New method quantifies uncertainty in estimates of child mortality rates

December 11, 2012

Measures of uncertainty should be taken into account when estimating progress towards Millennium Development Goal 4 (to reduce the mortality rate of children under 5 years by two thirds from the 1990 level by 2015) in order to give more accurate assessments of countries' progress, according to a study published in this week's PLOS Medicine.

Leontine Alkema and Jin Rou New from the National University of Singapore used a statistical method called bootstrapping to calculate uncertainty intervals for the estimates of mortality rates in children aged under 5 years and the yearly reduction in these rates for 174 countries.

Factoring in uncertainty is necessary because many poor countries do not have well-functioning vital registration systems to record the number of child deaths. When analysing trends in under-5 mortality rates, researchers typically focus on the "best" estimates, but this practice can lead to misleading results and comparisons when such estimates are highly uncertain.

The authors found that in 86 high child mortality countries (with more than 40 deaths per 1,000 live births in 1990), there was much uncertainty about the levels and trends, especially more recently because of the limited availability of data. In 2011, the median width of the uncertainty intervals of the child mortality rates, relative to their level, was 48% among the high mortality countries compared with 19% in 1990. Furthermore, for 8 countries, the uncertainty level was high enough to not exclude the possibility that no progress had been made in reducing child mortality, whereas for 13 countries, progress is likely to have exceeded the Millennium Development Goal 4 target of a 4.4% annual rate of reduction since 1990.

The authors say: "The new uncertainty assessments provide more insights into countries' progress in reducing child mortality because they enable a categorization of countries based on the evidence for the progress that has been made (as supposed to focusing on potentially highly uncertain point estimates)".

The authors add: "Uncertainty assessments can and should be used to complement point estimates to avoid unwarranted conclusions about levels or trends in child mortality and to reduce confusion about differences in estimates, such as estimates from different groups such as the [United Nations Inter-agency Group for Child Mortality Estimation] and the [Institute for Health Metrics Evaluation], or after updating point estimates in light of new data."
-end-
Funding: LA was funded by a grant from the National University of Singapore. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: LA is a member of the technical advisory group of the UN IGME. JRN is a consultant for UNICEF. The views expressed in this paper are those of the authors and do not necessarily reflect the views of the United Nations Children's Fund. The authors declare that no other competing interests exist.

Citation: Alkema L, New JR (2012) Progress toward Global Reduction in Under-Five Mortality: A Bootstrap Analysis of Uncertainty in Millennium Development Goal 4 Estimates. PLoS Med 9(12): e1001355. doi:10.1371/journal.pmed.1001355

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER (THIS LINK WILL BECOME LIVE WHEN THE EMBARGO LIFTS):

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001355

CONTACT:Leontine Alkema
Department of Statistics and Applied Probability
National University of Singapore, Singapore
alkema@nus.edu.sg

PLOS

Related Mortality Rates Articles from Brightsurf:

COVID-19 mortality rates higher among men than women
A new review article from Beth Israel Deaconess Medical Center (BIDMC) shows people who are biologically male are dying from COVID-19 at a higher rate than people who are biologically female.

Study links three key variables to higher rural mortality rates in US
Since the 1980s, the all-cause mortality rate for rural residents in the US has exceeded that of urban residents.

Anal cancer rates and mortality have risen dramatically among Americans
Rates of new anal cancer diagnoses and deaths related to human papillomavirus (HPV), the most common sexually transmitted infection, have increased dramatically over the last 15 years, according to researchers at The University of Texas Health Science Center at Houston (UTHealth).

Men with breast cancer face high mortality rates: Study
Men with breast cancer are more likely to die than their female counterparts, across all stages of disease, with the disparity persisting even when clinical characteristics, such as cancer types, treatment and access to care are considered, according to a study by Vanderbilt researchers published in JAMA Oncology.

Mortality rates of major league baseball players
Major league baseball (MLB) players had lower death rates overall and from many underlying causes of death compared with men in the general US population, differences that could be associated in part with the physical fitness required for their jobs.

New Labour's policies reduced geographical inequalities in infant mortality rates
Efforts by the Labour government to reduce inequalities between the most deprived areas of England and the rest of the country had a positive impact on infant mortality rates, suggests research by the Universities of Newcastle, Leeds, York, and Liverpool published online in the Journal of Epidemiology & Community Health.

Global colorectal cancer mortality rates predicted to rise
In the first effort to predict the future burden of colorectal cancer mortality globally, researchers note that colon and rectal cancer mortality rates are projected to decrease in most countries apart from some Latin American and Caribbean countries, but increases are predicted for several countries from Europe, North America and Oceania.

Mortality rates rising for Gens X and Y too
Declining life expectancies in the US include Gen X and Y Americans, in addition to the older Baby Boomers.

Drug resistant infections associated with higher in-hospital mortality rates in India
In one of the largest studies to measure the burden of antibiotic resistance in a low- or middle-income country, researchers at the Center for Disease Dynamics, Economics & Policy report that in-hospital mortality is significantly higher among patients infected with multi-drug resistant (MDR) or extensively drug resistant (XDR) pathogens including Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii.

How have mortality rates changed over time for infants, children?
Mortality rates for death from any cause declined in all age groups from 1999 to 2015 in a study that analyzed death certificate data for people younger than 25 in the United States, Canada and England/Wales. More than 1.1 million deaths occurred during the study period in the United States, where mortality rates for death from any cause were the highest.

Read More: Mortality Rates News and Mortality Rates Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.