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Effect of timing of mother’s death on child survival in a rural HIV hyper-endemic South African population

BACKGROUND: Maternal mortality remains a tragedy and a key determinant for child survival. There is increasing evidence that the hazard ratio of demising for young children escalates after the death of their mothers, but few studies has been done in rural areas were HIV/AIDS is more prevalent. The a...

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Autores principales: Tlou, Boikhutso, Sartorius, Benn, Tanser, Frank
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220497/
https://www.ncbi.nlm.nih.gov/pubmed/30400789
http://dx.doi.org/10.1186/s12889-018-6152-8
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author Tlou, Boikhutso
Sartorius, Benn
Tanser, Frank
author_facet Tlou, Boikhutso
Sartorius, Benn
Tanser, Frank
author_sort Tlou, Boikhutso
collection PubMed
description BACKGROUND: Maternal mortality remains a tragedy and a key determinant for child survival. There is increasing evidence that the hazard ratio of demising for young children escalates after the death of their mothers, but few studies has been done in rural areas were HIV/AIDS is more prevalent. The aim of this study is to investigate the survival of children who lost their mothers soon or after their births in a rural setup with high HIV prevalence in South Africa. METHODS: This study used a data set from Africa Health Research Institute in rural South Africa.The study population comprised children (0–10 years of age) from 2000 to 2014. We employed a Cox regression modelling approach to estimate greatest temporal hazard of the child after the death of their mothers, accounting for the confounding influence of wealth index of the household and HIV status of the mother. RESULTS: We found 62,600 live births, and that 2191 children died when they were less than or equal to 10 years old. The mortality rates for < 5 and 5–9 years is 882.25 and 117.75 per 1000 live births respectively, with a maternal mortality rate of 447.3 deaths per 100,000 live births from 2000 to 2004. Child mortality risk was very high in less than 6 weeks after their mother’s death (HR 3.45 [95%CI: 1.3–6.54]), and decreased drastically after 3 years following her death (HR 0.8 [0.2–6.3]). This increased risk was more pronounced among children aged less than 1 month and living in poor households. CONCLUSIONS: Children (less than 10 years) in rural households are at their highest risk of dying within 6 weeks of mother’s death and this risk decreases substantially after the highly vulnerable window. This indicates that the period of mother’s death does play a critical role on the survival of her children.Thus, understanding this risk and its timing in relation to a mother’s death is critical to guide interventions and stress the relevance of assessing the interaction between clinical care and socio-economic programs in addressing the needs of orphans.
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spelling pubmed-62204972018-11-15 Effect of timing of mother’s death on child survival in a rural HIV hyper-endemic South African population Tlou, Boikhutso Sartorius, Benn Tanser, Frank BMC Public Health Research Article BACKGROUND: Maternal mortality remains a tragedy and a key determinant for child survival. There is increasing evidence that the hazard ratio of demising for young children escalates after the death of their mothers, but few studies has been done in rural areas were HIV/AIDS is more prevalent. The aim of this study is to investigate the survival of children who lost their mothers soon or after their births in a rural setup with high HIV prevalence in South Africa. METHODS: This study used a data set from Africa Health Research Institute in rural South Africa.The study population comprised children (0–10 years of age) from 2000 to 2014. We employed a Cox regression modelling approach to estimate greatest temporal hazard of the child after the death of their mothers, accounting for the confounding influence of wealth index of the household and HIV status of the mother. RESULTS: We found 62,600 live births, and that 2191 children died when they were less than or equal to 10 years old. The mortality rates for < 5 and 5–9 years is 882.25 and 117.75 per 1000 live births respectively, with a maternal mortality rate of 447.3 deaths per 100,000 live births from 2000 to 2004. Child mortality risk was very high in less than 6 weeks after their mother’s death (HR 3.45 [95%CI: 1.3–6.54]), and decreased drastically after 3 years following her death (HR 0.8 [0.2–6.3]). This increased risk was more pronounced among children aged less than 1 month and living in poor households. CONCLUSIONS: Children (less than 10 years) in rural households are at their highest risk of dying within 6 weeks of mother’s death and this risk decreases substantially after the highly vulnerable window. This indicates that the period of mother’s death does play a critical role on the survival of her children.Thus, understanding this risk and its timing in relation to a mother’s death is critical to guide interventions and stress the relevance of assessing the interaction between clinical care and socio-economic programs in addressing the needs of orphans. BioMed Central 2018-11-06 /pmc/articles/PMC6220497/ /pubmed/30400789 http://dx.doi.org/10.1186/s12889-018-6152-8 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Tlou, Boikhutso
Sartorius, Benn
Tanser, Frank
Effect of timing of mother’s death on child survival in a rural HIV hyper-endemic South African population
title Effect of timing of mother’s death on child survival in a rural HIV hyper-endemic South African population
title_full Effect of timing of mother’s death on child survival in a rural HIV hyper-endemic South African population
title_fullStr Effect of timing of mother’s death on child survival in a rural HIV hyper-endemic South African population
title_full_unstemmed Effect of timing of mother’s death on child survival in a rural HIV hyper-endemic South African population
title_short Effect of timing of mother’s death on child survival in a rural HIV hyper-endemic South African population
title_sort effect of timing of mother’s death on child survival in a rural hiv hyper-endemic south african population
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220497/
https://www.ncbi.nlm.nih.gov/pubmed/30400789
http://dx.doi.org/10.1186/s12889-018-6152-8
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