Document Detail


Causes of stillbirth, neonatal death and early childhood death in rural Zambia by verbal autopsy assessments.
MedLine Citation:
PMID:  21470348     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To describe specific causes of the high rates of stillbirth, neonatal death and early child childhood death in Zambia.
METHODS: We conducted a household-based survey in rural Zambia. Socio-demographic and delivery characteristics were recorded, alongside a maternal HIV test. Verbal autopsy questionnaires were administered to elicit mortality-related information and independently reviewed by three experienced paediatricians who assigned a cause and contributing factor to death. For this secondary analysis, deaths were categorized into: stillbirths (foetal death ≥28 weeks of gestation), neonatal deaths (≤28 days) and early childhood deaths (>28 days to <2 years).
RESULTS: Among 1679 households, information was collected on 148 deaths: 34% stillbirths, 26% neonatal and 40% early childhood deaths. Leading identifiable causes of stillbirth were intrauterine infection (26%) and birth asphyxia (18%). Of 32 neonatal deaths, 38 (84%) occurred within the first week of life, primarily because of infections (37%) and prematurity (34%). The majority of early childhood deaths were caused by suspected bacterial infections (82%). HIV prevalence was significantly higher in mothers who reported an early childhood death (44%) than mothers who did not (17%; P < 0.01). Factors significantly associated with mortality were lower socio-economic status (P < 0.01), inadequate water or sanitation facilities (P < 0.01), home delivery (P = 0.04) and absence of a trained delivery attendant (P < 0.01).
CONCLUSION: We provide community-level data about the causes of death among children under 2 years of age. Infectious etiologies for mortality ranked highest. At a public health level, such information may have an important role in guiding prevention and treatment strategies to address perinatal and early childhood mortality.
Authors:
Eleanor Turnbull; Mwila K Lembalemba; M Brad Guffey; Carolyn Bolton-Moore; Mwangelwa Mubiana-Mbewe; Namwinga Chintu; Mark J Giganti; Mutinta Nalubamba-Phiri; Elizabeth M Stringer; Jeffrey S A Stringer; Benjamin H Chi
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-04-07
Journal Detail:
Title:  Tropical medicine & international health : TM & IH     Volume:  16     ISSN:  1365-3156     ISO Abbreviation:  Trop. Med. Int. Health     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2012-07-23     Completed Date:  2012-10-01     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  9610576     Medline TA:  Trop Med Int Health     Country:  England    
Other Details:
Languages:  eng     Pagination:  894-901     Citation Subset:  IM    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
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MeSH Terms
Descriptor/Qualifier:
Autopsy
Cause of Death*
Female
Fetal Death / epidemiology*
Humans
Infant
Infant Mortality / trends*
Infant, Newborn
Infection / mortality
Male
Questionnaires
Rural Population / statistics & numerical data*
Stillbirth / epidemiology*
Zambia / epidemiology
Grant Support
ID/Acronym/Agency:
D43 TW001035/TW/FIC NIH HHS; D43-TW001035/TW/FIC NIH HHS; K01-TW06670/TW/FIC NIH HHS; P30-AI027767/AI/NIAID NIH HHS; R24 TW007988/TW/FIC NIH HHS; R24-TW007988/TW/FIC NIH HHS
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