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Epidemiology of mortality induced by acute respiratory infections in infants and children under the age of 5 years and its relationship with the Human Development Index in Asia: an updated ecological study

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Acute respiratory infection (ARI) is the most commonly reported disease in children. This study was conducted to investigate the epidemiology of mortality from ARI and its relationship with the Human Development Index (HDI) in children under the age of 5 years.

Subjects and methods

The study data included the HDI, neonatal mortality rates, and the mortality of children under the age of 5 years due to ARIs retrieved from the World Bank. In this study, the bivariate correlation method was employed and a significance level of less than 0.05 was considered.


The mortality of children under the age of 5 years (r = − 0.784, p < 0.0001) and neonatal death (r = − 0.792, p < 0.0001) induced by ARIs was negatively correlated with the HDI. There was also a significant negative correlation between neonatal death caused by ARIs and gross national income (GNI) per capita per 1000 lives (r = − 0.453, p < 0.001), mean years of schooling (r = − 0.645, p < 0.001), life expectancy at birth (r = − 0.801, p < 0.001), and expected years of schooling (r = − 0.736, p < 0.001). A negative and significant correlation was also observed between the ARI-induced mortality of children under the age of 5 years and GNI per capita per 1000 lives (r = − 0.469, p < 0.001), mean years of schooling (r = − 0.619, p < 0.001), life expectancy at birth (r = − 0.771, p < 0.001), and expected years of schooling (r = − 0.756, p < 0.01).


The components of the HDI are directly related to ARI deaths. Therefore, a careful analysis of these indicators in countries with a low HDI can be effective in promoting health and reducing ARI-related mortality in children.

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Correspondence to Zaher Khazaei.

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Goodarzi, E., Sohrabivafa, M., Darvishi, I. et al. Epidemiology of mortality induced by acute respiratory infections in infants and children under the age of 5 years and its relationship with the Human Development Index in Asia: an updated ecological study. J Public Health (Berl.) (2020). https://doi.org/10.1007/s10389-020-01195-1

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  • Mortality
  • Acute respiratory infections
  • Children
  • Human Development Index