782 results on '"CHILD mortality"'
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2. Pesti siji marga sewu: children may die for a thousand reasons.
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Rienks AS
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- Adolescent, Age Factors, Asia, Asia, Southeastern, Behavior, Delivery of Health Care, Demography, Developing Countries, Disease, Health Services, Indonesia, Population, Population Characteristics, Population Dynamics, Child Welfare, Health, Infant, Infant Mortality, Medicine, Morbidity, Mortality, Psychology, Social Change
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3. Implication of the 2014 World Health Organization Integrated Management of Childhood Illness Pneumonia Guidelines with and without pulse oximetry use in Malawi: A retrospective cohort study [version 2; peer review: 2 approved]
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Tisungane Mvalo, Eric D. McCollum, Charles Makwenda, Norman Lufesi, Carina King, Tim Colbourn, and Shubhada Hooli
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infant ,child ,pneumonia ,child mortality ,oximetry ,Malawi ,eng ,Medicine - Abstract
Background Under-5 pneumonia mortality remains high in low-income countries. In 2014 the World Health Organization (WHO) advised that children with chest indrawing pneumonia, but without danger signs or peripheral oxygen saturation (SpO2) < 90% be treated in the community, rather than hospitalized. In Malawi there is limited pulse oximetry availability. Methods Secondary analysis of 13,413 under-5 pneumonia cases in Malawi. Pneumonia associated case fatality ratios (CFR) were calculated by disease severity under the assumptions of the 2005 and 2014 WHO Integrated Management of Childhood Illness (IMCI) guidelines, with and without pulse oximetry. We investigated if pulse oximetry readings were missing not at random (MNAR). Results The CFR of patients classified as having non-severe pneumonia per the 2014 IMCI guidelines doubled under the assumption that pulse oximetry was not available (1.5% without pulse oximetry vs 0.7% with pulse oximetry, P
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- 2023
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4. Determinants of neonatal, infant and under-five mortalities: evidence from a developing country, Bangladesh.
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Murad, Md Wahid, Abdullah, A. B. M., Islam, Md Mazharul, Alam, Md Mahmudul, Reaiche, Carmen, and Boyle, Stephen
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INFANT mortality , *CHILD mortality , *MEDICAL care costs , *MEDICAL personnel ,DEVELOPING countries - Abstract
We investigated the macroeconomic determinants of neonatal, infant, and under-five mortalities in Bangladesh for the period 1991–2018 and discuss implications of the United Nations' Sustainable Development Goal 3 (SDG 3) and Millennium Development Goal 4 (MDG 4) for developing countries. We used annual time series data and the econometric techniques of Fully Modified Ordinary Least Squares (FMOLS) and Dynamic Ordinary Least Squares (DOLS) regressions for analysis. Determinants most effective in combating neonatal, infant, and under-five mortalities include variables such as 'protecting newborns against tetanus', 'increasing healthcare expenditure', and 'making sure births are attended by skilled healthcare staff'. Employing more healthcare workers and assuring more and improved healthcare provisions can further reduce the neonatal, infant, and under-five mortalities. Developing countries with similar macroeconomic profiles can achieve similar SDG 3 and MDG 4 outcomes by emulating the policies and strategies Bangladesh applied to reducing child mortalities over the last three decades. [ABSTRACT FROM AUTHOR]
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- 2023
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5. National data linkage assessment of live births and deaths in Mexico: Estimating under‐five mortality rate ratios for vulnerable newborns and trends from 2008 to 2019.
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Suárez‐Idueta, Lorena, Pita, Robespierre, Blencowe, Hannah, Barranco, Arturo, Gonzalez, Jesus F., Paixao, Enny S., Barreto, Mauricio L., Lawn, Joy E., and Ohuma, Eric O.
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COVID-19 , *DEATH rate , *CHILD mortality , *RECEIVER operating characteristic curves , *NEWBORN infants , *SERVER farms (Computer network management) - Abstract
Background: Linked datasets that enable longitudinal assessments are scarce in low and middle‐income countries. Objectives: We aimed to assess the linkage of administrative databases of live births and under‐five child deaths to explore mortality and trends for preterm, small (SGA) and large for gestational age (LGA) in Mexico. Methods: We linked individual‐level datasets collected by National statistics from 2008 to 2019. Linkage was performed based on agreement on birthday, sex, residential address. We used the Centre for Data and Knowledge Integration for Health software to identify the best candidate pairs based on similarity. Accuracy was assessed by calculating the area under the receiver operating characteristic curve. We evaluated completeness by comparing the number of linked records with reported deaths. We described the percentage of linked records by baseline characteristics to identify potential bias. Using the linked dataset, we calculated mortality rate ratios (RR) in neonatal, infants, and children under‐five according to gestational age, birthweight, and size. Results: For the period 2008–2019, a total of 24,955,172 live births and 321,165 under‐five deaths were available for linkage. We excluded 1,539,046 records (6.2%) with missing or implausible values. We succesfully linked 231,765 deaths (72.2%: range 57.1% in 2009 and 84.3% in 2011). The rate of neonatal mortality was higher for preterm compared with term (RR 3.83, 95% confidence interval, [CI] 3.78, 3.88) and for SGA compared with appropriate for gestational age (AGA) (RR 1.22 95% CI, 1.19, 1.24). Births at <28 weeks had the highest mortality (RR 35.92, 95% CI, 34.97, 36.88). LGA had no additional risk vs AGA among children under five (RR 0.92, 95% CI, 0.90, 0.93). Conclusions: We demonstrated the utility of linked data to understand neonatal vulnerability and child mortality. We created a linked dataset that would be a valuable resource for future population‐based research. [ABSTRACT FROM AUTHOR]
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- 2023
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6. The Impact of Early Enteral Nutrition on Post-operative Hospital Stay and Complications in Infants Undergoing Congenital Cardiac Surgery: A Systematic Review and Meta-analysis.
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Dhiraaj, Sanjay, Thimmappa, Latha, Issac, Alwin, Halemani, Kurvatteppa, Mishra, Prabhaker, and Mavinatop, Anusha
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ENTERAL feeding , *ARTIFICIAL respiration , *CARDIAC surgery , *CHILD mortality , *CONGENITAL heart disease , *INFANTS , *INTENSIVE care units - Abstract
Introduction: The congenital cardiac diseases (CHDs) are the leading cause of death in children. The CHDs detection and management have greatly improved over the past few decades. This review aimed to assess the effectiveness of early enteral nutrition (EEN) on postoperative outcomes in infants undergoing congenital cardiac surgery. Methods: Electronic databases PubMed, Clinical Key, UpToDate, the Cochrane Library, and Google Scholar were searched for studies published in the English language, between 2004 and 2021. This review carried out based on PRISMA statement and studies qualities assessed using "Downs and Black score". Hospital stay, intensive care unit (ICU) stay, mechanical ventilation support, aortic cross clamping and cardiopulmonary bypass were as primary outcomes. Similarly infections, vomiting and mortality were as secondary outcomes of included studies. Results: This review consists of 887 infants from 10 studies. Of these, 470 infants were assigned to the intervention group and 417 to the control group. The post-operative hospital stay shorted in the EEN group than the control group (SMD = -0.63, 95% CI: -1.03 to -0.22, P = 0.0, I2 = 87%). Similarly, EEN group lessen the ICU stay (SMD = -0.15, 95% CI: -0.42, 0.11, P = 0.0, I2 = 71%), mechanical ventilation support (SMD = -0.31, 95% CI: -0.51, -08, P = 0.08, I2 = 47%), aortic cross clamping (SMD = -0.92, 95% CI: -0.31, 2.4, P = 0.00, I2 = 96%), and cardiopulmonary bypass (SMD = -0.0, 95% CI: -0.42 to 43, P = 0.00, I2 = 71%). Secondary postoperative complications such as infections (RR = 0.68, 95% CI: 0.43 to 1.08, P = 0.40, I2 = 3%). vomiting (RR = 1.47, 95% CI: 0.80 to 2.69, P = 0.90, I2 = 0%) and postoperative mortality (RR = 0.42, 95% CI: 0.03 to 5.82, P = 0.00: I2 = 80%) significantly reduced. Conclusion: Postoperative outcomes were improved in the intervention group compared to the control group, including shorter hospital stays, ICU stays, mechanical ventilation, and less postoperative complications. [ABSTRACT FROM AUTHOR]
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- 2023
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7. Modelling the impact of maternal pneumococcal vaccination on infant pneumococcal disease in low-income settings.
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Bilgin, Gizem M., Lokuge, Kamalini, and Glass, Kathryn
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PNEUMOCOCCAL vaccines , *INFANT diseases , *CHILD mortality , *MATERNAL age - Abstract
Pneumococcal disease is a leading cause of mortality in young children. The largest burden of pneumococcal disease is in the first six months of life before protection from a complete schedule of direct immunisation is possible. Maternal pneumococcal vaccination has been proposed as a strategy for protection in this period of early childhood; however, limited clinical trial data exists. In this study, we developed an age-structured compartmental mathematical model to estimate the impact of maternal pneumococcal vaccination. Our model demonstrates how maternal pneumococcal vaccination could prevent 73% (range 49–88%) of cases in those aged <1 month and 55% (range 36–66%) in those 1–2 months old. This translates to an estimated 17% reduction in deaths due to invasive pneumococcal disease in children under five. Overall, this study demonstrates the potential for maternal pneumococcal vaccination to meaningfully reduce the burden of infant pneumococcal disease, supporting the case for appropriate field-based clinical studies. [ABSTRACT FROM AUTHOR]
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- 2022
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8. Child mortality of twins and singletons among late preterm and term birth: a study of national linked birth and under-five mortality data of Korea.
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Kim, Young Shin, Kang, Minku, Choe, Young June, Sung, Joohon, Lee, Ji Yeon, and Choe, Seung-Ah
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CHILD mortality , *NEWBORN infants , *TWINS , *PREGNANCY , *GESTATIONAL age - Abstract
Twins involve a higher risk of perinatal complications compared to singletons. We compared the risk of under five mortality between twins and singletons among late preterm and term births. The national birth data of South Korea pertaining to the years 2010–2014 linked with the mortality record of children aged under 5 years in 2010–2019 was analyzed. The final study population was 2,199,632 singletons and 62,351 twins. We conducted a survival analysis of under-five mortality with adjustment for neonatal and familial factors. Overall under-five mortality rates during the study period were 3.6 and 2.0 for twins and singletons, respectively. Although the unadjusted overall under-five mortality was higher in twins (hazard ratio [HR] = 1.80, 95% confidence interval [CI]: 1.57, 2.06, overall risk), twin birth was associated with comparable or lower risk (HR = 0.70, 95% CI: 0.58, 0.85, overall; 0.70, 95% CI: 0.56, 0.87, excluding neonatal mortality; 0.59, 95% CI: 0.40, 0.86, excluding infant mortality) after controlling for both neonatal and familial factors. Twins born at a gestational age of 34–35 weeks showed a generally lower risk of under-five mortality than their singleton counterparts, regardless of model specification. Conclusion: Among late preterm and term birth, under-5-year mortalities for twins were lower than singleton births when adjusted for neonatal and familial risk factors. This highlights the differential implication of gestational age at birth between twin and singleton in the child mortality. What is Known: • Twin births involve a higher risk of perinatal complications compared to singletons. What is New: • Among late preterm and term birth, twins showed lower under-5-year mortalities than singleton births when adjusted for neonatal and familial risk factors. • Birth at 34–35 weeks of gestation implicates different prognosis between twin and singleton in the child mortality. [ABSTRACT FROM AUTHOR]
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- 2022
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9. Post-Traumatic Growth in Parents following Their Child's Death in a Pediatric Intensive Care Unit.
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Suttle, Markita, Hall, Mark W., Pollack, Murray M., Berg, Robert A., McQuillen, Patrick S., Mourani, Peter M., Sapru, Anil, Carcillo, Joseph A., Startup, Emily, Holubkov, Richard, Notterman, Daniel A., Colville, Gillian, Meert, Kathleen L., Coleman, Whit, Dorton, Stephanie, Abdelsamad, Nael, Arbogast, Kylee, Flick, Kristi, Pawluszka, Ann, and Lulic, Melanie
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PARENT attitudes , *INTENSIVE care units , *GRIEF , *PEDIATRICS , *POST-traumatic stress disorder , *SURVEYS , *QUESTIONNAIRES , *MENTAL depression , *POSTTRAUMATIC growth , *CHILD mortality , *PARENTS , *LONGITUDINAL method , *BEREAVEMENT , *EDUCATIONAL attainment - Abstract
Background: Although bereaved parents suffer greatly, some may experience positive change referred to as post-traumatic growth. Objective: Explore the extent to which parents perceive post-traumatic growth after their child's death in a pediatric intensive care unit (PICU), and associated factors. Design: Longitudinal parent survey conducted 6 and 13 months after a child's death. Surveys included the Post-traumatic Growth Inventory-Short Form (PTGI-SF), a 10-item measure with range of 0–50 where higher scores indicate more post-traumatic growth. Surveys also included the Inventory of Complicated Grief (ICG), the Patient Health Questionnaire-8 (PHQ-8) for depression, the Short Post-Traumatic Stress Disorder Rating Interview (SPRINT), a single item on perceived overall health, and sociodemographics. Setting/Subjects: One hundred fifty-seven parents of 104 children who died in 1 of 8 PICUs affiliated with the U.S. Collaborative Pediatric Critical Care Research Network. Results: Of participating parents, 62.4% were female, 71.6% White, 82.7% married, and 89.2% had at least a high school education. Mean PTGI-SF scores were 27.5 ± 12.52 (range 5–50) at 6 months and 28.6 ± 11.52 (range 2–49) at 13 months (p = 0.181). On multivariate modeling, higher education (compared with those not completing high school) and higher 6-month ICG scores (reflecting more complicated grief symptoms) were associated with lower 13-month PTGI-SF scores (p = 0.005 and 0.033, respectively). Conclusion: Parents bereaved by their child's PICU death perceive a moderate degree of post-traumatic growth in the first 13 months after the death however variability is wide. Education level and complicated grief symptoms may influence parents' perception of post-traumatic growth. [ABSTRACT FROM AUTHOR]
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- 2022
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10. Pro12Ala polymorphism of peroxisome proliferator activated receptor gamma 2 may be associated with adverse neurodevelopment in European preterm babies.
