Articles 1970 1980 1990 2000 2010 (Continued from previous page) Caribbean Antigua and Barbuda 441(38-950-0) 302(255-35-9) 181(15-4-21-1) 23-2(202-27-0) 13-8(108-17-9) Barbados 715(65-9-77-7) 404(36.9-44-7) 264(23-6-294) 21-7(18-9-25-1) 106(8-1-13-7刀 Belize 127-6(109-6-1450) 78-0(71-0-85-9) 43-6(40-0-46-9) 31-0(287-34-1) 22-7(192-27-8) Cuba 38935-8-43-0) 23-3(21-6-25-3) 139(12-8-151) 8-6(7-9-94) 5-2(4-5-61) Dominica 631(58-6-68-0) 22-9(203-257) 24-1(213-26-6) 21-0(17.9-243) 16-5(12-5-215) Dominican Republic 1187(115-5-121-9) 84-4(824-86-5) 57-0(55-7-58.5) 38-3(37-1-394) 27-5(24-6-30-7) Grenada 80-0715-89-6) 45-0(391-52-0) 267(23-8-30-0) 21-6(183-24-9) 11-6(91-14-7 Guyana 72-0(67-4-76-6) 69-2(63-8-75-2) 61-0(57-2-64-6 46-8(43-9-49-9) 38-0(32.9-44-7刀 Haiti 229-6(2200-2409) 198-6(192-8-204-8) 149-2(1451-154-0) 998(95-9-103-3) 102-6(900-119-6) Jamaica 57-0(53-2-60-9) 45-0(42-4-48-1) 339(32-0-359) 254(23-5-27-2) 18-4(154-22-0) Saint Lucia 77-0713-84-0) 39-1(364-41-7刀 232(212-25-1) 164(149-184) 11-4(8-8-14-6) Saint Vincent and the 80-174-6-85-9) 601(55-8-65-1) 24-8(22.2-27-9) 24-0(21.6-26-8) 23-2(18-9-28-8) Grenadines Suriname 718(62-3-831) 60-5(56-565-0) 464(43-1-49-6) 43739-6-48-4) 35-5(28-5-43-7刀 The Bahamas 68-8(615-76-3) 49-9(457-544) 36-032-8-396) 183(16-3-21-0) 15-8(12-8-19-5) Trinidad and Tobago 51.6(48.8-54-4) 37-2(35-2-393) 30-2(281-32-4) 319(295-346) 25-4(204-31-4) Europe,central Albania 653(50-1-84-7) 42-5(38-3-47-3) 40-1(37-6-42-7刀 22-3(20-5-24-1) 15-1(12-1-19-0) Bosnia and Herzegovina 58.6(402-84-7刀 343(26-2-44-3) 17-716-9-18-7) 104(97-111) 7-9(62-98) Bulgaria 32.2(294-355) 239(21.9-260) 18.3(16-6-20-0) 17-4(15-9-19-0) 10-7(8-7-133) Croatia 40-8(29-7-56-2) 24-5(20-6-30-1) 13-4(12-8-14-0) 85(8-1-9-0) 5-4(47-6-2) Czech Republic 293(26-3-32-5) 21-1(195-22-9) 142(13-0-15-5) 74(67-83) 41(3-5-5-0) Hungary 38-0(34-3-41-5) 25-1(221-27-70 16-7(15-0-18-1) 10-2(93-113) 5-5(44-6-7八 Macedonia 59-6(413-86-4) 407(315-52.1) 26-2(23-6-28-9) 18-5(16-8-204) 11-8(93-15-0) Montenegro 82.6(56-2-119-0) 45-6(318-64-8) 25-1(18-5-34-1) 13-9(12-5-156) 947-7-11-8) Poland 365(36-0-369) 24-9(245-25-3 19-0(18-6-19-3) 96(93-99) 645-1-82) Romania 50-4(45-7-55-6) 36-3(32-5-408) 304(27-2-33-9) 22-2(20-0-24-8) 15-2(12-4-18-8) Serbia 37-7(26-0-546) 21-7(15-7-30-8) 127(9-6-16-6) 7-8(758-1) 4-0(3-5-4-6) Slovakia 31-9(30-8-33-0) 23-4(22-6-24-3) 14-2(135-14-9) 102(95-109) 6-6(5-1-8.6) Slovenia 42-6(31-5-579) 213(18-0-25-4) 10-6(99-113) 54(4959) 3-2(2-6-3-8) Europe,eastern Belarus 32-0(29-4-349) 27-5(25-5-29-7) 21-5(19-9-23-1) 169(15-7-18-1) 10-4(8-8-12-4) Estonia 23-6(21-8-25-8 21-8(20-0-23-8) 18-0(16-4-19-8) 11-0(99-12.1) 63(53-7-4) Latvia 232(213-25-3) 217(198-237) 173(157-19-0) 14-8(13-5-16-3) 9-57-7-113) Lithuania 24-9(23-8-26-0) 20-319-4-21.2) 14-4(13-7-15-2) 10-9(10-2-116) 6-8(57-7-9) Moldova 65-0(547-71) 56-2(51-6-615) 35133-0-37-6) 23-0(21-6-24-6) 13-7(11-7-16-1) Russia 354(32-0-391) 32-8(297-36-4) 26-7(237-297) 21.6(19-3-242) 145(12-0-17-3引 Ukraine 30-5(28-0-333) 29-2(27-2-31-3) 21-6(20-3-230) 19-7(18.6-20-9) 