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SIDS and Developing Countries

I do not believe there is very good information in SIDS rates in developing vs. developed countries. The problem is that many less developed countries still have high infant mortality rates from identifiable causes of death, such as respiratory infections, malnutrition, and diarrhea. These are so much more common than SIDS, that public health officials are, appropriately, concerned about what they can do to decrease these largely preventable deaths. I suspect a number of SIDS deaths are included in these numbers. Many under developed countries state that SIDS is not a problem in their country. I think that should just be translated to "less of a problem" than the other causes. If they are not looking for SIDS, they won't see it.

A specific example: I had the opportunity to visit Japan last autumn, and to speak with their leading SIDS researcher, Professor Nishida, at the Women's Medical College in Tokyo. The SIDS rate in Japan has always been quoted to be quite low. However, he told me that the rate has "risen" as people have started to look more carefully for it. Autopsies are performed on only about 1/3 of potential SIDS in Japan. The SIDS rate has climbed to 0.5 per 1,000. However, if the Japanese do not think that SIDS is a problem, they will not make the diagnosis, especially in those infants who do not have an autopsy. Professor Nishida finds that the SIDS rate is comparable to North America in areas where it is being actively sought and autopsies are being performed.

I hope this helps. Thank you.

Tom Keens
Children's Hospital Los Angeles

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