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Victor, Suresh, Chew, Andrew, and Falconer, Shona
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PREMATURE infants , *CHILD mortality , *NEURAL development , *PEROXISOME proliferator-activated receptors , *GENDER - Abstract
Introduction: Prematurity is the leading cause of death and disability in children under 5 years of age. Understanding the molecular mechanisms of the biological processes involved in preterm brain injury may help develop novel neuroprotective treatment strategies. A growing body of evidence suggest that peroxisome proliferator‐activated receptor gamma (PPARγ) signaling is associated with inhibited brain development in preterm babies. The Ala allele of the Pro12Ala polymorphism of PPARγ2 decreases receptor binding affinity and consequently induces a reduction of PPARγ signaling. Methods: In this study, we carried out a preliminary analysis of existing datasets to test the hypothesis that reduced transactivation capacity of PPARγ in the presence of the Ala variant of PPARγ2 may be associated with adverse neurodevelopment in preterm babies. The association between PPAR‐γ2 Pro12Ala polymorphism and neurodevelopment at 18–24 months of age was assessed in two groups of European infants, 155 born before 33 weeks' gestation and 180 born later than 36 weeks' gestation using a linear regression model. The Bayley Scales of Infant and Toddler Development–3rd edition was administered to assess neurodevelopment at 18–24 months of age. Results: We observed the Ala allele of the Pro12Ala polymorphism in 25% preterm infants and 20% term infants. The Ala allele of PPARγ2 was significantly associated with adverse cognitive (p =.019), language (p =.03), and motor development (p = 0.036) at 18–24 months of age after taking into consideration the duration of ventilation, gender, and index of multiple deprivation scores, but without correction for potential shared ancestry. There was no association between the PPAR‐γ2 Pro12Ala polymorphism and neurodevelopment in term infants. Conclusions: These preliminary data suggest that PPARγ signaling in the presence of the Ala variant of PPARγ2 may be associated with adverse neurodevelopment in preterm infants suggesting that further studies are warranted. There are multiple definitions of hyposmia in Parkinson's disease (PD), and subtle differences between them can lead to different and often non‐comparable results. To illustrate the need for a standardised definition of hyposmia in PD, that would adjust for age and gender and account for the background decline in olfactory performance with ageing, this paper compares four published definitions of hyposmia, demonstrating the effect of each definition on the research outcomes when applied to the same cohort. [ABSTRACT FROM AUTHOR]
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- 2021
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11. Income-based inequality in full immunization coverage of children aged 12-23 months in Eastern India: A decomposition analysis
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Shantanu Sharma, Sonali Maheshwari, Ajit Kumar Jaiswal, and Sunil Mehra
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Child mortality ,Infant ,Vaccination ,Vaccine preventable diseases ,Public aspects of medicine ,RA1-1270 - Abstract
Introduction: Notably, less than two-thirds of under-5 children received full immunization in 2016 in India. It is critical to understand the inequalities in access to immunization for determining an effective health policy agenda to ensure universal health coverage. Hence, we performed a study to assess the determinants of income-based inequality in the full immunization of children aged 12–23 using Fairlie decomposition analysis. Methods: This cross-sectional study was a part of a community-based project that aimed to improve maternal and child health in the backward states of India, namely Bihar and Assam. The study was conducted in the rural and urban areas of Munger and Darrang districts of Bihar and Assam, respectively. The degree of income-related inequality in full immunization coverage was obtained through the concentration index. The Fairlie decomposition was employed to quantify the absolute contribution of socio-demographic factors explaining the group differences (higher or lower income) in the probability of having full immunization. Results: There were 73 fully and 82 non-fully immunized children. The concentration curve was lying above the line of equality, which implied that full immunization coverage was concentrated towards the lower-income group. Maternal education (7.5%) and place of residence (5.1%) widened the inequality gap, and caste (−13.5%) and age of the child (−2.5%) narrowed down the inequality gap for full immunization among lower and higher-income groups. Conclusions: The socio-economic inequalities in access to full immunization can be mitigated by multi-sectoral interventions with a focus on children with less-educated mothers and living in urban slums.
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- 2021
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12. Mothers' Perspectives of Complementary Feeding Practices in an Urban Informal Settlement in Kisumu County, Western Kenya.
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Reynolds, Elise C, Onyango, Dickens, Mwando, Rael, Oele, Elizabeth, Misore, Thomas, Agaya, Janet, Otieno, Peter, Tippett Barr, Beth A, Lee, Gwenyth O, and Akelo, Victor
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SQUATTER settlements , *SOCIAL services , *COMMUNITY health workers , *CHILD mortality , *MOTHERS , *INFRASTRUCTURE (Economics) - Abstract
Background In informal settlements, the benefits of urban dwelling are diminished by conditions of poverty that exacerbate child undernutrition. The Child Health and Mortality Prevention Surveillance (CHAMPS) project has identified malnutrition as the leading underlying cause of death in children under 5 in the Manyatta urban informal settlement in Kisumu County, Kenya. Objective This qualitative study, nested within the CHAMPS project, aimed to understand community perspectives on complementary feeding practices in this settlement. Methods In-depth interviews were conducted with 20 mothers who lived in the urban informal settlement and had a child 6–23 months old. Two focus group discussions were conducted, 1 with mothers and 1 with community health workers (CHWs), to further explore themes related to complementary feeding. Results Mothers were knowledgeable about globally recommended feeding practices, but such practices were often not implemented due to 1) the community/household water and sanitation environment, 2) the community/household food environment, 3) a lack of income and employment opportunities for women, and 4) sociocultural factors. Together, these create an environment that is not conducive to optimal child feeding practices. Conclusions To improve complementary feeding practices and child nutritional outcomes in Kenya's informal urban settings, both community- and individual-level factors should be addressed. Possible interventions include investment in water infrastructure and social protection programs, such as cash transfers. [ABSTRACT FROM AUTHOR]
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- 2021
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13. Neonatal deaths in Cambodia: findings from a community-based mortality review
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A. N. Bazzano, C. Var, D. Wilkosz, R. Duggal, and R. A. Oberhelman
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Infant ,Newborn ,Cambodia ,Child mortality ,Perinatal mortality ,Health services ,Medicine ,Biology (General) ,QH301-705.5 ,Science (General) ,Q1-390 - Abstract
Abstract Objectives The aim of this study was to describe potential factors contributing to neonatal mortality in Takeo, Cambodia through assessment of verbal autopsies collected following newborn deaths in the community. The mortality review was nested within a trial of a behavioral intervention to improve newborn survival, and was conducted after the close of the trial, within the study setting. The World Health Organization standardized definition of neonatal mortality was employed, and two pediatricians independently reviewed data collected from each event to assign a cause of death. Results Thirteen newborn deaths of infants born in health facilities participating in a community based, behavioral intervention were reported during February 2015–November 2016. Ten deaths (76.92%) were early neonatal deaths, two (15.38%) were late neonatal deaths, and one was a stillbirth. Five out of 13 deaths (38.46%) occurred within the first day of life. The largest single contributor to mortality was neonatal sepsis; six of 13 deaths (46.15%) were attributed to some form of sepsis. Twenty-three percent of deaths were attributed to asphyxia. The study highlights the continuing need to improve quality of care and infection prevention and control, and to fully address causes of sepsis, in order to effectively reduce mortality in the newborn period.
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- 2019
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14. Prevalence and Correlates of Cryptosporidium Infections in Kenyan Children With Diarrhea and Their Primary Caregivers.
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Deichsel, Emily L, Hillesland, Heidi K, Gilchrist, Carol A, Naulikha, Jaqueline M, McGrath, Christine J, Voorhis, Wesley C Van, Rwigi, Doreen, Singa, Benson O, Walson, Judd L, and Pavlinac, Patricia B
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CRYPTOSPORIDIOSIS , *CAREGIVERS , *DIARRHEA , *POLYMERASE chain reaction , *CHILD mortality , *MILK allergy - Abstract
Background Cryptosporidium is a leading cause of diarrhea in Sub-Saharan Africa and is associated with substantial morbidity and mortality in young children. Methods We analyzed data from children aged 6–71 months presenting to 2 public hospitals in Western Kenya with acute diarrhea and their primary caregivers, including detection of Cryptosporidium by quantitative polymerase chain reaction (PCR) and immunoassay analysis in stool samples from both children and their caregivers. Associations between potential transmission sources and child/caregiver Cryptosporidium infection were evaluated using prevalence ratios (PRs). Secondary analyses evaluated host and clinical risk factors of child/caregiver Cryptosporidium infection. Results Among 243 child–caregiver pairs enrolled, 77 children (32%) and 57 caregivers (23%) had Cryptosporidium identified by either immunoassay or PCR. Twenty-six of the 243 child–caregiver pairs (11%) had concordant detection of Cryptosporidium. Cryptosporidium infection in children was associated with detection of Cryptosporidium in caregivers (adjusted PR [aPR], 1.8; 95% CI, 1.2 to 2.6; P = .002) and unprotected water source (aPR, 2.0; 95% CI, 1.3 to 3.2; P = .003). Risk factors for Cryptosporidium detection in caregivers included child Cryptosporidium infection (aPR, 2.0; 95% CI, 1.3 to 3.0; P = .002) as well as cow (aPR, 3.1; 95% CI, 1.4 to 7.0; P = .02) and other livestock ownership (aPR, 2.6; 95% CI, 1.1 to 6.3; P = .03) vs no livestock ownership. Recent diarrhea in caregivers and children was independently associated with child and caregiver Cryptosporidium infections, respectively. Conclusions Our results are consistent with the hypothesis that Cryptosporidium transmission can occur directly between child–caregiver dyads as well as through other pathways involving water and livestock. Additional research into caregivers as a source of childhood Cryptosporidium infection is warranted. [ABSTRACT FROM AUTHOR]
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- 2020
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15. Prospective Analytical Study of Burn Deaths in Infant and Children Below 6 Year.
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Dewangan, Tikendra, Ramteke, Rajesh Babulalji, Patani, Kalpesh C., Nagrale, Ninad, and Nagpure, Shailesh
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CHILD death ,BURNS & scalds ,LONGITUDINAL method ,SURGICAL dressings ,FORENSIC toxicology ,BIOLOGICAL dressings ,CHILD mortality - Abstract
Introduction: Burn injury is not only leading health problem in adult but it also cause significant mortality and morbidity in children.Burns can be devastating injuries for children, the immediate effect of which is compounded by ongoing pain, cosmetic and physical disfigurement, impairment, multiple dressing changes and surgical procedures. This prospective analytical study was planned to study the pattern of burn deaths in infant and children. Material and Method: This Study was carried out in department of forensic medicine and Toxicology, B.J. Medical College, Ahmedabad over the period of 2 year during which 30 cases were studied and analysed. Data was maintained using Microsoft Office Excel and analysed suing test of proportions. Result: Out of 30 cases studied during this period 18 (60%) cases were males and rest 12 (40%) were females. Most common type of burn was scald in 25 (83%) of cases, followed by electrocution in 3 (10%) cases and most common cause of death was septicaemia in 70% of cases followed by shock due to burns in 6 (20%) cases. Conclusion: Burn injuries caused to them are because of their curiosity and innocent nature and unable to understand the extent of damage that will be cause by it. As these injuries are accidental and mostly occur in home, they are preventable. [ABSTRACT FROM AUTHOR]
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- 2020
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16. Diagnosis and treatment of infantile malignant solid tumors in beijing, China: A multicenter 10‐year retrospective study.
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Jin, Mei, Tian, Zhi, Xie, Yao, Zhang, Zhaoxia, Li, Miao, Yu, Yaxiong, Zhang, Weiling, Zhao, Junyang, Wang, Huanmin, Zeng, Qi, Li, Long, Ge, Ming, Sun, Ning, Zhang, Xiaolun, Gong, Jian, Wu, Wanshui, Liu, Rong, Zhao, Weihong, Huang, Dongsheng, and Ma, Xiaoli
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NEUROBLASTOMA ,CANCER ,SARCOMA ,CENTRAL nervous system tumors ,CHILD mortality ,TERATOCARCINOMA - Abstract
Importance: Cancer is the main cause of death by disease in children. Children experience the highest incidence of cancer in the first year of life. However, there is no comprehensive registration system for children with tumors in China. Objective: To summarize the diagnosis and treatment of infant cancer and analyze the status of standardized diagnosis and management among several treatment centers in Beijing, China, thereby providing evidence to guide further clinical research. Methods: From January 1, 2010 to December 31, 2019, patients with newly diagnosed infantile malignant solid tumors were admitted to six large tertiary pediatric solid tumor diagnosis and treatment centers in Beijing. The epidemiology, clinical features, and therapeutic effects of tumors in these patients were analyzed retrospectively. All patients were followed up until March 31, 2020. Results: In total, 938 patients were enrolled in this study. There were 530 boys (56.5%) and 408 girls (43.5%); the median age was 6.0 months (range, 0–12.0 months). The three most common tumors were retinoblastoma in 366 patients (39.0%), neuroblastoma in 266 patients (28.4%), hepatoblastoma in 133 patients (14.2%), and central nervous system tumors in 52 patients (5.5%). The estimated 5‐year overall survival rate was 81.3% ± 1.8%, and the 5‐year event‐free survival rate was 71.8% ± 2.9%. The 5‐year overall survival rates of non‐rhabdomyosarcoma soft tissue sarcoma, neuroblastoma, and retinoblastoma were 100%, 88% ± 2.2%, and 86.9% ±2.1%, respectively. The 5‐year event‐free survival rates were 81.1% ± 2.7% for neuroblastoma, 81.6% ± 9.8% for non‐rhabdomyosarcoma soft tissue sarcoma, and 72.7% ± 14.1% for extracranial malignant germ cell tumors. Interpretation: The three most common infantile malignant solid tumors were retinoblastoma, neuroblastoma, and hepatoblastoma. Multidisciplinary combined diagnosis and treatment is needed for infantile tumors. [ABSTRACT FROM AUTHOR]
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- 2020
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17. Seeing Beyond Traditional Measurement: Recognizing the Value of the Experience of the Place, the People, and Their Work.
