IJE Advance Access originally published online on March 11, 2005
International Journal of Epidemiology 2005 34(2):375-377; doi:10.1093/ije/dyi028
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2005; all rights reserved.
Commentary |
Commentary: Comorbidity as a factor in child health and child survival in developing countries
Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. E-mail: kim.mulholland@lshtm.ac.uk
| The first 150 words of the full text of this article appear below. |
Ask any clinician who has looked after children in a developing country about co-morbidity in childhood disease and you are likely to get a similar answer. Children in developing countries get ill and die in large numbers from a relatively small number of causes. Frequently they present with more than one problem and those with multiple problems are more likely to die. This co-morbidity is more than would be expected by chance alone, and is largely due to common risk factors, particularly malnutrition. This view is reinforced by studies of the aetiology of pneumonia and diarrhoeal disease in developing countries, which reveal a population of high risk, often malnourished children from whom multiple pathogens can be identified.1
These impressions are largely based on hospital experience, yet we know that most illnesses and deaths occurring in children in developing countries occur in the community rather than in health facilities. Hospitals in
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