BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

190 Patternsof Mortalityin Childhood
Fia. 97. Mortality of Children 1-4 Years of Age
with Congenital Anomalies as Underlying or Associated
Causes or as Minor Anomalies in 15 Projects.
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CAUSE CAUSE ANOMALY
genital hernias as well as a few other anomalies
have been added to those in Section
XIV. However, these additions are not sufficient
to explain the differences between the
data for the countries as a whole and those
for the projects. The findings of the Investigation
are probably more complete than the
information hitherto available.
Of the 7,493 deceased children 1-4 years
of age, 444 or 5.9 per cent were found to
have at least one anomaly, which gave a
rate of 26.9 per 100,000 population in that
age group. The variation was from 18.8 to
61.7 per 100,000 (Figure 97) in 14 of the
projects. As in the case of infants, the death
rate in Bolivia was very low (11.4). The
comparison of the 1967 rates as underlying
causes for five countries (WHO, 1971) and
for the seven projects of the Investigation
is as follows:
WHO data, 1967
Investigation
Canada 12.5 Sherbrooke 9.4
Chile 5.9 Chile project 17.9
Colombia 5.4 Cali 14.8
Cartagena 20.3
Medellin 28.2
Mexico 4.1 Monterrey 15.3
United States 9.7 California project 13.7
The rates obtained in the Investigation
in this age period were higher in all projects
except that in Sherbrooke. (The experience
in that project was small, and variations
would be expected to occur from year to
year; there were only seven deaths of children
1-4 years of age with an anomaly as
underlying cause.) The findings of the Investigation
are providing more complete and
reliable information regarding the important
problem of congenital anomalies than
that available from the official reports of
countries.
DIAGNOSTIC EVIDENCE
The completeness of the information on
congenital anomalies depends in part on the
diagnostic evidence available. Table 102
shows the type of evidence obtained for the
anomalies assigned as underlying causes of
death in 1,948 infants and children 1-4
years of age. Out of this number, autopsies
had been performed on 544 or 27.9 per cent,
a proportion that was much higher than
that for deaths from all causes (16.9 per
cent). Clinical information only was available
for 64.7 per cent. Relatively few anomalies
were included as underlying causes on
the basis of medical interviews only (80