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Martin, Bobbi and Balwanaki, Chris Anold
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NURSING education , *CHILDREN'S hospitals , *CHILD mortality , *COMMUNITIES , *CARDIOPULMONARY resuscitation , *GOAL (Psychology) , *HEALTH , *HEALTH status indicators , *INTERPROFESSIONAL relations , *MEDICALLY underserved areas , *SUSTAINABLE development , *TELEMEDICINE , *EVIDENCE-based nursing - Abstract
Seeing beyond traditional measurement means knowing the story behind the outcome. It means recognizing the value of the experience of the place, the people, and their work. The global community recognizes the crucial need to end preventable child deaths, making it an essential part of the Global Strategy for Women, Children, and Adolescent Health (2016–2030) and the third Sustainable Development Goal to ensure healthy lives and promote wellbeing for all people at all ages (World Health Organization, 2019). This article shares statistically significant results of a nursing training initiative at Whispers Magical Children's Hospital (WMCH) in Jinja, Uganda, in sub-Saharan Africa where the region persists with the highest under-five mortality rate in the world. But the richer data yield can be found in the experiences of two in-country visits. Finding ways to create educational efforts for nurses in underserved geographical areas is critical to the improvement of the health status of their communities. Bringing health technology to these areas will improve the delivery of high-quality, evidence-based care by nurses, with a direct effect of positively influencing the health status of women, children, and communities. [ABSTRACT FROM AUTHOR]
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- 2020
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18. Effectiveness of Flax Seed Pillow on Stress and Physical Parameters of Premature Infants.
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Thomas, Tessy and R., Sujatha
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PHYSIOLOGICAL stress ,NEONATAL intensive care ,FLAXSEED ,NEONATAL intensive care units ,PRE-tests & post-tests ,T-test (Statistics) ,PILLOWS ,HEARING disorders ,DESCRIPTIVE statistics ,CONTROL groups ,JUDGMENT sampling ,CHILD mortality ,INTELLECTUAL disabilities ,CHILDREN - Abstract
Introduction: As per WHO report in 2018, every year, 15 million babies are born prematurely, the leading cause of child deaths under age five every year. Many survivors of preterm birth face a lifetime of disability, including learning disabilities and visual and hearing problems. Purpose of the study: To find the effectiveness of a flaxseed pillow on stress and physical parameters in premature infants. Methodology: An evaluative two group pretest post-test approach selected for the study. Premature infants selected by a purposive sampling technique and applied with a flaxseed pillow. All the infants were observed two times per day for five consecutive days from the day of recruitment. Stress and Physical parameters obtained and analyzed to find the effectiveness of the intervention. Results: Out of 34 Premature infants, 17 (50%) underwent flax seed pillow treatment, and remaining were the control group. Independent sample t-test results showed that there is a significant difference (pre-post) in the stress score between the experimental and control group. The paired t-test result revealed that there is a difference (p< 0.05) in the stress score among the experimental groups for all five days. Conclusion: An increasing number of premature birth is one of the most significant issues faced by the country today. Many developmental care interventions provided to preterm babies, which are cost-effective care and help these vulnerable in their phase of prematurity. Flaxseed pillow was effective in reducing the stress of premature infants in the NICU. [ABSTRACT FROM AUTHOR]
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- 2020
19. High-Dose Neonatal Vitamin A Supplementation Transiently Decreases Thymic Function in Early Infancy.
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Ahmad, Shaikh M, Raqib, Rubhana, Huda, M Nazmul, Alam, Md J, Monirujjaman, Md, Akhter, Taslima, Wagatsuma, Yukiko, Qadri, Firdausi, Zerofsky, Melissa S, and Stephensen, Charles B
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INFANTS , *CHILD mortality , *VITAMINS , *AGE differences , *BIRTH weight , *T cells , *RESEARCH , *RESEARCH methodology , *EVALUATION research , *MEDICAL cooperation , *VITAMIN A deficiency , *DIETARY supplements , *COMPARATIVE studies , *VITAMIN A , *RESEARCH funding , *THYMUS , *NUTRITIONAL status - Abstract
Background: Vitamin A deficiency (VAD) impairs T-cell-mediated immunity. In regions where VAD is prevalent, vitamin A supplementation (VAS) reduces child mortality, perhaps by improving immune function.Objective: Our objective was to determine if neonatal VAS would improve thymic function in Bangladeshi infants, and to determine if such effects differed by sex or nutritional status (i.e., birth weight above/below the median).Methods: Three hundred and six infants were randomly assigned to 50,000 IU vitamin A (VA) or placebo (PL) within 48 h of birth. Primary outcomes were measured at multiple ages and included 1) thymic index (TI) at 1, 6, 10, and 15 wk; 2) T-cell receptor excision circles (TREC), an index of thymic output of naïve T cells; and 3) total/naïve T cells in peripheral blood at 6 wk, 15 wk, and 2 y. A mixed linear model for repeated measures was used to assess group differences at each age and identify interactions with sex and birth weight.Results: VAS did not significantly (P = 0.21) affect TI overall (i.e., at all ages) but decreased TI by 7.8% (P = 0.029) at 6 wk: adjusted TI means for the PL and VA groups at 1, 6, 10, and 15 wk were 4.09 compared with 3.80 cm2, 7.78 compared with 7.18 cm2, 8.11 compared with 7.84 cm2, and 7.91 compared with 7.97 cm2, respectively. VAS did not significantly (P = 0.25) affect TREC overall but decreased TREC by 19% (P = 0.029) at 15 wk: adjusted TREC means for the PL and VA groups at 6 wk, 15 wk, and 2 y were 13.6 compared with 16.1 copies/pg DNA, 19.4 compared with 15.7 copies/pg DNA, and 11.8 compared with 10.0 copies/pg DNA, respectively. VAS did not significantly affect overall total (P = 0.10) or naïve (P = 0.092) T cells: adjusted naïve T-cell means for the PL and VA groups at 6 wk, 15 wk, and 2 y were 3259 compared with 3109 cells/µL, 3771 compared with 3487 cells/µL, and 1976 compared with 1898 cells/µL, respectively.Conclusion: In contrast to our hypothesis, VAS decreased thymic function early in infancy but health effects are presumably negligible owing to the transience and small magnitude of this effect. This trial was registered at clinicaltrials.gov as NCT01583972 and NCT02027610. [ABSTRACT FROM AUTHOR]- Published
- 2020
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20. Childhood mortality during and after acute illness in Africa and south Asia
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Abdoulaye Hama Diallo, Abu Sadat Mohammad Sayeem Bin Shahid, Ali Fazal Khan, Ali Faisal Saleem, Benson O Singa, Blaise Siezanga Gnoumou, Caroline Tigoi, Catherine Achieng Otieno, Celine Bourdon, Chris Odhiambo Oduol, Christina L Lancioni, Christine Manyasi, Christine J McGrath, Christopher Maronga, Christopher Lwanga, Daniella Brals, Dilruba Ahmed, Dinesh Mondal, Donna M Denno, Dorothy I Mangale, Emmanuel Chimezi, Emmie Mbale, Ezekiel Mupere, Gazi Md. Salauddin Mamun, Issaka Ouedraogo, James A Berkley, Jenala Njirammadzi, John Mukisa, Johnstone Thitiri, Joseph D Carreon, Judd L Walson, Julie Jemutai, Kirkby D Tickell, Lubaba Shahrin, MacPherson Mallewa, Md. Iqbal Hossain, Mohammod Jobayer Chisti, Molly Timbwa, Moses Mburu, Moses M Ngari, Narshion Ngao, Peace Aber, Philliness Prisca Harawa, Priya Sukhtankar, Robert H J Bandsma, Roseline Maimouna Bamouni, Sassy Molyneux, Shalton Mwaringa, Shamsun Nahar Shaima, Syed Asad Ali, Syeda Momena Afsana, Syera Banu, Tahmeed Ahmed, Wieger P Voskuijl, Zaubina Kazi, APH - Health Behaviors & Chronic Diseases, APH - Global Health, Pediatrics, Network, The Childhood Acute Illness and Nutrition (CHAIN), Graduate School, Global Health, Amsterdam Gastroenterology Endocrinology Metabolism, and General Paediatrics
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Asia ,Child, Preschool ,Kwashiorkor ,Acute Disease ,Child Mortality ,Aftercare ,Humans ,Infant ,General Medicine ,Prospective Studies ,Child ,Africa South of the Sahara ,Patient Discharge - Abstract
Background Mortality among children with acute illness in low-income and middle-income settings remains unacceptably high and the importance of post-discharge mortality is increasingly recognised. We aimed to explore the epidemiology of deaths among young children with acute illness across sub-Saharan Africa and south Asia to inform the development of interventions and improved guidelines. Methods In this prospective cohort study, we enrolled children aged 2–23 months with acute illness, stratified by nutritional status defined by anthropometry (ie, no wasting, moderate wasting, or severe wasting or kwashiorkor), who were admitted to one of nine hospitals in six countries across sub-Saharan Africa and south Asia between Nov 20, 2016, and Jan 31, 2019. We assisted sites to comply with national guidelines. Co-primary outcomes were mortality within 30 days of hospital admission and post-discharge mortality within 180 days of hospital discharge. A priori exposure domains, including demographic, clinical, and anthropometric characteristics at hospital admission and discharge, as well as child, caregiver, and household-level characteristics, were examined in regression and survival structural equation models. Findings Of 3101 children (median age 11 months [IQR 7–16]), 1120 (36·1%) had no wasting, 763 (24·6%) had moderate wasting, and 1218 (39·3%) had severe wasting or kwashiorkor. Of 350 (11·3%) deaths overall, 234 (66·9%) occurred within 30 days of hospital admission and 168 (48·0%) within 180 days of hospital discharge. 90 (53·6%) post-discharge deaths occurred at home. The proportion of children who died following discharge was relatively preserved across nutritional strata. Numerically large high-risk and low-risk groups could be disaggregated for early mortality and post-discharge mortality. Structural equation models identified direct pathways to mortality and multiple socioeconomic, clinical, and nutritional domains acting indirectly through anthropometric status. Interpretation Among diverse sites in Africa and south Asia, almost half of mortality occurs following hospital discharge. Despite being highly predictable, these deaths are not addressed in current guidelines. A fundamental shift to a child-centred, risk-based approach to inpatient and post-discharge management is needed to further reduce childhood mortality, and clinical trials of these approaches with outcomes of mortality, readmission, and cost are warranted.
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- 2022
21. Adherence to the National Immunization Schedule for the First Year of Life in Misan, Iraq.
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Ali, Esraa Abd Al-Muhsen and Aljawadi, Hussein Fadhil Musa
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IMMUNIZATION ,PRIMARY care ,CHILD mortality ,MOTHER-infant relationship - Abstract
Background: Compliance with age-appropriate receipt of immunization is critical for providing maximum effectiveness against the vaccine-preventable diseases. The Advisory Committee on Immunization Practices recommends specific ages and intervals for vaccines to be administered to maximize their effectiveness. Till now in Misan (South East of Iraq),a considerable proportion of morbidity and mortality was detected in children under the age of 5 years due to vaccine-preventable diseases. Objectives: zz To determine the rate of adherence to the immunization schedule in the first year of life in order to generate a baseline data that can be used to improve the vaccination uptake in Misan, thus, saving more lives. zz To determine the causes and risk factors influencing the pattern of immunization adherence. Patients and Method: A cross-sectional study was conducted in Misan Hospital for Child and Maternity. By a random selection, the study enrolled 250 mothers having infants aged 1-2 years attending the hospital as out-patient visitors. Through an interview with the mother, the required data were collected. Results: Among 250 infants,22.8% with complete adherence to the national immunization schedule during the first year of life, 68% with partial adherence, and 9.2 % with no adherence. Statistically, immunization adherence was significantly associated with mother's education, residence, and place of delivery. Conclusion: Adherence to the national immunization schedule in the first year of the life in Misan province was low and not the promising rate. Efforts toward the primary health care centers to raise the awareness and education about immunizations are still required to further reduce the vaccine-preventable morbidity and mortality in children. [ABSTRACT FROM AUTHOR]
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- 2019
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22. Pathophysiology of diarrhoea.
