

b. Lawn, Wilczynska, and Cousens (forthcoming) for the CHERG estimate (2005) that 7 percent (260,000) of the 3.854 million global neonatal deaths occur due to tetanus, similar to the WHO and GAVI estimates of 220,000 for the year 2000. Chapter 3 provides an estimate for tetanus deaths ages zero to four of only 187,000. The (unpublished) GBD files used here to allocate deaths under age five to over and under age one allocated 52 percent of tetanus deaths to under age one. The CHERG review (Lawn, Wilczynska, and Cousens forthcoming) suggests this to be a major underestimate, and the 52 percent figure has thus here been revised upward to 90 percent. Consistent with the objectives of this chapter, GBD numbers have been used wherever possible, and the CHERG and WHO estimates are accordingly revised downward by allocating all infant tetanus deaths to the neonatal period.

c. WHO 2005b and Bryce and others (2005) estimate that 853,000 deaths occur due to malaria. Chapter 3 provides an estimate for malaria deaths age zero to four of 1,208,000.

d. Hepatitis, tropical-cluster diseases, leprosy, dengue, Japanese encephalitis, trachoma, intestinal nematode infections, and other infectious diseases.

e. Deaths for respiratory infections in the neonatal age group are those estimated by Lawn, Cousens, and Wilczynska (forthcoming) for their category sepsis or pneumonia. This number was then subtracted from the GBD number of respiratory infections between age zero and one to derive the total in column e.

f. Low-birthweight deaths are those resulting from intrauterine growth retardation or preterm birth. Almost all low-birthweight deaths in the neonatal period result from preterm birth.

g. Lawn, Wilczynska, and Cousens (forthcoming) for the CHERG estimate that 23 percent (887,000) of the 4 million global neonatal deaths occur due to birth asphyxia. Chapter 3 of this volume provides an estimate for birth asphyxia and birth trauma deaths ages zero to four of only 739,000 globally, of which 734,000 were estimated to occur under age one. Consistent with the objectives of this chapter, GBD numbers have been used wherever possible, and the CHERG and WHO estimates are accordingly revised downward by allocating all infant birth asphyxia deaths to the neonatal period. Better data in the future will allow for improved estimates.

h. Epilepsy, alcohol use disorders, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, drug use disorders, post-traumatic stress disorder, obsessive-compulsive disorder, panic disorder, insomnia (primary), migraine, mental retardation attributable to lead exposure, and other neuropsychiatric disorders.

i. Rheumatic heart disease, hypertensive heart disease, inflammatory heart diseases, and other cardiovascular diseases.

j. Other neoplasms, endocrine disorders, sense organ diseases, genitourinary diseases, skin diseases, musculoskeletal diseases, and oral conditions.

k. Poisonings, falls, fires, drownings, and other unintentional injuries.

l. Violence, war, and other intentional injuries.

Sources: WHO 2005a for columns a-d, unreported estimates undertaken as part of the GBD study, reported in chapter 3 for columns f-g, and chapter 3 of this volume.

Note: The absence of an entry in columns a-d denotes either a value of less than 1,000 deaths or that no estimate was allocated to that entry. For columns f-k, a blank cell indicates that fewer than 1,000 deaths are attributable to the specific cause. Infant and child deaths in columns f and g are based on unreported estimates undertaken as part of the GBD study, reported in chapter 3, of the percentage of under five deaths that were under age one. Because the sources used for neonatal deaths left a large number unallocated, it is not appropriate to calculate values of column e by subtracting column d from column f except where explicitly noted.

a. Hepatitis, tropical-cluster diseases, leprosy, dengue, Japanese encephalitis, trachoma, intestinal nematode infections, and other infectious diseases.

b. This table does not attempt to partition by age the very small number of deaths from respiratory infections under age 5.

c. Low-birthweight deaths are those resulting from intrauterine growth retardation or preterm birth. Almost all low-birthweight deaths in the neonatal period result from preterm birth.

d. The World Health Report 2005 cites that 45 percent (19,000) of the 4 million global neonatal deaths occur due to pre-term birth. Chapter 3 of this volume provides an estimate for low birthweight deaths ages zero to four of only 10,000, of which 10,000 were estimated to occur under age one. Consistent with the objectives of this chapter, GBD numbers have been used wherever possible, and the World Health Report 2005 estimates are accordingly revised downward by allocating all low-birthweight deaths to the neonatal period. Better data in the future will allow for improved estimates.

