Verbal autopsy analysis of childhood deaths in rural Gambia.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2023
2023
Historique:
received:
24
10
2022
accepted:
15
06
2023
medline:
10
7
2023
pubmed:
6
7
2023
entrez:
6
7
2023
Statut:
epublish
Résumé
In low-resource settings, it is challenging to ascertain the burden and causes of under-5 mortality as many deaths occur outside health facilities. We aimed to determine the causes of childhood deaths in rural Gambia using verbal autopsies (VA). We used WHO VA questionnaires to conduct VAs for deaths under-5 years of age in the Basse and Fuladu West Health and Demographic Surveillance Systems (HDSS) in rural Gambia between September 01, 2019, and December 31, 2021. Using a standardized cause of death list, two physicians assigned causes of death and discordant diagnoses were resolved by consensus. VAs were conducted for 89% (647/727) of deaths. Of these deaths, 49.5% (n = 319) occurred at home, 50.1% (n = 324) in females, and 32.3% (n = 209) in neonates. Acute respiratory infection including pneumonia (ARIP) (33.7%, n = 137) and diarrhoeal diseases (23.3%, n = 95) were the commonest primary causes of death in the post-neonatal period. In the neonatal period, unspecified perinatal causes of death (34.0%, n = 71) and deaths due to birth asphyxia (27.3%, n = 57) were the commonest causes of death. Severe malnutrition (28.6%, n = 185) was the commonest underlying cause of death. In the neonatal period, deaths due to birth asphyxia (p-value<0.001) and severe anaemia (p-value = 0.03) were more likely to occur at hospitals while unspecified perinatal deaths (p-value = 0.01) were more likely to occur at home. In the post-neonatal period, deaths due to ARIP (p-value = 0.04) and diarrhoeal disease (p-value = 0.001) were more likely to occur among children aged 1-11 months and 12-23 months respectively. According to VA analysis of deaths identified within two HDSS in rural Gambia, half of deaths amongst children under-5 in rural Gambia occur at home. ARIP and diarrhoea, and the underlying cause of severe malnutrition remain the predominant causes of child mortality. Improved health care and health-seeking behaviour may reduce childhood deaths in rural Gambia.
Sections du résumé
BACKGROUND
In low-resource settings, it is challenging to ascertain the burden and causes of under-5 mortality as many deaths occur outside health facilities. We aimed to determine the causes of childhood deaths in rural Gambia using verbal autopsies (VA).
METHODOLOGY
We used WHO VA questionnaires to conduct VAs for deaths under-5 years of age in the Basse and Fuladu West Health and Demographic Surveillance Systems (HDSS) in rural Gambia between September 01, 2019, and December 31, 2021. Using a standardized cause of death list, two physicians assigned causes of death and discordant diagnoses were resolved by consensus.
RESULTS
VAs were conducted for 89% (647/727) of deaths. Of these deaths, 49.5% (n = 319) occurred at home, 50.1% (n = 324) in females, and 32.3% (n = 209) in neonates. Acute respiratory infection including pneumonia (ARIP) (33.7%, n = 137) and diarrhoeal diseases (23.3%, n = 95) were the commonest primary causes of death in the post-neonatal period. In the neonatal period, unspecified perinatal causes of death (34.0%, n = 71) and deaths due to birth asphyxia (27.3%, n = 57) were the commonest causes of death. Severe malnutrition (28.6%, n = 185) was the commonest underlying cause of death. In the neonatal period, deaths due to birth asphyxia (p-value<0.001) and severe anaemia (p-value = 0.03) were more likely to occur at hospitals while unspecified perinatal deaths (p-value = 0.01) were more likely to occur at home. In the post-neonatal period, deaths due to ARIP (p-value = 0.04) and diarrhoeal disease (p-value = 0.001) were more likely to occur among children aged 1-11 months and 12-23 months respectively.
CONCLUSION
According to VA analysis of deaths identified within two HDSS in rural Gambia, half of deaths amongst children under-5 in rural Gambia occur at home. ARIP and diarrhoea, and the underlying cause of severe malnutrition remain the predominant causes of child mortality. Improved health care and health-seeking behaviour may reduce childhood deaths in rural Gambia.
Identifiants
pubmed: 37410741
doi: 10.1371/journal.pone.0277377
pii: PONE-D-22-29378
pmc: PMC10325104
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0277377Subventions
Organisme : Medical Research Council
ID : MC_EX_MR/R006121/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00031/8
Pays : United Kingdom
Informations de copyright
Copyright: © 2023 Wutor et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Glob Health Action. 2013 Sep 13;6:21518
pubmed: 24041439
BMC Med Res Methodol. 2018 May 18;18(1):43
pubmed: 29776431
Int J Epidemiol. 1996 Aug;25(4):885-93
pubmed: 8921471
BMC Public Health. 2018 Dec 17;18(1):1378
pubmed: 30558586
PLoS One. 2014 Sep 18;9(9):e107280
pubmed: 25232830
Bull World Health Organ. 2006 Mar;84(3):239-45
pubmed: 16583084
J Glob Health. 2017 Jun;7(1):010601
pubmed: 28400957
J Public Health Afr. 2011 May 13;2(2):e18
pubmed: 28299059
Pan Afr Med J. 2019 Aug 22;33:318
pubmed: 31692720
Scand J Public Health Suppl. 2003;62:32-7
pubmed: 14649636
Bull World Health Organ. 2006 Mar;84(3):163
pubmed: 16583067
BMC Public Health. 2022 Jun 6;22(1):1130
pubmed: 35668378
Int J Tuberc Lung Dis. 2016 Oct;20(10):1405-1415
pubmed: 27725055
Bull World Health Organ. 2007 Aug;85(8):570-1
pubmed: 17768508
Trials. 2022 Jan 24;23(1):71
pubmed: 35073989
BMC Public Health. 2017 Aug 11;17(1):653
pubmed: 28800758
PLoS One. 2022 Aug 4;17(8):e0270245
pubmed: 35925957
Trop Med Int Health. 2015 Jul;20(7):941-51
pubmed: 25728631
Soc Sci Med. 1994 Apr;38(8):1091-110
pubmed: 8042057
Bull World Health Organ. 1996;74(2):199-208
pubmed: 8706236
BMC Public Health. 2022 Nov 29;22(1):2215
pubmed: 36447199
PLoS Med. 2007 Nov 20;4(11):e333
pubmed: 18031198
Lancet. 2008 Nov 1;372(9649):1545-54
pubmed: 18984187
Trop Med Int Health. 2000 Jan;5(1):33-9
pubmed: 10672203
Lancet Infect Dis. 2016 Jun;16(6):703-711
pubmed: 26897105
Popul Health Metr. 2011 Aug 04;9:34
pubmed: 21816102
J Biomed Inform. 2019 Jul;95:103208
pubmed: 31078660
BMC Public Health. 2016 Aug 04;16:719
pubmed: 27491865
Bull World Health Organ. 2005 Mar;83(3):171-7
pubmed: 15798840
Int J Epidemiol. 1991 Jun;20(2):424-9
pubmed: 1917245
Lancet. 2018 Apr 14;391(10129):1538-1548
pubmed: 29395268
BMJ Open. 2017 Aug 11;7(8):e012856
pubmed: 28801384
PLoS One. 2010 Aug 18;5(8):e12242
pubmed: 20805878
Int J Environ Res Public Health. 2022 Sep 17;19(18):
pubmed: 36142022
Bull World Health Organ. 1998;76(2):161-71
pubmed: 9648357