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Kelly, Laura, Jenkins, Huw, and Whyte, Lisa
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CHILD mortality ,DIARRHEA ,DISEASES ,INTESTINAL absorption ,INTESTINAL mucosa ,ORAL rehydration therapy ,WATER-electrolyte balance (Physiology) ,GUT microbiome ,PROBIOTICS ,DISEASE prevalence ,OSMOTIC pressure ,SECONDARY care (Medicine) ,TERTIARY care ,CHILDREN ,PREVENTION - Abstract
Abstract Diarrhoea results when there is loss of the dynamic and finely balanced absorption and secretion of water and electrolytes within the gut. Diarrhoea remains a major cause of morbidity and mortality worldwide and it is important for those who care for children to have a clear understanding of the pathophysiology of diarrhoea. Diarrhoea can be considered to be either osmotic or secretory. Osmotic diarrhoea occurs when excessive osmotically active particles are present in the lumen, resulting in more fluid passively moving into the bowel lumen down the osmotic gradient. Secretory diarrhoea occurs when the bowel mucosa secretes excessive amounts of fluid into the gut lumen, either due to activation of a pathway by a toxin, or due to inherent abnormalities in the enterocytes. The management of acute diarrhoea is based on assessment of fluid balance of the child and rehydration. Oral rehydration solution is extremely effective and has significantly reduced childhood mortality from acute infective diarrhoea over the past 40 years. Chronic diarrhoea has a number of infective and non-infective causes, careful history and specific investigation and management in secondary or tertiary care is often necessary. This update contains new details on the investigation of chronic diarrhoea and in particular use of imaging, the 'non-GI' causes of diarrhoea, updates on the changing prevalence of infective pathogens and research into the use of probiotics. [ABSTRACT FROM AUTHOR]
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- 2018
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23. Global, regional, and national causes of under-5 mortality in 2000–19: an updated systematic analysis with implications for the Sustainable Development Goals
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Diana Yeung, Gerard Lopez, Li Liu, Francisco Villavicencio, Amy Mulick, Kathleen Strong, Simon Cousens, Robert E. Black, David Prieto-Merino, and Jamie Perin
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Male ,Tuberculosis ,Psychological intervention ,MEDLINE ,Global Health ,World Health Organization ,Corrections ,Measles ,Cause of Death ,Infant Mortality ,Developmental and Educational Psychology ,Humans ,Medicine ,Models, Statistical ,business.industry ,Infant ,Articles ,Sustainable Development ,medicine.disease ,Random effects model ,Verbal autopsy ,Child, Preschool ,Child Mortality ,Pediatrics, Perinatology and Child Health ,Female ,business ,Meningitis ,Malaria ,Demography - Abstract
Background\ud Causes of mortality are a crucial input for health systems for identifying appropriate interventions for child survival. We present an updated series of cause-specific mortality for neonates and children younger than 5 years from 2000 to 2019.\ud Methods\ud We updated cause-specific mortality estimates for neonates and children aged 1-59 months, stratified by level (low, moderate, or high) of mortality. We made a substantial change in the statistical methods used for previous estimates, transitioning to a Bayesian framework that includes a structure to account for unreported causes in verbal autopsy studies. We also used systematic covariate selection in the multinomial framework, gave more weight to nationally representative verbal autopsy studies using a random effects model, and included mortality due to tuberculosis.\ud Findings\ud In 2019, there were 5·30 million deaths (95% uncertainty range 4·92-5·68) among children younger than 5 years, primarily due to preterm birth complications (17·7%, 16·1-19·5), lower respiratory infections (13·9%, 12·0-15·1), intrapartum-related events (11·6%, 10·6-12·5), and diarrhoea (9·1%, 7·9-9·9), with 49·2% (47·3-51·9) due to infectious causes. Vaccine-preventable deaths, such as for lower respiratory infections, meningitis, and measles, constituted 21·7% (20·4-25·6) of under-5 deaths, and many other causes, such as diarrhoea, were preventable with low-cost interventions. Under-5 mortality has declined substantially since 2000, primarily because of a decrease in mortality due to lower respiratory infections, diarrhoea, preterm birth complications, intrapartum-related events, malaria, and measles. There is considerable variation in the extent and trends in cause-specific mortality across regions and for different strata of all-cause under-5 mortality.\ud Interpretation\ud Progress is needed to improve child health and end preventable deaths among children younger than 5 years. Countries should strategize how to reduce mortality among this age group using interventions that are relevant to their specific causes of death.\ud Funding\ud Bill & Melinda Gates Foundation; WHO.
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- 2022
24. Adapting and validating the log quadratic model to derive under-five age- and cause-specific mortality (U5ACSM): a preliminary analysis
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Jamie Perin, Yue Chu, Francisco Villavicencio, Austin Schumacher, Tyler McCormick, Michel Guillot, and Li Liu
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RESPIRATORY_DISEASES ,China ,Epidemiology ,MODELS ,Computer applications to medicine. Medical informatics ,R858-859.7 ,Injury ,Under-five mortality ,Infant mortality ,Cause of Death ,Humans ,Life Tables ,Child ,NEONATAL_MORTALITY ,Neonatal mortality ,Research ,Public Health, Environmental and Occupational Health ,Infant, Newborn ,Infant ,Pneumonia ,INFANT_MORTALITY ,Child, Preschool ,Child Mortality ,SIMULATION ,INJURIES ,Public aspects of medicine ,RA1-1270 - Abstract
Background The mortality pattern from birth to age five is known to vary by underlying cause of mortality, which has been documented in multiple instances. Many countries without high functioning vital registration systems could benefit from estimates of age- and cause-specific mortality to inform health programming, however, to date the causes of under-five death have only been described for broad age categories such as for neonates (0–27 days), infants (0–11 months), and children age 12–59 months. Methods We adapt the log quadratic model to mortality patterns for children under five to all-cause child mortality and then to age- and cause-specific mortality (U5ACSM). We apply these methods to empirical sample registration system mortality data in China from 1996 to 2015. Based on these empirical data, we simulate probabilities of mortality in the case when the true relationships between age and mortality by cause are known. Results We estimate U5ACSM within 0.1–0.7 deaths per 1000 livebirths in hold out strata for life tables constructed from the China sample registration system, representing considerable improvement compared to an error of 1.2 per 1000 livebirths using a standard approach. This improved prediction error for U5ACSM is consistently demonstrated for all-cause as well as pneumonia- and injury-specific mortality. We also consistently identified cause-specific mortality patterns in simulated mortality scenarios. Conclusion The log quadratic model is a significant improvement over the standard approach for deriving U5ACSM based on both simulation and empirical results.
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- 2022
25. What does early initiation and duration of breastfeeding have to do with childhood mortality? Analysis of pooled population-based data in 35 sub-Saharan African countries
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Amadou Barrow and Michael Ekholuenetale
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Male ,DHS ,Research ,Parturition ,Obstetrics and Gynecology ,Infant ,Childhood mortality ,Pediatrics ,RJ1-570 ,Optimal breastfeeding ,Breast Feeding ,Cognition ,Pregnancy ,Pediatrics, Perinatology and Child Health ,Child Mortality ,Infant Mortality ,Humans ,Female ,Public aspects of medicine ,RA1-1270 ,Child ,Early breastfeeding initiation - Abstract
Background Breastfeeding practices and their impact on infant health and survival are unquestionably of global interest. The aim of this study was to examine the link between breastfeeding initiation within one hour of birth, breastfeeding duration and childhood mortality in sub-Saharan Africa. Methods This study used data from the Demographic and Health Survey, which was conducted in 35 Sub-Saharan African countries between 2008 and 2017. Early initiation and duration of breastfeeding, food consumption indices, and infant mortality were all important variables. Analysis used percentage, median/interquartile range, and regression models (logistic, linear, Cox). Results Early initiation of breastfeeding within one hour after birth was lowest in Chad (23.0%) and highest in Burundi (85.0%). The pooled median duration of breastfeeding was 12 months. Female children had 3% significant lower odds of consuming tinned, powdered or fresh milk, compared with male children (OR 0.97; 95% CI 0.94, 0.99). Conversely, female children were more likely to be put to breast within one hour after birth, compared with male children (OR 1.03; 95% CI 1.01, 1.05). Results from the pooled sample showed approximately 20% (HR 0.80; 95% CI 0.67, 0.96) and 21% (HR 0.79; 95% CI 0.77, 0.80) reduction in infant mortality for children breastfed within one hour after birth and for every unit increase in the months of breastfeeding respectively. In addition, countries with the leading infant mortality rate include; Sierra Leone (92 deaths per 1000 live births), Chad (72 deaths per 1000 live births), Nigeria (69 deaths per 1000 live births), Cote d’ Ivoire (68 deaths per 1000 live births), Guinea (67 deaths per 1000 live births), Burkina-Faso (65 deaths per 1000 live births) and Mozambique (64 deaths per 1000 live births) respectively. Conclusions The findings from this study underscores the need for early breastfeeding initiation and prolong breastfeeding to be considered in programmes on improving childhood survival. Efforts should be made to improve optimal breastfeeding practices as only about half of children in the pooled sample had best practices of breastfeeding.
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- 2021
26. Access to sanitary toilets and health outcomes: A panel data analysis using two-way fixed effects model
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Yingwen Gu, Wanli Zhou, and Xiulin Wang
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Data Analysis ,China ,education ,Developing country ,child mortality ,fluids and secretions ,Environmental health ,medicine ,QA1-939 ,Humans ,Sanitation ,Toilet Facilities ,Child ,Toilet ,business.industry ,Applied Mathematics ,Incidence (epidemiology) ,Mortality rate ,rate of access to sanitary toilets ,Hepatitis A ,Infant ,General Medicine ,Fixed effects model ,medicine.disease ,Infant mortality ,digestive system diseases ,Child mortality ,Computational Mathematics ,intestinal infectious diseases ,Modeling and Simulation ,Bathroom Equipment ,General Agricultural and Biological Sciences ,business ,TP248.13-248.65 ,Mathematics ,two-way fixed effects model ,Biotechnology - Abstract
Based on the data regarding the renovation of the toilets of 30 provinces (municipalities) in rural China from 2005 to 2017, this study utilized a two-way fixed effect model to empirically test the impact of access to sanitary toilets on health, which include intestinal infectious diseases (consisting of hepatitis A, dysentery, and typhoid) and child mortality (consisting of perinatal mortality, infant mortality, and the mortality rate of children under 5). This study attempted to assess the health outcomes of the "toilet revolution" in rural China. The results showed that: (1) Access to sanitary toilets effectively reduced the incidence of hepatitis A and dysentery. For every 1% increase in the rate of access to sanitary toilets, the incidence of hepatitis A was reduced by 5.6%, and the incidence of dysentery was reduced by 36.5%. (2) Access to sanitary toilets does not significantly reduce child mortality. (3) There are obviously regional differences in the impact of access to sanitary toilets on the health outcomes. The renovation of sanitary toilets has shown the most significant effect on reducing the incidence of intestinal infectious diseases in the central region as well as the effect on reducing child mortality in the western region. It is implied that the health outcomes of China's "toilet revolution" may provide supporting evidence and experience for other developing countries and regions in implementing toilet renovation projects.
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- 2021
27. Indirect effects of the SARS CoV-2 pandemic on the prevalence of breastfeeding: Modeling its impact
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Nayide Barahona, Álvaro Jácome, and Carlos A Castañeda-Orjuela
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breastfeeding ,Population ,prevalence ,RC955-962 ,infecciones por coronavirus ,Breastfeeding ,pandemias ,lactancia materna ,Colombia ,evaluación del impacto en la salud ,pandemics ,General Biochemistry, Genetics and Molecular Biology ,coronavirus infections ,Environmental health ,Arctic medicine. Tropical medicine ,Infant Mortality ,medicine ,Humans ,education ,Growth Disorders ,education.field_of_study ,SARS-CoV-2 ,business.industry ,prevalencia ,COVID-19 ,Infant ,Models, Theoretical ,Infant mortality ,Child mortality ,Diarrhea ,Breast Feeding ,Social Isolation ,Child, Preschool ,Relative risk ,Child Mortality ,Diarrhea, Infantile ,Attributable risk ,health impact assessment ,Medicine ,Female ,Original Article ,medicine.symptom ,business ,Breast feeding - Abstract
Breastfeeding has a protective effect against acute respiratory and diarrheal infections. There are psychological and social effects due to physical isolation in the population in the mother-child group.To assess the impact on infant mortality due to a decrease in the prevalence of breastfeeding during 2020 due to the physical isolation against the SARS CoV-2 (COVID-19) pandemic in Colombia.We used the population attributable risk approach taking into account the prevalence of breastfeeding and its potential decrease associated with the measures of physical isolation and the relative risk (RR) of the association between exclusive breastfeeding and the occurrence of acute infection consequences in the growth (weight for height) of children under the age of five through a mathematical modeling program.We found an increase of 11.39% in the number of cases of growth arrest in the age group of 6 to 11 months with a 50% decrease in breastfeeding prevalence, as well as an increase in the number of diarrhea cases in children between 1 and 5 months of age from 5% (5.67%) on, and an increased number of deaths in children under 5 years (9.04%) with a 50% decrease in the prevalence of exclusive breastfeeding.A lower prevalence of breastfeeding has an impact on infant morbidity and mortality in the short and medium-term. As a public health policy, current maternal and childcare strategies must be kept in order to reduce risks in the pediatric population.Introducción. La lactancia materna tiene un efecto protector frente a infecciones respiratorias y diarreicas agudas. Hay efectos psicológicos y sociales por el aislamiento físico en la población en el grupo materno-infantil. Objetivo. Evaluar el eventual impacto en la mortalidad infantil de la disminución en la prevalencia de la lactancia materna durante el 2020 a causa del aislamiento físico por la pandemia del SARS CoV-2 (COVID-19) en Colombia. Materiales y métodos. Se utilizó el enfoque de riesgo atribuible poblacional, teniendo en cuenta la prevalencia de la lactancia materna y su potencial disminución asociada con las medidas de aislamiento físico y el riesgo relativo (RR) de la asociación entre la lactancia materna exclusiva y el efecto de la aparición de infecciones agudas en el crecimiento (peso para la altura) de niños menores de cinco años mediante un programa de modelamiento matemático. Resultados. Se registró un aumento del número casos de detención del crecimiento en el grupo etario de 6 a 11 meses de 11,39 % al disminuir en 50 % la prevalencia de la lactancia materna, así como un mayor número de casos por diarrea en los cinco primeros meses a partir del 5 % (5,67 %), y un incremento en el número de muertes en menores de 5 años (9,04 %) al disminuirse en 50 % la prevalencia de la lactancia materna. Conclusiones. Se registró un impacto en la morbilidad y la mortalidad infantil a corto y mediano plazo al disminuir la prevalencia en la lactancia materna. Como política pública en salud, deben mantenerse las estrategias actuales de atención materno-infantil para disminuir riesgos en la población infantil.
