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7 and 3.1 in central rural areas and between 4.4 and 9.8 in western areas during the four study intervals. Acute respiratory infection (ARI) accounted for 71% of deaths, followed by diarrhea and septicemia. CONCLUSIONS IMR due to communicable disease remains a major public health issue. ARI is the leading cause of mortality, followed by diarrhea. A regional gap remains in the risk of infant exposure to communicable disease in rural China. More attention should be paid to western rural areas.BACKGROUND Evidence-based criteria for the tre