15-5(13-0-18.5) (Continues on next page) HIV-negative women.We have simulated the effect of Neonatal,postneonatal,and childhood death rates this range on our estimates in view of the types of We divided the estimates of under-5 mortality generated analytical methods we apply,and find that biases even by GPR into estimates of neonatal (the probability of in the presence of HIV seroprevalence of 20%range death before age 1 month),postneonatal(the probability from underestimation of ten per 1000 to overestimation of death before age 1 year conditional on surviving to age of six per 1000.Trends in the past 10-15 years are largely 1 month),and childhood (the probability of death from unaffected.Because of the enormous variation in the age 1 year to age 5 years)risks of death by use of a potential bias and,the further confounding of this two-step modelling process in which we first predicted association by scale-up of prevention of mother-to-child sex-specific under-5 mortality and then predicted the sex- transmission and antiretroviral drugs,we have opted to specific neonatal,postneonatal,and childhood risks of not apply any standard correction to the estimated rates death.We modelled the age breakdown by use of separate of child mortality. models for boys and girls because different levels of www.thelancet.com Vol 375 June 5,2010 1993Articles www.thelancet.com Vol 375 June 5, 2010 1993 HIV-negative women. We have simulated the eff ect of this range on our estimates in view of the types of analytical methods we apply, and fi nd that biases even in the presence of HIV seroprevalence of 20% range from underestimation of ten per 1000 to overestimation of six per 1000. Trends in the past 10–15 years are largely unaff ected. Because of the enormous variation in the potential bias and, the further confounding of this association by scale-up of prevention of mother-to-child transmission and antiretroviral drugs, we have opted to not apply any standard correction to the estimated rates of child mortality. Neonatal, postneonatal, and childhood death rates We divided the estimates of under-5 mortality generated by GPR into estimates of neonatal (the probability of death before age 1 month), postneonatal (the probability of death before age 1 year conditional on surviving to age 1 month), and childhood (the probability of death from age 1 year to age 5 years) risks of death by use of a two-step modelling process in which we fi rst predicted sex-specifi c under-5 mortality and then predicted the sex￾specifi c neonatal, postneonatal, and childhood risks of death. We modelled the age breakdown by use of separate models for boys and girls because diff erent levels of 1970 1980 1990 2000 2010 (Continued from previous page) Caribbean Antigua and Barbuda 44·1 (38·9–50·0) 30·2 (25·5–35·9) 18·1 (15·4–21·1) 23·2 (20·2–27·0) 13·8 (10·8–17·9) Barbados 71·5 (65·9–77·7) 40·4 (36·9–44·7) 26·4 (23·6–29·4) 21·7 (18·9–25·1) 10·6 (8·1–13·7) Belize 127·6 (109·6–145·0) 78·0 (71·0–85·9) 43·6 (40·0–46·9) 31·0 (28·7–34·1) 22·7 (19·2–27·8) Cuba 38·9 (35·8–43·0) 23·3 (21·6–25·3) 13·9 (12·8–15·1) 8·6 (7·9–9·4) 5·2 (4·5–6·1) Dominica 63·1 (58·6–68·0) 22·9 (20·3–25·7) 24·1 (21·3–26·6) 21·0 (17·9–24·3) 16·5 (12·5–21·5) Dominican Republic 118·7 (115·5–121·9) 84·4 (82·4–86·5) 57·0 (55·7–58·5) 38·3 (37·1–39·4) 27·5 (24·6–30·7) Grenada 80·0 (71·5–89·6) 45·0 (39·1–52·0) 26·7 (23·8–30·0) 21·6 (18·3–24·9) 11·6 (9·1–14·7) Guyana 72·0 (67·4–76·6) 69·2 (63·8–75·2) 61·0 (57·2–64·6) 46·8 (43·9–49·9) 38·0 (32·9–44·7) Haiti 229·6 (220·0–240·9) 198·6 (192·8–204·8) 149·2 (145·1–154·0) 99·8 (95·9–103·3) 102·6 (90·0–119·6) Jamaica 57·0 (53·2–60·9) 45·0 (42·4–48·1) 33·9 (32·0–35·9) 25·4 (23·5–27·2) 18·4 (15·4–22·0) Saint Lucia 77·0 (71·3–84·0) 39·1 (36·4–41·7) 23·2 (21·2–25·1) 16·4 (14·9–18·4) 11·4 (8·8–14·6) Saint Vincent and the Grenadines 80·1 (74·6–85·9) 60·1 (55·8–65·1) 24·8 (22·2–27·9) 24·0 (21·6–26·8) 23·2 (18·9–28·8) Suriname 71·8 (62·3–83·1) 60·5 (56·5–65·0) 46·4 (43·1–49·6) 43·7 (39·6–48·4) 35·5 (28·5–43·7) The Bahamas 68·8 (61·5–76·3) 49·9 (45·7–54·4) 36·0 (32·8–39·6) 18·3 (16·3–21·0) 15·8 (12·8–19·5) Trinidad and Tobago 51·6 (48·8–54·4) 37·2 (35·2–39·3) 30·2 (28·1–32·4) 31·9 (29·5–34·6) 25·4 (20·4–31·4) Europe, central Albania 65·3 (50·1–84·7) 42·5 (38·3–47·3) 40·1 (37·6–42·7) 22·3 (20·5–24·1) 15·1 (12·1–19·0) Bosnia and Herzegovina 58·6 (40·2–84·7) 34·3 (26·2–44·3) 17·7 (16·9–18·7) 10·4 (9·7–11·1) 7·9 (6·2–9·8) Bulgaria 32·2 (29·4–35·5) 23·9 (21·9–26·0) 18·3 (16·6–20·0) 17·4 (15·9–19·0) 10·7 (8·7–13·3) Croatia 40·8 (29·7–56·2) 24·5 (20·6–30·1) 13·4 (12·8–14·0) 8·5 (8·1–9·0) 5·4 (4·7–6·2) Czech Republic 29·3 (26·3–32·5) 21·1 (19·5–22·9) 14·2 (13·0–15·5) 7·4 (6·7–8·3) 4·1 (3·5–5·0) Hungary 38·0 (34·3–41·5) 25·1 (22·1–27·7) 16·7 (15·0–18·1) 10·2 (9·3–11·3) 5·5 (4·4–6·7) Macedonia 59·6 (41·3–86·4) 40·7 (31·5–52·1) 26·2 (23·6–28·9) 18·5 (16·8–20·4) 11·8 (9·3–15·0) Montenegro 82·6 (56·2–119·0) 45·6 (31·8–64·8) 25·1 (18·5–34·1) 13·9 (12·5–15·6) 9·4 (7·7–11·8) Poland 36·5 (36·0–36·9) 24·9 (24·5–25·3) 19·0 (18·6–19·3) 9·6 (9·3–9·9) 6·4 (5·1–8·2) Romania 50·4 (45·7–55·6) 36·3 (32·5–40·8) 30·4 (27·2–33·9) 22·2 (20·0–24·8) 15·2 (12·4–18·8) Serbia 37·7 (26·0–54·6) 21·7 (15·7–30·8) 12·7 (9·6–16·6) 7·8 (7·5–8·1) 4·0 (3·5–4·6) Slovakia 31·9 (30·8–33·0) 23·4 (22·6–24·3) 14·2 (13·5–14·9) 10·2 (9·5–10·9) 6·6 (5·1–8·6) Slovenia 42·6 (31·5–57·9) 21·3 (18·0–25·4) 10·6 (9·9–11·3) 5·4 (4·9–5·9) 3·2 (2·6–3·8) Europe, eastern Belarus 32·0 (29·4–34·9) 27·5 (25·5–29·7) 21·5 (19·9–23·1) 16·9 (15·7–18·1) 10·4 (8·8–12·4) Estonia 23·6 (21·8–25·8) 21·8 (20·0–23·8) 18·0 (16·4–19·8) 11·0 (9·9–12·1) 6·3 (5·3–7·4) Latvia 23·2 (21·3–25·3) 21·7 (19·8–23·7) 17·3 (15·7–19·0) 14·8 (13·5–16·3) 9·5 (7·7–11·3) Lithuania 24·9 (23·8–26·0) 20·3 (19·4–21·2) 14·4 (13·7–15·2) 10·9 (10·2–11·6) 6·8 (5·7–7·9) Moldova 65·0 (54·7–77·1) 56·2 (51·6–61·5) 35·1 (33·0–37·6) 23·0 (21·6–24·6) 13·7 (11·7–16·1) Russia 35·4 (32·0–39·1) 32·8 (29·7–36·4) 26·7 (23·7–29·7) 21·6 (19·3–24·2) 14·5 (12·0–17·3) Ukraine 30·5 (28·0–33·3) 29·2 (27·2–31·3) 21·6 (20·3–23·0) 19·7 (18·6–20·9) 15·5 (13·0–18·5) (Continues on next page)