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Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India
OBJECTIVE: Understanding the causes of death is key to tackling the burden of three million annual neonatal deaths. Resource-poor settings lack effective vital registration systems for births, deaths and causes of death. We set out to describe cause-specific neonatal mortality in rural areas of Mala...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552925/ https://www.ncbi.nlm.nih.gov/pubmed/25972443 http://dx.doi.org/10.1136/archdischild-2014-307636 |
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author | Fottrell, Edward Osrin, David Alcock, Glyn Azad, Kishwar Bapat, Ujwala Beard, James Bondo, Austin Colbourn, Tim Das, Sushmita King, Carina Manandhar, Dharma Manandhar, Sunil Morrison, Joanna Mwansambo, Charles Nair, Nirmala Nambiar, Bejoy Neuman, Melissa Phiri, Tambosi Saville, Naomi Sen, Aman Seward, Nadine Shah Moore, Neena Shrestha, Bhim Prasad Singini, Bright Tumbahangphe, Kirti Man Costello, Anthony Prost, Audrey |
author_facet | Fottrell, Edward Osrin, David Alcock, Glyn Azad, Kishwar Bapat, Ujwala Beard, James Bondo, Austin Colbourn, Tim Das, Sushmita King, Carina Manandhar, Dharma Manandhar, Sunil Morrison, Joanna Mwansambo, Charles Nair, Nirmala Nambiar, Bejoy Neuman, Melissa Phiri, Tambosi Saville, Naomi Sen, Aman Seward, Nadine Shah Moore, Neena Shrestha, Bhim Prasad Singini, Bright Tumbahangphe, Kirti Man Costello, Anthony Prost, Audrey |
author_sort | Fottrell, Edward |
collection | PubMed |
description | OBJECTIVE: Understanding the causes of death is key to tackling the burden of three million annual neonatal deaths. Resource-poor settings lack effective vital registration systems for births, deaths and causes of death. We set out to describe cause-specific neonatal mortality in rural areas of Malawi, Bangladesh, Nepal and rural and urban India using verbal autopsy (VA) data. DESIGN: We prospectively recorded births, neonatal deaths and stillbirths in seven population surveillance sites. VAs were carried out to ascertain cause of death. We applied descriptive epidemiological techniques and the InterVA method to characterise the burden, timing and causes of neonatal mortality at each site. RESULTS: Analysis included 3772 neonatal deaths and 3256 stillbirths. Between 63% and 82% of neonatal deaths occurred in the first week of life, and males were more likely to die than females. Prematurity, birth asphyxia and infections accounted for most neonatal deaths, but important subnational and regional differences were observed. More than one-third of deaths in urban India were attributed to asphyxia, making it the leading cause of death in this setting. CONCLUSIONS: Population-based VA methods can fill information gaps on the burden and causes of neonatal mortality in resource-poor and data-poor settings. Local data should be used to inform and monitor the implementation of interventions to improve newborn health. High rates of home births demand a particular focus on community interventions to improve hygienic delivery and essential newborn care. |
format | Online Article Text |
id | pubmed-4552925 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-45529252015-09-02 Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India Fottrell, Edward Osrin, David Alcock, Glyn Azad, Kishwar Bapat, Ujwala Beard, James Bondo, Austin Colbourn, Tim Das, Sushmita King, Carina Manandhar, Dharma Manandhar, Sunil Morrison, Joanna Mwansambo, Charles Nair, Nirmala Nambiar, Bejoy Neuman, Melissa Phiri, Tambosi Saville, Naomi Sen, Aman Seward, Nadine Shah Moore, Neena Shrestha, Bhim Prasad Singini, Bright Tumbahangphe, Kirti Man Costello, Anthony Prost, Audrey Arch Dis Child Fetal Neonatal Ed Global Child Health OBJECTIVE: Understanding the causes of death is key to tackling the burden of three million annual neonatal deaths. Resource-poor settings lack effective vital registration systems for births, deaths and causes of death. We set out to describe cause-specific neonatal mortality in rural areas of Malawi, Bangladesh, Nepal and rural and urban India using verbal autopsy (VA) data. DESIGN: We prospectively recorded births, neonatal deaths and stillbirths in seven population surveillance sites. VAs were carried out to ascertain cause of death. We applied descriptive epidemiological techniques and the InterVA method to characterise the burden, timing and causes of neonatal mortality at each site. RESULTS: Analysis included 3772 neonatal deaths and 3256 stillbirths. Between 63% and 82% of neonatal deaths occurred in the first week of life, and males were more likely to die than females. Prematurity, birth asphyxia and infections accounted for most neonatal deaths, but important subnational and regional differences were observed. More than one-third of deaths in urban India were attributed to asphyxia, making it the leading cause of death in this setting. CONCLUSIONS: Population-based VA methods can fill information gaps on the burden and causes of neonatal mortality in resource-poor and data-poor settings. Local data should be used to inform and monitor the implementation of interventions to improve newborn health. High rates of home births demand a particular focus on community interventions to improve hygienic delivery and essential newborn care. BMJ Publishing Group 2015-09 2015-05-13 /pmc/articles/PMC4552925/ /pubmed/25972443 http://dx.doi.org/10.1136/archdischild-2014-307636 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ |
spellingShingle | Global Child Health Fottrell, Edward Osrin, David Alcock, Glyn Azad, Kishwar Bapat, Ujwala Beard, James Bondo, Austin Colbourn, Tim Das, Sushmita King, Carina Manandhar, Dharma Manandhar, Sunil Morrison, Joanna Mwansambo, Charles Nair, Nirmala Nambiar, Bejoy Neuman, Melissa Phiri, Tambosi Saville, Naomi Sen, Aman Seward, Nadine Shah Moore, Neena Shrestha, Bhim Prasad Singini, Bright Tumbahangphe, Kirti Man Costello, Anthony Prost, Audrey Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India |
title | Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India |
title_full | Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India |
title_fullStr | Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India |
title_full_unstemmed | Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India |
title_short | Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India |
title_sort | cause-specific neonatal mortality: analysis of 3772 neonatal deaths in nepal, bangladesh, malawi and india |
topic | Global Child Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552925/ https://www.ncbi.nlm.nih.gov/pubmed/25972443 http://dx.doi.org/10.1136/archdischild-2014-307636 |
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