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- 2021
28. Mapping of mothers' suffering and child mortality in Sub-Saharan Africa
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Gebremariam Ketema, Bayuh Asmamaw Hailu, and Joseph Beyene
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Adult ,medicine.medical_specialty ,Sub saharan ,Science ,Psychological intervention ,Mothers ,Disease cluster ,Article ,Odds ,Young Adult ,Medical research ,Cause of Death ,Environmental health ,Humans ,Medicine ,Public Health Surveillance ,Multiple indicator ,Child ,Africa South of the Sahara ,Aged ,Aged, 80 and over ,Multidisciplinary ,business.industry ,Public health ,Health care ,Infant ,Middle Aged ,Models, Theoretical ,Confidence interval ,Child mortality ,Mental Health ,Risk factors ,Socioeconomic Factors ,Child, Preschool ,Child Mortality ,Female ,business - Abstract
Child death and mothers who suffer from child death are a public health concern in Sub-Saharan Africa. The location and associated factors of child death and mothers who suffer child death were not identified. To monitor and prioritize effective interventions, it is important to identify hotspots areas and associated factors. Data from nationally representative demographic and health survey and Multiple Indicator Cluster administrated in 42 Sub-Sahara Africa countries, which comprised a total of 398,574 mothers with 1,521,312 children. Spatial heterogeneity conducted hotspot regions identified. A mixed-effect regression model was run, and the adjusted ratio with corresponding 95% confidence intervals was estimated. The prevalence of mothers who suffer child death 27% and 45–49 year of age mother 48%. In Niger, 47% of mothers were suffering child death. Women being without HIV knowledge, stunted, wasted, uneducated, not household head, poor, from rural, and from subtropical significantly increased the odds of the case (P
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- 2021
29. The impact of equity factors on receipt of timely appropriate care for children with suspected malaria in eastern Uganda
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David Humphreys, Tobias Alfvén, and Joan N. Kalyango
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Rural Population ,Child mortality ,medicine.medical_specialty ,Fever ,Context (language use) ,Antimalarials ,Rurality ,Environmental health ,Epidemiology ,medicine ,Humans ,Uganda ,Care-seeking ,business.industry ,Public health ,Research ,Public Health, Environmental and Occupational Health ,Infant ,Equity ,Patient Acceptance of Health Care ,medicine.disease ,Checklist ,Malaria ,Cross-Sectional Studies ,Child, Preschool ,Biostatistics ,Public aspects of medicine ,RA1-1270 ,business - Abstract
Introduction Malaria accounts for more than one-tenth of sub-Saharan Africa’s 2.8 million annual childhood deaths, and remains a leading cause of post-neonatal child mortality in Uganda. Despite increased community-based treatment in Uganda, children continue to die because services fail to reach those most at risk. This study explores the influence of two key equity factors, socioeconomic position and rurality, on whether children with fever in eastern Uganda receive timely access to appropriate treatment for suspected malaria. Methods This was a cross-sectional study in which data were collected from 1094 caregivers of children aged 6–59 months on: illness and care-seeking during the previous two weeks, treatment received, and treatment dosing schedule. Additional data on rurality and household socioeconomic position were extracted from the Iganga-Mayuge Health and Demographic Surveillance Site (HDSS) database. A child was considered to have received prompt and appropriate care for symptoms of malaria if they received the recommended drug in the recommended dosing schedule on the day of symptom onset or the next day. Unadjusted and adjusted logistic regression models were developed to explore associations of the two equity factors with the outcome. The STROBE checklist for observational studies guided reporting. Results Seventy-four percent of children had symptoms of illness in the preceding two weeks, of which fever was the most common. Children from rural households were statistically more likely to receive prompt and appropriate treatment with artemisinin-combination therapy than their semi-urban counterparts (OR 2.32, CI 1.17–4.59, p = 0.016). This association remained significant following application of an adjusted regression model that included the age of the child, caregiver relationship, and household wealth index (OR 2.4, p = 0.036). Wealth index in its own right did not exert a significant effect for children with reported fever (OR for wealthiest quintile = 1.02, CI 0.48–2.15, p = 0.958). Conclusions The findings from this study help to identify the role and importance of two key equity determinants on care seeking and treatment receipt for fever in children. Whilst results should be interpreted within the limitations of data and context, further studies have the potential to assist policy makers to target inequitable social and spatial variations in health outcomes as a key strategy in ending preventable child morbidity and mortality.
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- 2021
30. A silent epidemic of major congenital malformations in Tigray, northern Ethiopia: hospital-based study
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Afework Mulugeta, Abera Hadgu, Tony Magana, Letekirstos Gebregziabher, Etenat Halefom Berhe, Hayelom Kebede Mekonen, Yibrah Berhe, Hale Teka, and Birhane Alem Berihu
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Adult ,Male ,medicine.medical_specialty ,Science ,Folic Acid Deficiency ,Abortion ,Article ,Pregnancy ,Developmental biology ,Anencephaly ,medicine ,Humans ,Spinal Dysraphism ,Fetus ,Multidisciplinary ,Obstetrics ,Spina bifida ,business.industry ,Infant, Newborn ,Infant ,medicine.disease ,Child mortality ,Cross-Sectional Studies ,Population study ,Gestation ,Medicine ,Female ,Ethiopia ,Anatomy ,Structural biology ,business - Abstract
Congenital malformations are defects of the morphogenesis of organs or body during the pregnancy period and are identifiable at pre- or postnatal. They are identified as the major cause of child mortality worldwide. There is a need to understand the prevalence of congenital malformations in Tigray and Ethiopia in general as surveillance data are lacking. Hence, this study was designed to investigate the burden of major congenital malformations in the Tigray Region, Northern Ethiopia. Hospital-based cross-sectional study was conducted to identify neonates with major congenital anomalies in the labor ward admitted at six major public hospitals of Tigray region, Ethiopia between January 2018 and 2019. All newborns/neonates delivered in all study hospitals during the study period were considered as the study population. The prevalence of major congenital anomalies and the distribution of each type of major congenital anomalies within total birth were calculated. Data on maternal, and newborn demographic characteristics was collected. Statistical analysis was done using SPSS and p value p p p p p
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- 2021
31. Macro-economic determinants, maternal and infant SDG targets in Nigeria: Correlation and predictive modeling
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Yetunde Oluranti, Adegoke, Josue, Mbonigaba, and Gavin, George
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Infant Mortality ,Child Mortality ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Humans ,Infant ,Nigeria ,Family ,Sustainable Development ,Child - Abstract
ObjectivesUnambiguously, Nigeria is off-track in achieving the health-related SDGs. Consequentially, this study aligns with SDG 3 which calls for “good health and wellbeing for people by ensuring healthy lives and promoting wellbeing for all at all ages”. This article examines the combined effect of health expenditure and other key macro-economic factors on health indices such as maternal and newborn and child mortality in Nigeria. Contrary to existing literature, we formulated a model that predicts the level of macro-economic determinants needed to achieve the SDG targets for maternal and newborn and child mortality in Nigeria by 2030.MethodologyThe study used Autoregressive Distributed Lag (ARDL), which is usually used for large T models. The study period spans from 1995 to 2020.ResultsWe found a significant negative relationship between health outcomes and macro-economic determinants namely, household consumption, total health expenditure, and gross fixed capital while we determined a significant positive relationship between health outcomes and unemployment. Our findings are further supported by out-of-sample forecast results suggesting a reduction in unemployment to 1.84 percent and an increase in health expenditure, gross fixed capital, household consumption, control of corruption to 1,818.87 billon (naira), 94.46 billion (naira), 3.2 percent, and −4.2 percent respectively to achieve SDG health targets in Nigeria by 2030.Policy implicationThe outcome of this result will give the Nigerian government and stakeholders a deeper understanding of the workings of the macro-economic factors, concerning health performance and will help position Nigeria, and other SSA countries by extension, toward reducing maternal mortality to 70 per 100,000 and newborn and child mortality to 25 per 1,000 births by 2030. The African leaders should consider passing into law the need for improvement in macro-economic factors for better health in Africa. We also recommend that the Nigerian government should steadily increase health expenditure to reach and move beyond the forecast level for improvement in maternal and infant mortality, given the present low and unimpressive funding for the health sector in the country.
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- 2022
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32. Trends in the association between educational assortative mating, infant and child mortality in Nigeria
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Tolulope Ariyo and Quanbao Jiang
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Multivariate analysis ,030309 nutrition & dietetics ,Assortative matching ,Nigeria ,Parent education ,Context (language use) ,Under-five mortality ,03 medical and health sciences ,0302 clinical medicine ,Infant Mortality ,Humans ,Medicine ,030212 general & internal medicine ,Child ,0303 health sciences ,business.industry ,Research ,Mortality rate ,Assortative mating ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Infant ,Hypergamy ,Infant mortality ,Child mortality ,Sub-Sahara Africa ,Cross-Sectional Studies ,Socioeconomic Factors ,Child, Preschool ,Child Mortality ,Educational Status ,Marital status ,Female ,Educational homogamy ,Childhood survival ,Public aspects of medicine ,RA1-1270 ,business ,Demography - Abstract
Background Existing knowledge has established the connection between maternal education and child survival, but little is known about how educational assortative mating (EAM), relates to childhood mortality. We attempt to examine this association in the context of Nigeria. Methods Data was obtained from the 2008, 2013, and 2018 waves of the Nigeria Demographic and Health Survey, which is a cross-sectional study. The sample includes the analysis of 72,527 newborns within the 5 years preceding each survey. The dependent variables include the risk of a newborn dying before 12 months of age (infant mortality), or between the age of 12–59 months (child mortality). From the perspective of the mother, the independent variable, EAM, includes four categories (high-education homogamy, low-education homogamy, hypergamy, and hypogamy). The Cox proportional hazard regression was employed for multivariate analyses, while the estimation of mortality rates across the spectrum of EAM was obtained through the synthetic cohort technique. Results The risk of childhood mortality varied across the spectrum of EAM and was particularly lowest among those with high-education homogamy. Compared to children of mothers in low-education homogamy, children of mothers in high-education homogamy had 25, 31 to 19% significantly less likelihood of infant mortality, and 34, 41, and 57% significantly less likelihood of child mortality in 2008, 2013 and 2018 survey data, respectively. Also, compared to children of mothers in hypergamy, children of mothers in hypogamous unions had 20, 12, and 11% less likelihood of infant mortality, and 27, 36, and 1% less likelihood of child mortality across 2008, 2013 and 2018 surveys, respectively, although not significant at p Conclusion This indicates that, beyond the absolute level of education, the similarities or dissimilarities in partners’ education may have consequences for child survival, alluding to the family system theory. Future studies could investigate how this association varies when marital status is put into consideration.
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- 2021
33. Preceding child survival status and its effect on infant and child mortality in India: An evidence from National Family Health Survey 2015–16
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Shobhit Srivastava, Manoj Alagarajan, Shubhranshu Kumar Upadhyay, and Shekhar Chauhan
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Male ,medicine.medical_specialty ,Maternal and child health ,media_common.quotation_subject ,India ,Birth Intervals ,Infant Mortality ,Humans ,Medicine ,Girl ,Mortality ,Child ,Survival analysis ,Retrospective Studies ,media_common ,business.industry ,Proportional hazards model ,Public health ,Public Health, Environmental and Occupational Health ,Infant ,Health Surveys ,Infant mortality ,Child mortality ,Socioeconomic Factors ,Child Mortality ,Female ,Residence ,Biostatistics ,Public aspects of medicine ,RA1-1270 ,business ,Research Article ,Demography - Abstract
Background India has achieved impressive gains in child survival over the last two decades; however, it was not successful in attaining MDG 2015 goals. The study’s objective is to inquire how the survival status of the preceding child affects the survival of the next born child. Methods This is a retrospective analysis of data from the National Family Health Survey, 2015–16. Analysis was restricted to women with second or higher-order births because women with first-order births do not have a preceding child. Proportional hazards regression, also called the Cox regression model, has been used to carry out the analysis. Kaplan–Meier (K–M) survival curves were also generated, with a focus on preceding birth intervals. Results Results found that female children were more likely to experience infant mortality than their male counterparts. Children born after birth intervals of 36+ months were least likely to experience infant mortality. Mother’s education and household wealth are two strong predictors of child survival, while the place of residence and caste did not show any effect in the Cox proportional model. Infant and child deaths are highly clustered among those mothers whose earlier child is dead. Conclusion Maternal childbearing age is still low in India, and it poses a high risk of infant and child death. Education is a way out, and there is a need to focus on girl’s education. The government shall also focus on raising awareness of the importance of spacing between two successive births. There is also a need to create a better health infrastructure catering to the needs of rich and poor people alike.
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- 2021
34. Divergent age patterns of under-5 mortality in south Asia and sub-Saharan Africa: a modelling study
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Andrea Verhulst, Julio Romero Prieto, Nurul Alam, Hallie Eilerts-Spinelli, Daniel J Erchick, Patrick Gerland, Joanne Katz, Bruno Lankoande, Li Liu, Gilles Pison, Georges Reniers, Seema Subedi, Francisco Villavicencio, and Michel Guillot
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Asia ,Infant, Newborn ,Infant ,Succinates ,SOUTH_ASIA ,General Medicine ,Global Health ,United States ,INTERNATIONAL_COMPARISON ,AGE_AT_DEATH ,INFANT_MORTALITY ,DEMOGRAPHIC_SURVEILLANCE_SYSTEM ,Child Mortality ,Humans ,SUB-SAHARAN_AFRICA ,DEMOGRAPHIC_AND_HEALTH_SURVEYS_(DHS) ,Child ,Africa South of the Sahara - Abstract
Altres ajuts: Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health. Background: Understanding the age pattern of under-5 mortality is essential for identifying the most vulnerable ages and underlying causes of death, and for assessing why the decline in child mortality is slower in some countries and subnational areas than others. The aim of this study is to detect age patterns of under-5 mortality that are specific to low-income and middle-income countries (LMICs). Methods: In this modelling study, we used data from 277 Demographic and Health Surveys (DHSs), 58 Health and Demographic Surveillance Systems (HDSSs), two cohort studies, and two sample-registration systems. From these sources, we collected child date of birth and date of death (or age at death) from LMICs between 1966 and 2020. We computed 22 deaths rates from each survey with the following age breakdowns: 0, 7, 14, 21, and 28 days; 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 15, 18, and 21 months; and 2, 3, 4, and 5 years. We assessed how probabilities of dying estimated for the 22 age groups deviated from predictions generated by a vital registration model that reflects the historical mortality of 25 high-income countries. Findings : We calculated mortality rates of 81 LMICs between 1966 and 2020. In contrast with the other regions of the world, we found that under-5 mortality in south Asia and sub-Saharan Africa was characterised by increased mortality at both ends of the age range (ie, younger than 28 days and older than 6 months) at a given level of mortality. Observed mortality in these regions was up to 2 times higher than predicted by the vital registration model for the younger-than-28 days age bracket, and up to 10 times higher than predicted for the older-than-6 months age bracket. This age pattern of under-5 mortality is significant in 17 countries in south Asia and sub-Saharan Africa. Excess mortality in children older than 6 months without excess mortality in children younger than 28 days was found in 38 countries. In south Asia, results were consistent across data sources. In sub-Saharan Africa, excess mortality in children younger than 28 days was found mostly in DHSs; the majority of HDSSs did not show this excess mortality. We have attributed this difference in data sources mainly to omissions of early deaths in HDSSs. Interpretation : In countries with age patterns of under-5 mortality that diverge from predictions, evidence-based public health interventions should focus on the causes of excess of mortality; notably, the effect of fetal growth restriction and infectious diseases. The age pattern of under-5 mortality will be instrumental in assessing progress towards the decline of under-5 mortality and the Sustainable Development Goals.
