Global Infections and Child Health









James P. Nataro, MD, PhD, MBA, Editor
At the Millennium Summit in 2000, world leaders articulated an ambitious agenda to reduce extreme poverty, improve child and maternal health, reduce gender disparities, and improve environmental sustainability. The framers proposed specific measureable goals that were to be met by the end of 2015. Examining the trajectory of these efforts over this 15-year span reveals impressive progress in some areas, with remaining large disparities. Among the successes include reduction of the number of people living in extreme poverty by an estimated 130 million, reduction of child mortalities from 103 deaths per thousand live births per year to 88, and improvement of life expectancy from 63 years to nearly 65 years globally. Child deaths from infection have also improved, as fewer children than ever succumb to malaria and diarrheal diseases. HIV diagnosis and therapy is now available in much of the world, and HIV itself could become a manageable chronic disease where resources are available.


In light of the relative success controlling infectious diseases, some have called for a redirection of emphasis toward noncommunicable diseases. While it is true that noncommunicable diseases are on the rise in developing countries, accounting for an increasing proportion of overall deaths since 1990, most children continue to succumb to infectious diseases, perinatal morbidity, and nutritional disorders. Moreover, a health economics focus on disability-adjusted-life-years-lost from death and disease continues to demonstrate that morbidity and mortality in children account for the greatest loss of productive years. Therefore, now and for the foreseeable future, it is appropriate to maintain a focus on our most vulnerable pediatric populations.


Beyond the social imperative of caring for populations in greatest need, the globalization of infectious disease has never been a greater threat. With growing penetration into hitherto remote areas and rapid transportation across the globe, the movement of infected individuals and the migration of infectious agents have become urgent threats. Experience in this decade with Ebola virus and Zika virus illustrates these principles. Migration of peoples is also occurring in dramatic fashion. Refugees now move from country to country and continent to continent with prodigious volume and speed. International adoption, clearly a blessing for a child in compromised circumstances, represents a challenge to a family and a health care provider in an industrialized setting.


With these considerations in mind, we focus this issue of the Pediatric Clinics of North America on global infections and child health. We present a consideration of the overall state of children’s health after the endpoint of the Millennium Development Goals. We also focus on specific infectious diseases that continue to afflict children in developing countries, and which can be seen by providers who treat adoptees, migrants, and travelers. We consider as well the global ecology of infectious diseases, including such agents as Zika virus and influenza, so as to provide an overall appreciation of the influence of infectious diseases on man and vice versa.


My thanks to the Pediatric Clinics of North America and the outstanding authors who have committed their time to this endeavor.


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  3. The Burden of Enteropathy and “Subclinical” Infections
  4. Influenza

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Oct 2, 2017 | Posted by in PEDIATRICS | Comments Off on Global Infections and Child Health

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