According to United Nations, in 2018, an estimated 6.2 million children and adolescents under the age of 15-year-old died from preventable causes. Of which, 5.3 million deaths took place in the first five years of lives. As such, one of its Sustainable Development Goals is to call for a substantial reduction in preventable deaths among children aged five and below by 2030. All along, intervention programs were targeted purely based on poverty although past studies had suggested that multiple other risk factors impacting under-5 mortality.
A new model to capture preventable deaths in children
This week, a group of researchers at the University of California, Los Angeles’ Fielding School of Public Health released a new model to capture, more accurately and efficiently, children who are at the highest risks of preventable death, so that more appropriate actions can be taken. The model was published in the open-access journal PLoS ONE on 14 October (Wednesday).
To ensure the comprehensiveness of this model and to have a framework that takes into consideration of mortality inequalities and high-risk sub-populations of children that would otherwise be left behind, researchers used Demographic and Health Surveys (DHS) which included data on more than 1.6 million births happened in 67 low and middle-income countries collated from 182 different surveys. They estimated the mortality risk of each children and quantified the variability of these risks within and between socioeconomic groups.
Researchers realized there are more variability in mortality within socioeconomic groups rather than between them in all 67 countries and within countries, socioeconomic status only accounted for 20% if not less of the variation in mortality risk. Children with the highest under-5 mortality risks are those whose mothers are from the lowest socioeconomic group who live in rural areas and experienced of deaths of a previous child.
Again, researchers warned the insufficiency to catch all potentially at-risk children by tackling only poverty, even though it has a clear link to an increased risk in mortality. It is more important to examine poverty alongside with other risk factors in singling out the most left behind groups of children. As the researchers wrote in the paper, “Policy makers often target the poorest 20% children for interventions to decrease risks of premature death. However, children with high risk of premature death exist across all socioeconomic groups”.
In fact, child deaths do occurred outside of the 20 percentile. It varies from 65% in Brazil, South Africa and India to 95% in Ukraine. Thus, researchers strongly believe looking at at-risk children within the 20% poorest are likely to miss the majority of children who could benefit from health policy interventions.
The many medical opportunities
Apart from child mortality, another area that is often overlooked in pediatric is pediatric drug development. Most of the time, children are seen as “little adults” rather than a vulnerable, heterogeneous group, there is not much of a medical enthusiasm around generating medications for younger patients. In US and EU, most pediatrics drugs are not tested on children, even if they are, clinical trials recruit individuals who are presently receiving medical care, instead of healthy volunteers as in the case of adults. Thus, it is hard for clinical pharmacologists to establish an understanding of the initial dose-exposure relationship.
At the recent AIMed webinar, Dr. G. Hamilton Baker, Associate Professor of Pediatric and Congenital Cardiology at the Medical University of South Carolina mentioned creation of a digital twin project using real-time location tracking system that garnered him and his team a huge amount of data. With that, perhaps the future drug trial can take place in a patient’s digital twin rather than on a real patient?
Besides, Dr. Peter Laussen, Executive Vice President of Health Affairs at Boston Children’s Hospital also exemplified his work on collecting physiologic data streaming from Intensive Care Unit (ICU) patients and a platform that has been developed to facilitate the process so that his team can be much more efficient in the allocation of manpower and resources during care. Delegates at the recent AIMed NHS (National Health Service) AI Lab virtual conference, also discussed and agreed the potential artificial intelligence (AI) and other data-driven technologies in closing existing health disparity and helping underserved communities including children.
There are many medical opportunities out there but many of them will remain solution-less until researchers get hold onto diverse datasets which allowed them to have insights that they won’t normally have.
AIMed will be hosting our first ever AIMed Pediatric virtual event in association with the International Pediatric Endosurgery Group (IPEG) and the International Society for Pediatric Innovation (iSPI) between 10 and 11 November. Do not miss the event if you are interested in how technology, particularly, AI, robotics, virtual/augmented/mixed realities, and many others are influencing pediatric or will like to join in the discussions to explore how new technologies can be better introduce or deploy in the realm. Register your interest or get a copy of the agenda here today!