e. Epilepsy, alcohol use disorders, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, drug use disorders, post-traumatic stress disorder, obsessive-compulsive disorder, panic disorder, insomnia (primary), migraine, mental retardation attributable to lead exposure, and other neuropsychiatric disorders.

f. Rheumatic heart disease, hypertensive heart disease, inflammatory heart diseases, and other cardiovascular diseases.

g. Other neoplasms, endocrine disorders, sense organ diseases, genitourinary diseases, skin diseases, musculoskeletal diseases, and oral conditions.

h. Poisonings, falls, fires, drownings, and other unintentional injuries.

i. Violence, war, and other intentional injuries.

Sources: WHO 2005a for columns a-d, unreported estimates undertaken as part of the GBD study, reported in chapter 3 for columns f-g, and chapter 3 of this volume.

Note: The absence of an entry in columns a-d denotes either a value of less than 1,000 deaths or that no estimate was allocated to that entry. For columns f-k, a blank cell indicates that fewer than 1,000 deaths are attributable to the specific cause. Infant and child deaths in columns f and g are based on unreported estimates undertaken as part of the GBD study, reported in chapter 3, of the percentage of under five deaths that were under age one. Because the sources used for neonatal deaths left a large number unallocated, it is not appropriate to calculate values of column e by subtracting column d from column f except where explicitly noted.

a. WHO 2005b and Bryce and others (2005) estimate that 395,000 deaths occur due to measles. Chapter 3 provides an estimate for measles deaths age zero to four of 763,000.

b. Lawn, Wilczynska, and Cousens (forthcoming) for the CHERG estimate (2005) that 7 percent (260,000) of the 3.854 million global neonatal deaths occur due to tetanus, similar to the WHO and GAVI estimates of 220,000 for the year 2000. Chapter 3 provides an estimate for tetanus deaths ages zero to four of only 187,000. The (unpublished) GBD files used here to allocate deaths under age five to over and under age one allocated 52 percent of tetanus deaths to under age one. The CHERG review (Lawn, Wilczynska, and Cousens forthcoming) suggests this to be a major underestimate, and the 52 percent figure has thus here been revised upward to 90 percent. Consistent with the objectives of this chapter, GBD numbers have been used wherever possible, and the CHERG and WHO estimates are accordingly revised downward by allocating all infant tetanus deaths to the neonatal period.

c. WHO 2005b and Bryce and others (2005) estimate that 853,000 deaths occur due to malaria. Chapter 3 provides an estimate for malaria deaths age zero to four of 1,208,000.

d. Hepatitis, tropical-cluster diseases, leprosy, dengue, Japanese encephalitis, trachoma, intestinal nematode infections, and other infectious diseases.

e. Deaths for respiratory infections in the neonatal age group are those estimated by Lawn, Cousens, and Wilczynska (forthcoming) for their category sepsis or pneumonia. This number was then subtracted from the GBD number of respiratory infections between age zero and one to derive the total in column e.

f. Low-birthweight deaths are those resulting from intrauterine growth retardation or preterm birth. Almost all low-birthweight deaths in the neonatal period result from preterm birth.

g. Lawn, Wilczynska, and Cousens (forthcoming) for the CHERG estimate that 23 percent (887,000) of the 4 million global neonatal deaths occur due to birth asphyxia. Chapter 3 of this volume provides an estimate for birth asphyxia and birth trauma deaths ages zero to four of only 739,000 globally, of which 734,000 were estimated to occur under age one. Consistent with the objectives of this chapter, GBD numbers have been used wherever possible, and the CHERG and WHO estimates are accordingly revised downward by allocating all infant birth asphyxia deaths to the neonatal period. Better data in the future will allow for improved estimates.

h. Epilepsy, alcohol use disorders, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, drug use disorders, post-traumatic stress disorder, obsessive-compulsive disorder, panic disorder, insomnia (primary), migraine, mental retardation attributable to lead exposure, and other neuropsychiatric disorders.

i. Rheumatic heart disease, hypertensive heart disease, inflammatory heart diseases, and other cardiovascular diseases.

j. Other neoplasms, endocrine disorders, sense organ diseases, genitourinary diseases, skin diseases, musculoskeletal diseases, and oral conditions.

k. Poisonings, falls, fires, drownings, and other unintentional injuries.

l. Violence, war, and other intentional injuries.