South African Press Association - December 18, 2003

HIV/Aids had accounted for 40% of the deaths of young children in 2000, head of the MRC's Burden of Disease research unit Debbie Bradshaw said in a statement.

"Although the percentage of deaths is higher in the 1-4 year age group, the largest number of deaths occurs in the under-one age group," she said.

The MRC identified three broad areas that would require differing approaches for prevention: the prevention of mother-to-child transmission of HIV, even at its current efficacy, is the single most effective intervention to reduce mortality among under five year olds, eclipsing all other interventions for other causes of death combined;

although dominated by the rise of HIV/Aids, the classic infectious diseases such as diarrhoea, respiratory infections and malnutrition are still important causes of mortality; and

road traffic accidents and violence, which includes homicide and suicide is another group of high mortality conditions that will require dedicated interventions.

Bradshaw said that the leading causes of death among children aged one and four in 2000 were associated with poor socio-economic conditions.

"Many of these deaths can be prevented. Reducing poverty, meeting basic needs and adopting a comprehensive primary health care approach with renewed vigour must be high on the agenda in the next few years."

In older children aged between five and 14, it was found that as children get older, external causes of death (e.g. road traffic injuries and drowning) rise in importance.

"This is particularly noticeable among boys who die in greater numbers than girls," Bradshaw said.

In recent years mortality among young adults, and in particular young women, has increased dramatically as a result of HIV/Aids.

Such mortality and also the illness preceding it, had a devastating effect on children leading to increased morbidity, mortality and orphanhood, she said.

"One of the most important results of the roll-out of anti-retroviral therapy among the general population will be the extension of the lives of Aids sick parents leading to a dramatic decline in the number of orphans."

The study, which was partially funded by Unicef South Africa to focus on the burden of disease among children particularly children under the age of five years, highlighted that without an intervention to extend the lives of people living with Aids, the total premature mortality burden in South Africa could be expected to double by 2010, she said.

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