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- 2022
35. Insights on the differentiation of stillbirths and early neonatal deaths: a study from the Child Health and Mortality Prevention Surveillance (CHAMPS) network
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Elizabeth Quincer, Rebecca Philipsborn, Diane Morof, Navit T. Salzberg, Pio Vitorino, Sara Ajanovic, Dickens Onyango, Ikechukwu Ogbuanu, Nega Assefa, Samba O. Sow, Portia Mutevedzi, Shams El Arifeen, Beth A. Tippet Barr, J. Anthony G. Scott, Inacio Mandomando, Karen L. Kotloff, Amara Jambai, Victor Akelo, Carrie Jo Cain, Atique Iqbal Chowdhury, Tadesse Gure, Kitiezo Aggrey Igunza, Farzana Islam, Adama Mamby Keita, Lola Madrid, Sana Mahtab, Ashka Mehta, Paul K. Mitei, Constance Ntuli, Julius Ojulong, Afruna Rahman, Solomon Samura, Diakaridia Sidibe, Bukiwe Nana Thwala, Rosauro Varo, Shabir A. Madhi, Quique Bassat, Emily S. Gurley, Dianna M. Blau, and Cynthia G. Whitney
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Multidisciplinary ,Pregnancy ,Perinatal Death ,Child Mortality ,Infant Mortality ,Child Health ,Infant, Newborn ,Humans ,Infant ,Family ,Female ,Stillbirth ,Child - Abstract
Introduction The high burden of stillbirths and neonatal deaths is driving global initiatives to improve birth outcomes. Discerning stillbirths from neonatal deaths can be difficult in some settings, yet this distinction is critical for understanding causes of perinatal deaths and improving resuscitation practices for live born babies. Methods We evaluated data from the Child Health and Mortality Prevention Surveillance (CHAMPS) network to compare the accuracy of determining stillbirths versus neonatal deaths from different data sources and to evaluate evidence of resuscitation at delivery in accordance with World Health Organization (WHO) guidelines. CHAMPS works to identify causes of stillbirth and death in children Results Of 1967 deaths ultimately classified as stillbirth, only 28 (1.4%) were initially reported as livebirths. Of 845 cases classified as very early neonatal death, 33 (4%) were initially reported as stillbirth. Of 367 cases with post-mortem examination showing delivery weight >1000g and no maceration, the maternal clinical record documented that resuscitation was not performed in 161 cases (44%), performed in 14 (3%), and unknown or data missing for 192 (52%). Conclusion This analysis found that CHAMPS cases assigned as stillbirth or neonatal death after DeCoDe expert panel review were generally consistent with the initial report of the case as a stillbirth or neonatal death. Our findings suggest that more frequent use of resuscitation at delivery and improvements in documentation around events at birth could help improve perinatal outcomes.
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- 2022
36. Postmortem investigations and identification of multiple causes of child deaths: an analysis of findings from the Child Health and Mortality Prevention Surveillance (CHAMPS) network
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Pio Vitorino, Ikechukwu U. Ogbuanu, Muntasir Alam, Rosauro Varo, Vicky L. Baillie, Ashka Mehta, Janet Agaya, Afruna Rahman, Victor Akelo, Sana Mahtab, Samba O. Sow, Beth A. Tippett-Barr, Dickson Gethi, Alexander M. Ibrahim, Addisu Alemu, Shabir A. Madhi, Amara Jambai, Nega Assefa, Lola Madrid, Milagritos D. Tapia, Portia Mutevedzi, Atique Iqbal Chowdhury, Nana Bukiwe Thwala, Mischka Garel, Shams El Arifeen, Solomon Samura, Quique Bassat, Inacio Mandomando, Cynthia G. Whitney, Antonio Sitoe, Ima-Abasi Bassey, J. Anthony G. Scott, Adama Mamby Keita, Karen L. Kotloff, Dianna M. Blau, Dickens Onyango, Robert F. Breiman, Julius Ojulong, and Emily S. Gurley
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Male ,Pediatrics ,Pulmonology ,Maternal Health ,Global Burden of Disease ,Families ,Medical Conditions ,Risk Factors ,Pregnancy ,Infectious Diseases of the Nervous System ,Cause of Death ,Infant Mortality ,Medicine and Health Sciences ,Public and Occupational Health ,Children ,Cause of death ,Neonatal sepsis ,Medical record ,Age Factors ,Child Health ,Obstetrics and Gynecology ,General Medicine ,Infectious Diseases ,Neurology ,Child, Preschool ,Population Surveillance ,Child Mortality ,Medicine ,Female ,Autopsy ,Neonatal Sepsis ,Infants ,Research Article ,medicine.medical_specialty ,Asia ,Inflammatory Diseases ,Preterm Birth ,Sierra leone ,Respiratory Disorders ,Signs and Symptoms ,Sepsis ,medicine ,Congenital Disorders ,Humans ,Infant Health ,Meningitis ,business.industry ,Infant, Newborn ,Infant ,Biology and Life Sciences ,Neonates ,medicine.disease ,Verbal autopsy ,Infant mortality ,Perinatal asphyxia ,Pregnancy Complications ,Malnutrition ,Age Groups ,Africa ,People and Places ,Respiratory Infections ,Birth ,Women's Health ,Population Groupings ,Clinical Medicine ,business ,Developmental Biology - Abstract
Background The current burden of >5 million deaths yearly is the focus of the Sustainable Development Goal (SDG) to end preventable deaths of newborns and children under 5 years old by 2030. To accelerate progression toward this goal, data are needed that accurately quantify the leading causes of death, so that interventions can target the common causes. By adding postmortem pathology and microbiology studies to other available data, the Child Health and Mortality Prevention Surveillance (CHAMPS) network provides comprehensive evaluations of conditions leading to death, in contrast to standard methods that rely on data from medical records and verbal autopsy and report only a single underlying condition. We analyzed CHAMPS data to characterize the value of considering multiple causes of death. Methods and findings We examined deaths identified from December 2016 through November 2020 from 7 CHAMPS sites (in Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa), including 741 neonatal, 278 infant, and 241 child, In an analysis of data from the Child Health and Mortality Prevention Surveillance (CHAMPS) network, Robert Breiman, Dianna Blau, and colleagues investigate how considering all conditions in the causal chain leading to death informs the identification of deaths attributable to various diagnoses., Author summary Why was this study done? More than 5 million deaths occur annually in children
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- 2022
37. Improving oxygen therapy for children and neonates in secondary hospitals in Nigeria: study protocol for a stepped-wedge cluster randomised trial.
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Graham, Hamish R., Ayede, Adejumoke I., Bakare, Ayobami A., Oyewole, Oladapo B., Peel, David, Gray, Amy, McPake, Barbara, Neal, Eleanor, Qazi, Shamim, Izadnegahdar, Rasa, Falade, Adegoke G., and Duke, Trevor
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OXYGEN therapy for children , *NEWBORN infants , *OXYGEN in the body , *OXIMETRY , *CLUSTER randomized controlled trials , *OXYGEN therapy equipment , *ALLIED health education , *PNEUMONIA diagnosis , *PNEUMONIA treatment , *PNEUMONIA-related mortality , *CHILD mortality , *CLINICAL medicine , *COMPARATIVE studies , *ELECTRIC power supplies to apparatus , *EMPLOYEE orientation , *EXPERIMENTAL design , *HEALTH care teams , *HEALTH facilities , *INFANT mortality , *INTEGRATED health care delivery , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH protocols , *OXYGEN therapy , *QUALITY assurance , *RESEARCH , *RESEARCH funding , *STATISTICAL sampling , *TIME , *EVALUATION research , *KEY performance indicators (Management) , *RANDOMIZED controlled trials , *TREATMENT effectiveness , *HOSPITAL mortality ,DEVELOPING countries - Abstract
Background: Oxygen is a life-saving, essential medicine that is important for the treatment of many common childhood conditions. Improved oxygen systems can reduce childhood pneumonia mortality substantially. However, providing oxygen to children is challenging, especially in small hospitals with weak infrastructure and low human resource capacity.Methods/design: This trial will evaluate the implementation of improved oxygen systems at secondary-level hospitals in southwest Nigeria. The improved oxygen system includes: a standardised equipment package; training of clinical and technical staff; infrastructure support (including improved power supply); and quality improvement activities such as supportive supervision. Phase 1 will involve the introduction of pulse oximetry alone; phase 2 will involve the introduction of the full, improved oxygen system package. We have based the intervention design on a theory-based analysis of previous oxygen projects, and used quality improvement principles, evidence-based teaching methods, and behaviour-change strategies. We are using a stepped-wedge cluster randomised design with participating hospitals randomised to receive an improved oxygen system at 4-month steps (three hospitals per step). Our mixed-methods evaluation will evaluate effectiveness, impact, sustainability, process and fidelity. Our primary outcome measures are childhood pneumonia case fatality rate and inpatient neonatal mortality rate. Secondary outcome measures include a range of clinical, quality of care, technical, and health systems outcomes. The planned study duration is from 2015 to 2018.Discussion: Our study will provide quality evidence on the effectiveness of improved oxygen systems, and how to better implement and scale-up oxygen systems in resource-limited settings. Our results should have important implications for policy-makers, hospital administrators, and child health organisations in Africa and globally.Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12617000341325 . Retrospectively registered on 6 March 2017. [ABSTRACT FROM AUTHOR]- Published
- 2017
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38. Anesthesia-related and perioperative mortality: An audit of 8493 cases at a tertiary pediatric teaching hospital in South Africa.
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Meyer, Heidi M., Thomas, Jenny, Wilson, Graeme S., de Kock, Marianna, and Veyckemans, Francis
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CHILD mortality , *ANESTHESIA complications , *GENERAL anesthesia , *PEDIATRIC anesthesia , *PEDIATRIC surgery , *HOSPITALS - Abstract
Aim: This study aimed to quantify the incidence of anesthesia-related and perioperative mortality at a large tertiary pediatric hospital in South Africa. Methods: This study included all children aged <18 years who died prior to discharge from hospital and within 30 days of their last anesthetic at the Red Cross War Memorial Children's Hospital between January 1, 2015 to December 31, 2015. A panel of three senior anesthetists reviewed each death to reach a consensus as to whether: (i) anesthesia caused the death; (ii) anesthesia may have contributed to or influenced the timing of death; or (iii) anesthesia was entirely unrelated to the death. Results: There were 47 deaths within 30 days of anesthesia prior to discharge from hospital during this 12-month period. The in-hospital mortality within 24 h of administration of anesthesia was 16.5 per 10 000 cases (95% confidence intervals [CI]=7.8-25.1) and within 30 days of administration of anesthesia was 55.3 per 10 000 cases (95% CI=39.5-71.2). Age under 1 year (OR 4.5; 95% CI=2.5-8.0, P=.012) and cardiac surgery and interventional cardiology procedures (OR 2.5; 95% CI=1.2-5.2, P<.01) were both independent predictors of increased risk of perioperative mortality. Conclusion: The overall 24-h and 30-day anesthesia-related and in-hospital perioperative mortality rates in our study are comparable with other similar studies from tertiary pediatric centers. [ABSTRACT FROM AUTHOR]
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- 2017
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39. Association between household air pollution and child mortality in Myanmar using a multilevel mixed-effects Poisson regression with robust variance
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Rakibul M. Islam, Nuruzzaman Khan, Juwel Rana, Youssef Oulhote, and Razia Aliani
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Adult ,Male ,medicine.medical_specialty ,Science ,Air pollution ,Myanmar ,010501 environmental sciences ,medicine.disease_cause ,01 natural sciences ,Risk Assessment ,Article ,Environmental impact ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Environmental health ,Infant Mortality ,medicine ,Humans ,030212 general & internal medicine ,Poisson regression ,Poisson Distribution ,0105 earth and related environmental sciences ,Family Characteristics ,Multidisciplinary ,Neonatal mortality ,business.industry ,Public health ,Infant, Newborn ,Infant ,Survey research ,Health Surveys ,Confidence interval ,Child mortality ,Risk factors ,Air Pollution, Indoor ,Child, Preschool ,Child Mortality ,symbols ,Mixed effects ,Medicine ,Female ,business - Abstract
Household air pollution (HAP) from solid fuel use (SFU) for cooking is a major public health threat for women and children in low and middle-income countries. This study investigated the associations between HAP and neonatal, infant, and under-five child mortality in Myanmar. The study consisted of 3249 sample of under-five children in the households from the first Myanmar Demographic and Health Survey 2016. Fuel types and levels of exposure to SFU (no, moderate and high) were proxies for HAP. We estimated covariate-adjusted relative risks (aRR) of neonatal, infant, and under-five child mortality with 95% confidence intervals, accounting for the survey design. The prevalence of SFU was 79.0%. The neonatal, infant, and under-five child mortality rates were 26, 45, and 49 per 1000 live births, respectively. The risks of infant (aRR 2.02; 95% CI 1.01–4.05; p-value = 0.048) and under-five mortality (aRR 2.16; 95% CI 1.07–4.36; p-value = 0.031), but not neonatal mortality, were higher among children from households with SFU compared to children from households using clean fuel. Likewise, children highly exposed to HAP had higher risks of mortality than unexposed children. HAP increases the risks of infant and under-five child mortality in Myanmar, which could be reduced by increasing access to clean cookstoves and fuels.
