A prospective study tracking children in Sierra Leone has identified malaria, respiratory infections, and diarrhea as the three leading causes of hospitalization and death during the first two years of life. The findings, published in The Lancet Global Health, come from the ICARIA project, led by ISGlobal, a research center supported by the "la Caixa" Foundation.

The result carries weight because Sierra Leone continues to record one of the highest child mortality rates in the world, even after rolling out the main preventive strategies currently available for those conditions. The study underscores how much ground remains before childhood survival in the West African country approaches regional or global averages.

What did the ICARIA project track?

ICARIA followed children from birth through age two, recording every hospital admission and in-hospital death. Observing a cohort over time, rather than reviewing past records, gives researchers a clearer view of how often these illnesses send children to the hospital and how often those visits end in death.

The team focused on the three conditions that global health agencies have long treated as the main drivers of young-child mortality in low-income countries. Each can become life-threatening within hours when diagnosis and treatment arrive too late.