More than 16.8 lakh children below five years died of infectious but preventable diseases in India in 2010 and more than half of them could not complete the first month of their life, a new study has claimed.

Of the total deaths, 52 per cent or about 0.875 million were among the children who died in the first 28 days of their life, according to the study published in The Lancet on Thursday.

Pneumonia remained the leading killer, which accounted for 28.6 per cent of all deaths in children under five, followed by preterm birth complications (18.1 per cent) and diarrhoea (12.6 per cent), the study found.

India was also among the five countries that collectively accounted for 49.3 per cent (or 3.754 million) of 7.6 million children who died in the first 5 years of their life in 2010.

These countries — India, Nigeria, Democratic Republic of the Congo, Pakistan, and China — also accounted for half (2.4 million) of global deaths from infections and 53.3 per cent (1.636 million) of neonatal deaths.

“In the past decade, the country-specific under-five mortality rate reduced at an average rate of 2.6 per cent per annum, which is less than 4.4 per cent of the annual rate of decrease needed to reach Millennium Development Goal [MDG] 4,” said lead study author Robert Black of John Hopkins Bloomberg School of Public Health in the U.S.

“The attainment of MDG4 is possible only if life-saving maternal, newborn, and child health interventions are rapidly scaled up in high-burden regions and countries and across major causes in the next few years.”

For the study, the researchers used vital registration systems, household surveys, verbal autopsy, and multi-cause models to assess data for 193 countries.

The estimation for India was directly extracted from the Million Death Study with additional adjustments for selected causes, the authors said.

As per the Sample Registration System data 2009, about 17.4 lakh children are estimated to die before the age of five years, with a mortality rate of 66 per 1,000 live births. And about 55 per cent of the deaths were neonatal or deaths in the first 28 days of life.

In 2010, according to the study, a third of under five deaths occurred in southeast Asia and half in Africa.

A striking 73 per cent (2.6 million) of all child deaths in Africa were due to infectious causes, including 96 per cent of all deaths due to malaria and 90 per cent due to AIDS.

In comparison, neonatal causes were the leading cause of death (1.096 million deaths) in southeast Asia, they said.

They concluded: “Across all the previous and current rounds of causes of childhood death estimation, pneumonia and preterm birth complications consistently rank as the leading causes at the global level.

“Our trend analysis shows that accelerated reductions are needed in the two major causes and in the two high-burden regions to achieve MDG4 by 2015.”