In a review of published literature, the researchers found that the highest mortality rates following armed conflicts, natural disasters, population displacements or famines are often in children younger than five years. The most common causes of death are diarrhea, acute respiratory infections, measles, malaria and malnutrition; these are also the major causes of death in countries with high child mortality rates.

“The major causes of child mortality in complex emergencies are well known and we have learned how to manage these conditions in stable situations. However, conflict or disaster often exacerbates the magnitude and severity of these illnesses. What we need are simple, easy-to-use guidelines that are brought together in a single package for the different levels of health workers caring for children in complex emergencies,” said William J. Moss, MD, MPH, senior author of the study and an assistant professor in the Bloomberg School of Public Health’s Department of Epidemiology.

The researchers came to their conclusions after reviewing previously published literature and interviewing representatives from international relief organizations. They found that in emergency situations, most relief organizations use WHO, UNICEF and other ministry of health guidelines that are intended for stable environments. Few studies, however, have assessed how effective these interventions are in reducing child mortality in complex emergencies.

The guidelines should be brought together from existing clinical guidelines into an accessible and comprehensive package, according to the study authors. The guidelines should not only address issues such as how to treat patients when referral facilities are not accessible, but also fill some of the gaps in current treatment guidelines. The special needs of unaccompanied children and common mental health problems of all children also should be addressed.; Source: Johns Hopkins University Bloomberg School of Public Health