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- 2021
40. Breastfeeding and employed mothers in Ethiopia: legal protection, arrangement, and support
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Ermiyas Mulu Kebede and Benyam Seifu
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0301 basic medicine ,Economic growth ,media_common.quotation_subject ,Psychological intervention ,Breastfeeding ,Mothers ,Pediatrics ,RJ1-570 ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Humans ,Medicine ,030212 general & internal medicine ,Child ,Workplace ,Enforcement ,Empowerment ,media_common ,Government ,030109 nutrition & dietetics ,Informal sector ,business.industry ,Employed mothers ,Infant ,Obstetrics and Gynecology ,Child mortality ,Intervention (law) ,Breast Feeding ,Pediatrics, Perinatology and Child Health ,Income ,Commentary ,Female ,Ethiopia ,Public aspects of medicine ,RA1-1270 ,business ,Law - Abstract
Background Breastfeeding is the single, most cost-effective intervention to reduce worldwide child mortality. Women empowerment interventions have positive impacts on child and maternal nutritional, and health status. Women’s employment and economic participation in Ethiopia have shown progress over the past three decades. However, consistent evidence indicated that maternal employment is often negatively associated with optimal breastfeeding in Ethiopia. The existence and enforcement of breastfeeding law, arrangement, and support in the workplace have vital roles in protecting employed mothers’ ability and right to breastfeed upon return to work from maternity leave. This commentary compared the breastfeeding laws, policies, and arrangements in Ethiopia with international standards, recommendations, and evidence-based practices. Workplace breastfeeding policies in Ethiopia Public legislations of Ethiopia poorly protect the breastfeeding right of most new mothers. Ethiopian revised Labor Proclamation (No.1156/2019) incorporates most of the International Labour Organization maternity protection recommendations. However, it poorly safeguards breastfeeding rights and abilities of employed women. The provided maternity leave period is also shorter than the recommended exclusive breastfeeding duration. The revised Federal Civil Servant Proclamation of Ethiopia (NO.1064/2017) mandates the establishment of a nursery in government institutions where female civil servants could breastfeed and take care of their babies in a private room. Though, it protects only a small proportion of working mothers in Ethiopia, as majority women employed in the agriculture and informal economy sectors. So far, there are no notable workplace breastfeeding arrangements and support for employed mothers by employers and other initiatives. The ILO recommendation and experience of other middle income and low-income countries can be legal and practical grounds for establishment of breastfeeding-friendly workplace in Ethiopia. Conclusions The lack of workplace breastfeeding laws, arrangements, and supports in Ethiopia limits mothers’ right to practice optimal breastfeeding. Policymakers, the government, and all concerned bodies should give due attention to enacting and enforcing sound laws and arrangements that will enable employed mothers to practice optimal breastfeeding upon return to work.
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- 2021
41. Approximation of the Cox survival regression model by MCMC Bayesian Hierarchical Poisson modelling of factors associated with childhood mortality in Nigeria
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S. M. Abatan, Adeniyi Francis Fagbamigbe, O. Ajumobi, M.M. Salawu, University of St Andrews. Population and Behavioural Science Division, and University of St Andrews. School of Medicine
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Adult ,Male ,Rural Population ,Adolescent ,Epidemiology ,Science ,HA ,Nigeria ,Poisson distribution ,Models, Biological ,Article ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Infant Mortality ,Humans ,HA Statistics ,030212 general & internal medicine ,Poisson regression ,Child ,Functional illiteracy ,Proportional Hazards Models ,Mathematics ,Family Characteristics ,Multidisciplinary ,Proportional hazards model ,030503 health policy & services ,Statistics ,Infant, Newborn ,Health care ,Infant ,Regression analysis ,3rd-DAS ,Middle Aged ,Censoring (statistics) ,Infant mortality ,Child mortality ,Risk factors ,Child, Preschool ,Child Mortality ,symbols ,RA Public aspects of medicine ,Medicine ,Female ,0305 other medical science ,RA ,Demography - Abstract
The need for more pragmatic approaches to achieve sustainable development goal on childhood mortality reduction necessitated this study. Simultaneous study of the influence of where the children live and the censoring nature of children survival data is scarce. We identified the compositional and contextual factors associated with under-five (U5M) and infant (INM) mortality in Nigeria from 5 MCMC Bayesian hierarchical Poisson regression models as approximations of the Cox survival regression model. The 2018 DHS data of 33,924 under-five children were used. Life table techniques and the Mlwin 3.05 module for the analysis of hierarchical data were implemented in Stata Version 16. The overall INM rate (INMR) was 70 per 1000 livebirths compared with U5M rate (U5MR) of 131 per 1000 livebirth. The INMR was lowest in Ogun (17 per 1000 live births) and highest in Kaduna (106), Gombe (112) and Kebbi (116) while the lowest U5MR was found in Ogun (29) and highest in Jigawa (212) and Kebbi (248). The risks of INM and U5M were highest among children with none/low maternal education, multiple births, low birthweight, short birth interval, poorer households, when spouses decide on healthcare access, having a big problem getting to a healthcare facility, high community illiteracy level, and from states with a high proportion of the rural population in the fully adjusted model. Compared with the null model, 81% vs 13% and 59% vs 35% of the total variation in INM and U5M were explained by the state- and neighbourhood-level factors respectively. Infant- and under-five mortality in Nigeria is influenced by compositional and contextual factors. The Bayesian hierarchical Poisson regression model used in estimating the factors associated with childhood deaths in Nigeria fitted the survival data.
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- 2021
42. The impact of child health interventions and risk factors on child survival in Kenya, 1993–2014: a Bayesian spatio-temporal analysis with counterfactual scenarios
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Emelda A. Okiro, Noel K. Joseph, Robert W. Snow, Peter M. Macharia, and Benn Sartorius
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Counterfactual thinking ,Sanitation ,030231 tropical medicine ,Psychological intervention ,Breastfeeding ,Sub-national ,Disease ,Under-five mortality ,03 medical and health sciences ,Spatio-Temporal Analysis ,0302 clinical medicine ,Pregnancy ,Risk Factors ,11. Sustainability ,Humans ,Medicine ,030212 general & internal medicine ,Child ,2. Zero hunger ,business.industry ,Child Health ,1. No poverty ,Infant ,Bayes Theorem ,Regression analysis ,General Medicine ,Millennium Development Goals ,medicine.disease ,Kenya ,3. Good health ,Impact ,Child Mortality ,Female ,Spatio-temporal ,Counterfactual ,business ,Malaria ,Research Article ,Demography - Abstract
Background During the millennium development goals period, reduction in under-five mortality (U5M) and increases in child health intervention coverage were characterised by sub-national disparities and inequities across Kenya. The contribution of changing risk factors and intervention coverage on the sub-national changes in U5M remains poorly defined. Methods Sub-national county-level data on U5M and 43 factors known to be associated with U5M spanning 1993 and 2014 were assembled. Using a Bayesian ecological mixed-effects regression model, the relationships between U5M and significant intervention and infection risk ecological factors were quantified across 47 sub-national counties. The coefficients generated were used within a counterfactual framework to estimate U5M and under-five deaths averted (U5-DA) for every county and year (1993–2014) associated with changes in the coverage of interventions and disease infection prevalence relative to 1993. Results Nationally, the stagnation and increase in U5M in the 1990s were associated with rising human immunodeficiency virus (HIV) prevalence and reduced maternal autonomy while improvements after 2006 were associated with a decline in the prevalence of HIV and malaria, increase in access to better sanitation, fever treatment-seeking rates and maternal autonomy. Reduced stunting and increased coverage of early breastfeeding and institutional deliveries were associated with a smaller number of U5-DA compared to other factors while a reduction in high parity and fully immunised children were associated with under-five lives lost. Most of the U5-DA occurred after 2006 and varied spatially across counties. The highest number of U5-DA was recorded in western and coastal Kenya while northern Kenya recorded a lower number of U5-DA than western. Central Kenya had the lowest U5-DA. The deaths averted across the different regions were associated with a unique set of factors. Conclusion Contributions of interventions and risk factors to changing U5M vary sub-nationally. This has important implications for targeting future interventions within decentralised health systems such as those operated in Kenya. Targeting specific factors where U5M has been high and intervention coverage poor would lead to the highest likelihood of sub-national attainment of sustainable development goal (SDG) 3.2 on U5M in Kenya.
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- 2021
43. Health capabilities and the determinants of infant mortality in Brazil, 2004–2015: an innovative methodological framework
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Claude Sicotte, Roxane Borgès Da Silva, Ladislau Dowbor, and Alexandre Bugelli
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Total fertility rate ,Family income ,Infant mortality ,Health capabilities ,Public policies ,03 medical and health sciences ,Social determinants of health ,0302 clinical medicine ,Pregnancy ,Humans ,Medicine ,030212 general & internal medicine ,Mortality ,Multilevel panel data with fixed effect nested within-clusters ,Child ,030505 public health ,business.industry ,Research ,Mortality rate ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Infant ,Per capita income ,Child mortality ,Socioeconomic Factors ,Income ,Educational Status ,Household income ,Female ,Public aspects of medicine ,RA1-1270 ,0305 other medical science ,business ,Health economics ,Brazil ,Demography - Abstract
BackgroundDespite the implementation of a set of social and health policies, Brazil has experienced a slowdown in the decline of infant mortality, regional disparities and persistent high death levels, raising questions about the determinants of infant mortality after the implementation of these policies. The objective of this article is to propose a methodological approach aiming at identifying the determinants of infant mortality in Brazil after the implementation of those policies.MethodA series of multilevel panel data with fixed effect nested within-clusters were conducted supported by the concept of health capabilities based on data from 26 Brazilian states between 2004 and 2015. The dependent variables were the neonatal, the infant and the under-five mortality rates. The independent variables were the employment rate, per capita income,Bolsa FamíliaProgram coverage, the fertility rate, educational attainment, the number of live births by prenatal visits, the number of health professionals per thousand inhabitants, and the access to water supply and sewage services. We also used different time lags of employment rate to identify the impact of employment on the infant mortality rates over time, and household income stratified by minimum wages to analyze their effects on these rates.ResultsThe results showed that in addition to variables associated with infant mortality in previous studies, such asBolsa FamíliaProgram, per capita income and fertility rate, other factors affect child mortality. Educational attainment, quality of prenatal care and access to health professionals are also elements impacting infant deaths. The results also identified an association between employment rate and different infant mortality rates, with employment impacting neonatal mortality up to 3 years and that a family income below 2 minimum wages increases the odds of infant deaths.ConclusionThe results proved that the methodology proposed allowed the use of variables based on aggregated data that could hardly be used by other methodologies.
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- 2021
44. Socio-economic and proximate determinants of under-five mortality in Guinea
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Bright Opoku Ahinkorah, Eugene Budu, Abdul-Aziz Seidu, Ebenezer Agbaglo, Collins Adu, Dorothy Osei, Aduragbemi Banke-Thomas, and Sanni Yaya
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Family Characteristics ,Multidisciplinary ,General Science & Technology ,RJ101 ,Infant ,HV ,Birth Intervals ,Socioeconomic Factors ,RJ101 Child Health. Child health services ,RA0421 ,Pregnancy ,Child Mortality ,Infant Mortality ,Humans ,Female ,Guinea ,Child - Abstract
Background The death of children under-five years is one of the critical issues in public health and improving child survival continues to be a matter of urgent concern. In this paper, we assessed the proximate and socio-economics determinants of child mortality in Guinea. Methods Using the 2018 Guinea Demographic and Health Survey (GDHS), we extracted demographic and mortality data of 4,400 children under-five years. Both descriptive and multivariable logistic regression analyses were conducted. Results Under-five mortality was 111 deaths per 1,000 live births in Guinea. The likelihood of death was higher among children born to mothers who belong to other religions compared to Christians (aOR = 2.86, 95% CI: 1.10–7.41), smaller than average children compared to larger than average children (aOR = 1.97, 95% CI: 1.28–3.04) and those whose mothers had no postnatal check-up visits after delivery (aOR = 1.72, 95% CI: 1.13–2.63). Conversely, the odds of death in children with 2–3 birth rank & >2 years of birth interval compared to ≥4 birth rank and ≤2 years of birth interval were low (aOR = 0.53, 95% CI: 0.34–0.83). Conclusion We found that household/individual-level socioeconomic and proximate factors predict under-five mortality in Guinea. With just about a decade left to the 2030 deadline of the Sustainable Development Goals (SDGs), concerted efforts across all key stakeholders, including government and development partners, need to be geared towards implementing interventions that target these predictors.
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- 2022
45. Corruption and Population Health in the European Union Countries—An Institutionalist Perspective
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Oana-Ramona Socoliuc (Guriță), Nicoleta Sîrghi, Dănuţ-Vasile Jemna, and Mihaela David
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Life Expectancy ,Population Health ,Health, Toxicology and Mutagenesis ,Child Mortality ,Infant Mortality ,Public Health, Environmental and Occupational Health ,Humans ,Infant ,European Union ,Child ,corruption ,population health ,life expectancy at birth ,child mortality ,inclusive institutions ,extractive institutions - Abstract
Even though the European Union (EU) is considered one of the best performers in the world in fighting corruption, the situation changes when the analysis is shifted to the national dimension of its member states, with significant differences concerning the effects of corruption on population health. Using the theory of New Institutional Economics as a complementary tool that provides additional representativeness to this phenomenon, the aim of this paper is to empirically investigate the impact of corruption on population health, considering also other demographic and socio-economic determinants. Using data collected at the EU level registered between 2000–2019, we employ panel date models to validate the ongoing effect of perceived corruption on population health. Our empirical findings fully validate the institutionalist perspective, according to which countries with inclusive institutions better control the anomaly of corruption while benefitting from higher life expectancy and reducing child mortality rates. Conversely, the EU countries with rather extractive institutions suffer in terms of both longevity of population and infant mortality. Our study emphasizes that in tackling corruption pressure on population health, the most effective way is to improve the quality of governance in countries with fragile institutions.
