Verbal autopsy analysis of childhood deaths in rural Gambia.

Autor: Wutor BM; Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia., Osei I; Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia.; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom., Babila Galega L; Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia., Ezeani E; Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia., Adefila W; Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia., Hossain I; Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia., Sarwar G; Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia., Mackenzie G; Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia.; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.; Murdoch Children's Research Institute, Melbourne, Australia.; Department of Paediatrics, University of Melbourne, Melbourne, Australia.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Jul 06; Vol. 18 (7), pp. e0277377. Date of Electronic Publication: 2023 Jul 06 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0277377
Abstrakt: 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.
Competing Interests: The authors have declared that no competing interests exist.
(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.)
Databáze: MEDLINE
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