BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

230 Patternsof Mortality in Childhood
Fia. 113. Mortality from Diseases of Respiratory
System as Underlying or Associated Causes in Children
Under 5 Years, by Age Group, in 15 Projects.
DEAIhS PER 100.000 leV BITH$
0 1000 2000 3000 0 600
S UNDER I YEAR -4 YEARS
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In fact, the rates as underlying causes in
infancy varied from 159.1 in Sherbrooke to
2,751.9 in the Bolivia p~roject, while those
in children 1-4 years ranged from 3.1 in the
California project to 272.3 in Bolivia. Essentially
the same p~attern of variation was
found for these diseases as associated
causes.
WVith the exception of the projectts in Bolivia,
Chaico Province, and Sherbrooke,
death rates from diseases of the respiratory
system in infancy were higher as associated
causes thtan as underlying causes. In six
projects they wvere more than twice as high
as associated causes. In the Bolivia project
the problem of these diseases as underlying
causes seems to be particularly serious,
while in Recife the rate as associated causes,;
was exceedingly high, owing mainly to
complicationl s of neast and nutritional deficiency.
Of the 5,741 deaths from diseases of the
respiratory system, 4,576 were classified in
the group pneumonia and influenza (470­
486). Although deaths from this latter
group are referred to in various parts of this
report and are given in thle Appendix tables
for each area, only 55 deaths or 1.2 per cent
were lue to influenza (470474). In regard
to this group of diseases, in many instances
it was possilble to identify one or more bacterial
agents, though for many deat.hs the
diagnosis was not confirmed by special bacteriologic
studies. The distinction between
lpneurnonia and bronchopneumonia was
based sometimes on radiologic studies but
more often on clinical and autopsy findings.
Differences in terminology made it necessary
to consult with the local groups to
clarify the classification. For example, in
several areas the term acute pneumopathy
(in Spanish neunopatia aguda) (category
519.2) is commonly used to mean pneumonia
unspecified (486). Another problem