Cause-specific childhood mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites.
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Streatfield P Kim, Khan Wasif A, Bhuiya Abbas, Hanifi Syed M A, Alam Nurul, Ouattara Mamadou, Sanou Aboubakary, Sié Ali, Lankoandé Bruno, Soura Abdramane B, Bonfoh Bassirou, Jaeger Fabienne, Ngoran Eliezer K, Utzinger Juerg, Abreha Loko, Melaku Yohannes A, Weldearegawi Berhe, Ansah Akosua, Hodgson Abraham, Oduro Abraham, Welaga Paul, Gyapong Margaret, Narh Clement T, Narh-Bana Solomon A, Kant Shashi, Misra Puneet, Rai Sanjay K, Bauni Evasius, Mochamah George, Ndila Carolyne, Williams Thomas N, Hamel Mary J, Ngulukyo Emmanuel, Odhiambo Frank O, Sewe Maquins, Beguy Donatien, Ezeh Alex, Oti Samuel, Diallo Aldiouma, Douillot Laetitia, Sokhna Cheikh, Delaunay Valérie, Collinson Mark A, Kabudula Chodziwadziwa W, Kahn Kathleen, Herbst Kobus, Mossong Joël, Chuc Nguyen T K, Bangha Martin, Sankoh Osman A, Byass Peter
Аннотация
OBJECTIVE: To present a description of cause-specific mortality rates and fractions over the first 15 years of life as documented by INDEPTH Network sites in sub-Saharan Africa and south-east Asia.
DESIGN: All childhood deaths at INDEPTH sites are routinely registered and followed up with verbal autopsy (VA) interviews. For this study, VA archives were transformed into the WHO 2012 VA standard format and processed using the InterVA-4 model to assign cause of death. Routine surveillance data also provided person-time denominators for mortality rates. Cause-specific mortality rates and cause-specific mortality fractions are presented according to WHO 2012 VA cause groups for neonatal, infant, 1-4 year and 5-14 year age groups.
RESULTS: A total of 28,751 childhood deaths were documented during 4,387,824 person-years over 18 sites. Infant mortality ranged from 11 to 78 per 1,000 live births, with under-5 mortality from 15 to 152 per 1,000 live births. Sites in Vietnam and Kenya accounted for the lowest and highest mortality rates reported.
CONCLUSIONS: Many children continue to die from relatively preventable causes, particularly in areas with high rates of malaria and HIV/AIDS. Neonatal mortality persists at relatively high, and perhaps sometimes under-documented, rates. External causes of death are a significant childhood problem in some settings.