TY - JOUR
T1 - Causes of death identified in neonates enrolled through Child Health and Mortality Prevention Surveillance (CHAMPS), December 2016 –December 2021
AU - Mahtab, Sana
AU - Madhi, Shabir A.
AU - Baillie, Vicky L.
AU - Els, Toyah
AU - Thwala, Bukiwe Nana
AU - Onyango, Dickens
AU - Tippet-Barr, Beth A.
AU - Akelo, Victor
AU - Igunza, Kitiezo Aggrey
AU - Omore, Richard
AU - El Arifeen, Shams
AU - Gurley, Emily S.
AU - Alam, Muntasir
AU - Chowdhury, Atique Iqbal
AU - Rahman, Afruna
AU - Bassat, Quique
AU - Mandomando, Inacio
AU - Ajanovic, Sara
AU - Sitoe, Antonio
AU - Varo, Rosauro
AU - Sow, Samba O.
AU - Kotloff, Karen L.
AU - Badji, Henry
AU - Tapia, Milagritos D.
AU - Traore, Cheick B.
AU - Ogbuanu, Ikechukwu U.
AU - Bunn, James
AU - Luke, Ronita
AU - Sannoh, Sulaiman
AU - Swarray-Deen, Alim
AU - Assefa, Nega
AU - Scott, J. Anthony G.
AU - Madrid, Lola
AU - Marami, Dadi
AU - Fentaw, Surafel
AU - Diaz, Maureen H.
AU - Martines, Roosecelis B.
AU - Breiman, Robert F.
AU - Madewell, Zachary J.
AU - Blau, Dianna M.
AU - Whitney, Cynthia G.
AU - Hossain, Sazzad
AU - Islam, Saiful
AU - Pervez, Abu Faisal Md
AU - Hussain, Muhammad Faruqe
AU - Dessie, Yadeta
AU - Tesfaye, Tseyon
AU - Leulseged, Haleluya
AU - Dufera, Tadesse
AU - Yigzaw, Hiwot
PY - 2023/3/1
Y1 - 2023/3/1
N2 - Each year, 2.4 million children die within their first month of life. Child Health and Mortality Prevention Surveillance (CHAMPS) established in 7 countries aims to generate accurate data on why such deaths occur and inform prevention strategies. Neonatal deaths that occurred between December 2016 and December 2021 were investigated with MITS within 24–72 hours of death. Testing included blood, cerebrospinal fluid and lung cultures, multipathogen PCR on blood, CSF, nasopharyngeal swabs and lung tissue, and histopathology examination of lung, liver and brain. Data collection included clinical record review and family interview using standardized verbal autopsy. The full set of data was reviewed by local experts using a standardized process (Determination of Cause of Death) to identify all relevant conditions leading to death (causal chain), per WHO recommendations. For analysis we stratified neonatal death into 24-hours of birth, early (1-<7 days) and late (7-<28 days) neonatal deaths. We analyzed 1458 deaths, 41% occurring within 24-hours, 41% early and 18% late neonatal deaths. Leading underlying causes of death were complications of intrapartum events (31%), complications of prematurity (28%), infections (17%), respiratory disorders (11%), and congenital malformations (8%). In addition to the underlying cause, 62% of deaths had additional conditions and 14% had ≥3 other conditions in the causal chain. The most common causes considering the whole causal chain were infection (40%), prematurity (32%) and respiratory distress syndrome (28%). Common maternal conditions linked to neonatal death were maternal hypertension (10%), labour and delivery complications (8%), multiple gestation (7%), placental complications (6%) obstructed labour and chorioamnionitis (5%, each). CHAMPS’ findings showing the full causal chain of events that lead to death, in addition to maternal factors, highlights the complexities involved in each death along with the multiple opportunities for prevention. Highlighting improvements to prenatal and obstetric care and infection prevention are urgently needed in high-mortality settings.
AB - Each year, 2.4 million children die within their first month of life. Child Health and Mortality Prevention Surveillance (CHAMPS) established in 7 countries aims to generate accurate data on why such deaths occur and inform prevention strategies. Neonatal deaths that occurred between December 2016 and December 2021 were investigated with MITS within 24–72 hours of death. Testing included blood, cerebrospinal fluid and lung cultures, multipathogen PCR on blood, CSF, nasopharyngeal swabs and lung tissue, and histopathology examination of lung, liver and brain. Data collection included clinical record review and family interview using standardized verbal autopsy. The full set of data was reviewed by local experts using a standardized process (Determination of Cause of Death) to identify all relevant conditions leading to death (causal chain), per WHO recommendations. For analysis we stratified neonatal death into 24-hours of birth, early (1-<7 days) and late (7-<28 days) neonatal deaths. We analyzed 1458 deaths, 41% occurring within 24-hours, 41% early and 18% late neonatal deaths. Leading underlying causes of death were complications of intrapartum events (31%), complications of prematurity (28%), infections (17%), respiratory disorders (11%), and congenital malformations (8%). In addition to the underlying cause, 62% of deaths had additional conditions and 14% had ≥3 other conditions in the causal chain. The most common causes considering the whole causal chain were infection (40%), prematurity (32%) and respiratory distress syndrome (28%). Common maternal conditions linked to neonatal death were maternal hypertension (10%), labour and delivery complications (8%), multiple gestation (7%), placental complications (6%) obstructed labour and chorioamnionitis (5%, each). CHAMPS’ findings showing the full causal chain of events that lead to death, in addition to maternal factors, highlights the complexities involved in each death along with the multiple opportunities for prevention. Highlighting improvements to prenatal and obstetric care and infection prevention are urgently needed in high-mortality settings.
U2 - 10.1371/journal.pgph.0001612
DO - 10.1371/journal.pgph.0001612
M3 - Article
SN - 2767-3375
VL - 3
JO - PLOS Global Public Health
JF - PLOS Global Public Health
IS - 3
M1 - e0001612
ER -
SDG 3 Good Health and Well-being