Chapter 13 - Children in need of special protection - Children's ...

534metropolitan region of the Western Cape had an IMR of 22.5 and 22.9 in 1998 and 1999respectively. 1613.2.3 MorbidityAvailable data on the extent and nature of morbidity and mortality are limited and partial. Theabsence of a comprehensive national health information system, coupled with inadequatereporting of notifiable diseases (particularly within the formerly independent homelands), posesproblems for an analysis of the health status of different groups according to region, age genderetc. It is possible, nevertheless, to draw some common inferences on the basis of occasionalsurveys.Poverty, poor primary health care and unhealthy living conditions are major factors causingillness and death. Many parasitic and infectious diseases, which are aggravated by poverty, arepreventable through immunisation, increased access to primary health care, improvements inliving conditions and improvements in income levels.The Department of Health currently maintains a register of notifiable diseases. Of these,infectious diseases were the most prevalent among African and Coloured children.Tuberculosis (TB) is one of the most common notifiable diseases in South Africa. The lack offirm diagnostic criteria for notification, however, suggests that there is a significant degree ofunder reporting. Tuberculosis rates are highest in rural areas and particularly amongst childrenin poor living conditions. Geographically, the incidence of TB is highest in the rural areas of theWestern Cape.Measles is a leading cause of child mortality and morbidity in South Africa, although, onceagain, it is likely that there is significant under reporting. Unvaccinated children between nineand twelve months are the most vulnerable. Both measles and tuberculosis are eminentlypreventable through systematic vaccination programmes.16 A Report on the state of the Nation’s Children: South Africa (2001) 73.