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- 2022
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46. The impact of antenatal care on under‐five mortality in Ethiopia: a difference‐in‐differences analysis
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Temesgen Zewotir, Delia North, and Samuel Oduse
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Adult ,medicine.medical_specialty ,Time Factors ,Adolescent ,Under‐five mortality ,Reproductive medicine ,Antenatal care ,lcsh:Gynecology and obstetrics ,Child health ,Young Adult ,Pregnancy ,Propensity score matching ,Infant Mortality ,Confidence Intervals ,Difference‐in‐difference ,Humans ,Medicine ,Propensity Score ,lcsh:RG1-991 ,Mediation Analysis ,Under five mortality ,business.industry ,Child survival ,Mortality rate ,Causal effect ,Infant ,Obstetrics and Gynecology ,Prenatal Care ,Middle Aged ,Sustainable Development ,Health Surveys ,Difference in differences ,Treatment Outcome ,Child, Preschool ,Child Mortality ,Female ,Ethiopia ,Sustainable development goal ,business ,Research Article ,Demography - Abstract
Background Sub-Saharan Africa, as opposed to other regions, has the highest under-five mortality rates yet makes the least improvement in reducing under-five mortality. Despite the decline, Ethiopia is among the top ten countries contributing the most to global under-five mortalities. This article examines the impact of the number of antenatal care and the timing of first antenatal care on child health outcomes. We specifically investigated if the utilization of antenatal care services positively affects the reduction of under-five mortality. Methods We employ a difference-in-differences design with propensity score matching to identify direct causal effects of antenatal care on under-five mortality based on the Ethiopian Demographic Health Survey data of 2011 and 2016. Our sample includes 22 295 women between the ages of 14–49 who had antenatal care visits at different times before delivery. Results The study revealed 1 481 cases of reported under-five mortality. 99.0% of that under-five mortality cases are women who had less than eight antenatal care visits, while only 1% of that is by women who had eight or more antenatal care visits. Antenatal care visit decreases the likelihood of under-five mortality in Ethiopia by 45.2% (CI = 19.2–71.3%, P-value Conclusions To achieve a significant reduction in the under-five mortality rate, Intervention programs that encourages more antenatal care visits should be considered. This will improve child survival and help in attaining Sustainable Development Goal targets.
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- 2021
47. Performance of PRISM III and PIM 2 scores in a cancer pediatric intensive care unit
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de Farias, Emmerson Carlos Franco, Mello, Mary Lucy Ferraz Maia Fiuza, Assunção, Patrícia Barbosa Carvalho, Wanderley, Alayde Vieira, Ferraro, Kissila Márvia Matias Machado, Machado, Mayara Márvia Matias, and Marinho, Sarah Jennings
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Child mortality ,PRISM ,Intensive care units, pediatric ,Prognóstico ,Critical Illness ,Unidades de terapia intensiva pediátrica ,Infant ,Pediatric oncology ,PIM 2 ,Oncologia pediátrica ,Prognosis ,Severity of Illness Index ,hemic and lymphatic diseases ,Neoplasms ,Humans ,Original Article ,Hospital Mortality ,Prospective Studies ,Child ,Medição de risco ,Risk assessment ,Mortalidade da criança ,Retrospective Studies - Abstract
To assess the performance of Pediatric Risk of Mortality (PRISM) III and Pediatric Index of Mortality (PIM) 2 scores in the pediatric intensive care unit.A retrospective cohort study. Data were retrospectively collected from medical records of all patients admitted to the pediatric intensive care unit of a cancer hospital from January 2017 to June 2018.The mean PRISM III score was 15, and PIM 2, 24%. From the 338 studied patients, 62 (18.34%) died. The PRISM III estimated mortality was 79.52 patients (23.52%) and for PIM 2 80.19 patients (23.72%), corresponding to a standardized mortality ratio (95% confidence interval: 0.78 for PRISM II and 0.77 for PIM 2). The Hosmer-Lemeshow chi-square test was 11.56, 8df, 0.975 for PRISM II and 0.48, 8df, p = 0.999 for PIM 2. The area under the Receiver Operating Characteristic curve was 0.71 for PRISM III and 0.76 for PIM 2.Both scores overestimated mortality and have shown a regular ability to discriminate between survivors and non-survivors. Models should be developed to quantify the severity of cancer pediatric patients in Pediatric Intensive Care Units and to predict the mortality risk accounting for their peculiarities.Avaliar o desempenho do Pediatric Risk of Mortality (PRISM) III e do Pediatric Index of Mortality (PIM) 2 em unidade de terapia intensiva pediátrica.Estudo de coorte retrospectivo. Os dados retrospectivos foram coletados dos prontuários de todos os pacientes admitidos na unidade de terapia intensiva pediátrica de um hospital infantil oncológico, entre janeiro de 2017 a junho de 2018.A média do PRISM III foi de 15 e do PIM 2 de 24%. Dos 338 pacientes estudados, 62 (18,34%) morreram. A mortalidade estimada pelo PRISM III foi de 79,52 (23,52%) e pelo PIM 2 de 80,19 (23,72%) pacientes, correspondendo a taxa padronizada de mortalidade (intervalo de confiança de 95%) de 0,78 para o PRISM II e 0,77 para o PIM 2. O teste de ajuste de Hosmer-Lemeshow obteve qui-quadrado de 11,56, 8df, com p = 0,975, para PRISM III, e qui-quadrado de 0,48, 8df, p = 0,999, para o PIM 2. Foi obtida área sob a curva Característica de Operação do Receptor de 0,71 para o PRISM III e 0,76 para o PIM 2.Os dois escores superestimaram a mortalidade e demonstraram poder regular de discriminação entre sobreviventes e não sobreviventes. Devem ser desenvolvidos modelos para quantificar a gravidade de pacientes pediátricos com câncer em unidade de terapia intensiva pediátrica e predizer o risco de mortalidade que contemplem suas peculiaridades.
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- 2021
48. Morbidity and Mortality Patterns in Children Admitted to Hospital in Thai Binh, Vietnam: A Five-year Descriptive Study with a Focus on Infectious Diseases
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Thi Minh Chinh Nguyen, Duc Thanh Nguyen, Philippe Minodier, Nam Thang Nguyen, Thanh Tung Dao, Thi Thuy Vu, Thi Loi Dao, Minh Manh To, Van Thuan Hoang, Duc Long Phi, Xuan Duong Tran, Philippe Gautret, Thi Dung Pham, Duy Cuong Nguyen, Van Nghiem Dang, Thanh Liem Vu, Van Khoi Dang, Nang Trong Hoang, Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA)
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Pediatrics ,medicine.medical_specialty ,030309 nutrition & dietetics ,medicine.drug_class ,infectious disease ,Antibiotics ,gastrointestinal infections ,Diagnostic tools ,Communicable Diseases ,Gastrointestinal infections ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,medicine ,Humans ,[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology ,030212 general & internal medicine ,Antibiotic use ,Child ,Children ,ComputingMilieux_MISCELLANEOUS ,Retrospective Studies ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,0303 health sciences ,Retrospective review ,Respiratory tract infections ,business.industry ,lcsh:Public aspects of medicine ,other ,Infant, Newborn ,Infant ,lcsh:RA1-1270 ,Hospitals, Pediatric ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,3. Good health ,Hospitalization ,Thai Binh ,Vietnam ,Infectious disease (medical specialty) ,lower respiratory tract infections ,Child, Preschool ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Child Mortality ,Morbidity ,business ,influenza ,Research Article - Abstract
The objective of this study was to describe the overall pattern of morbidity and mortality of children seen at the Thai Binh Pediatric Hospital in Vietnam, with a focus on infectious diseases. A retrospective review of hospitalisation records was conducted from 1 January 2015 to 31 December 2019. Data were obtained from a total of 113,999 records. The median age of patients was 18 months, with 83.98% of patients aged
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- 2021
49. A scoping review of methods for assessment of sex differentials in early childhood mortality
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Janaina Calu Costa, Nurul Alam, and Cesar Victora
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Male ,medicine.medical_specialty ,Sex differentials ,Epidemiology ,Sexism ,Population ,Scopus ,Excess female mortality ,Review ,Under-five mortality ,03 medical and health sciences ,0302 clinical medicine ,5. Gender equality ,Infant Mortality ,0502 economics and business ,Humans ,Medicine ,Life Tables ,030212 general & internal medicine ,Early childhood ,Mortality ,050207 economics ,Child ,education ,Statistical hypothesis testing ,Sex Characteristics ,education.field_of_study ,business.industry ,05 social sciences ,Gender bias ,lcsh:RJ1-570 ,Infant ,lcsh:Pediatrics ,Infant mortality ,3. Good health ,Child mortality ,Child, Preschool ,Child Mortality ,Pediatrics, Perinatology and Child Health ,Female ,business ,Research Article ,Demography - Abstract
Background While assessment of sex differentials in child mortality is straightforward, their interpretation must consider that, in the absence of gender bias, boys are more likely to die than girls. The expected differences are also influenced by levels and causes of death. However, there is no standard approach for determining expected sex differences. Methods We performed a scoping review of studies on sex differentials in under-five mortality, using PubMed, Web of Science, and Scopus databases. Publication characteristics were described, and studies were grouped according to their methodology. Results From the 17,693 references initially retrieved we included 154 studies published since 1929. Indian, Bangladeshi, and Chinese populations were the focus of 44% of the works, and most studies addressed infant mortality. Fourteen publications were classified as reference studies, as these aimed to estimate expected sex differentials based upon the demographic experience of selected populations, either considered as gender-neutral or not. These studies used a variety of methods – from simple averages to sophisticated modeling – to define values against which observed estimates could be compared. The 21 comparative studies mostly used life tables from European populations as standard for expected values, but also relied on groups without assuming those values as expected, otherwise, just as comparison parameters. The remaining 119 studies were categorized as narrative and did not use reference values, being limited to reporting observed sex-specific estimates or used a variety of statistical models, and in general, did not account for mortality levels. Conclusion Studies aimed at identifying sex differentials in child mortality should consider overall mortality levels, and report on more than one age group. The comparison of results with one or more reference values, and the use of statistical testing, are strongly recommended. Time trends analyses will help understand changes in population characteristics and interpret findings from a historical perspective.
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- 2021
50. Complete basic childhood vaccination and associated factors among children aged 12–23 months in East Africa: a multilevel analysis of recent demographic and health surveys
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Getayeneh Antehunegn Tesema, Achamyeleh Birhanu Teshale, Zemenu Tadesse Tessema, and Koku Sisay Tamirat
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Adult ,Male ,medicine.medical_specialty ,Vaccination Coverage ,Burundi ,Mothers ,Tanzania ,Multilevel analysis ,Young Adult ,Pregnancy ,Epidemiology ,medicine ,Odds Ratio ,Humans ,Child ,Aged ,Poverty ,business.industry ,Public health ,lcsh:Public aspects of medicine ,Vaccination ,Public Health, Environmental and Occupational Health ,Rwanda ,Infant ,Secondary data ,lcsh:RA1-1270 ,Odds ratio ,Health Surveys ,Kenya ,East Africa ,Confidence interval ,Child mortality ,Logistic Models ,Socioeconomic Factors ,Child, Preschool ,Child Mortality ,Educational Status ,Female ,Ethiopia ,Health Facilities ,Biostatistics ,Complete basic vaccination ,business ,Demography ,Research Article - Abstract
Background Complete childhood vaccination remains poor in Sub-Saharan Africa, despite major improvement in childhood vaccination coverage worldwide. Globally, an estimated 2.5 million children die annually from vaccine-preventable diseases. While studies are being conducted in different East African countries, there is limited evidence of complete basic childhood vaccinations and associated factors in East Africa among children aged 12–23 months. Therefore, this study aimed to investigate complete basic childhood vaccinations and associated factors among children aged 12–23 months in East Africa. Methods Based on the Demographic and Health Surveys (DHSs) of 12 East African countries (Burundi, Ethiopia, Comoros, Uganda, Rwanda, Tanzania, Mozambique, Madagascar, Zimbabwe, Kenya, Zambia, and Malawi), secondary data analysis was performed. The study included a total weighted sample of 18,811 children aged 12–23 months. The basic childhood vaccination coverage was presented using a bar graph. Multilevel binary logistic regression analysis was fitted for identifying significantly associated factors because the DHS has a hierarchical nature. The Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance (−2LLR) were used for checking model fitness, and for model comparison. Variable with p-value ≤0.2 in the bi-variable multilevel analysis were considered for the multivariable analysis. In the multivariable multilevel analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the significance and strength of association with full vaccination. Results Complete basic childhood vaccination in East Africa was 69.21% (95% CI, 69.20, 69.21%). In the multivariable multilevel analysis; Mothers aged 25–34 years (AOR = 1.21, 95% CI: 1.10, 1.32), mothers aged 35 years and above (AOR = 1.50, 95% CI: 1.31, 1.71), maternal primary education (AOR = 1.26, 95% CI: 1.15, 1.38), maternal secondary education and above (AOR = 1.54, 95% CI: 1.36, 1.75), husband primary education (AOR = 1.25, 95% CI: 1.13, 1.39), husband secondary education and above (AOR = 1.24, 95% CI: 1.11, 1.40), media exposure (AOR = 1.23, 95% CI: 1.13, 1.33), birth interval of 24–48 months (AOR = 1.28, 95% CI: 1.15, 1.42), birth interval greater than 48 months (AOR = 1.35, 95% CI: 1.21, 1.50), having 1–3 ANC visit (AOR = 3.24, 95% CI: 2.78, 3.77), four and above ANC visit (AOR = 3.68, 95% CI: 3.17, 4.28), PNC visit (AOR = 1.34, 95% CI: 1.23, 1.47), health facility delivery (AOR = 1.48, 95% CI: 1.35, 1.62), large size at birth 1.09 (AOR = 1.09, 95% CI: 1.01, 1.19), being 4–6 births (AOR = 0.83, 95% CI: 0.75, 0.91), being above the sixth birth (AOR = 0.60, 95% CI: 0.52, 0.70), middle wealth index (AOR = 1.16, 95% CI: 1.06, 1.28), rich wealth index (AOR = 1.20, 95% CI: 1.09, 1.33), community poverty (AOR = 1.21, 95% CI: 1.11, 1.32) and country were significantly associated with complete childhood vaccination. Conclusions In East Africa, full basic childhood vaccine coverage remains a major public health concern with substantial differences across countries. Complete basic childhood vaccination was significantly associated with maternal age, maternal education, husband education, media exposure, preceding birth interval, number of ANC visits, PNC visits, place of delivery, child-size at birth, parity, wealth index, country, and community poverty. Public health interventions should therefore target children born to uneducated mothers and fathers, poor families, and those who have not used maternal health services to enhance full childhood vaccination to reduce the incidence of child mortality from vaccine-preventable diseases.
- Published
- 2020
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