Spatial-temporal dynamics and structural determinants of child and maternal mortality in a rural, high HIV burdened South African population, 2000-2014: a study protocol.
Spatial-temporal dynamics and structural determinants of child and maternal mortality in a rural, high HIV burdened South African population, 2000-2014: a study protocol.
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2000-2014 年农村、高艾滋病毒负担的南非人口中儿童和孕产妇死亡率的时空动态和结构决定因素：一项研究方案。
DOI：
10.1136/bmjopen-2015-010013
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发表时间：
2016
期刊：
影响因子：
2.9
通讯作者：
Tanser,F
中科院分区：
文献类型：
--
作者：
Tlou,B;Sartorius,B;Tanser,F
儿童（婴儿和5岁以下）和孕产妇死亡率是评估人口健康状况的关键指标。南非的孕产妇和儿童死亡率很高，反映了非洲大陆在实现千年发展目标方面进展缓慢的趋势。在儿童和孕产妇死亡率方面，农村地区受到的影响往往更大，特别是在艾滋病毒高负担地区。本研究旨在了解2003年至2014年影响非洲中心人口监测区儿童和孕产妇死亡率的因素，以制定有针对性的干预措施，减少资源匮乏环境中的死亡。这将是通过确定儿童和孕产妇死亡率的“热点”及其相关的风险factors.Methods和analysisThis回顾性研究将使用2003-2014年的数据从非洲中心人口信息系统（ACDIS）在农村夸祖鲁-纳塔尔省，南非。研究区域的所有家园都被绘制成精确度<2米的地图，所有死亡都被记录下来，并通过口头尸检访谈确定了指定的死亡原因。 先进的时空聚类技术（规则（Kulldorff）和不规则（FleXScan））将用于识别死亡率“热点”。将测试和使用各种先进的统计建模方法，以确定儿童和孕产妇死亡率的重大风险因素。将评估已确定的“热点”中归因性和风险因素概况的差异，以实现量身定制的干预指导/开发。这项多方面的研究将使一个完善的干预模式，以典型的农村人口与高艾滋病毒负担。伦理道德批准收到了生物医学研究伦理委员会（BREC）的夸祖鲁-纳塔尔大学（BE 169/15）。
IntroductionChild (infant and under-5) and maternal mortality rates are key indicators for assessing the health status of populations. South Africa's maternal and child mortality rates are high, and the country mirrors the continental trend of slow progress towards its Millennium Development Goals. Rural areas are often more affected regarding child and maternal mortalities, specifically in areas with a high HIV burden. This study aims to understand the factors affecting child and maternal mortality in the Africa Centre Demographic Surveillance Area (DSA) from 2003 to 2014 towards developing tailored interventions to reduce the deaths in resource poor settings. This will be done by identifying child and maternal mortality ‘hotspots’ and their associated risk factors.Methods and analysisThis retrospective study will use data for 2003–2014 from the Africa Centre Demographic Information System (ACDIS) in rural KwaZulu-Natal Province, South Africa. All homesteads in the study area have been mapped to an accuracy of <2 m, all deaths recorded and the assigned cause of death established using a verbal autopsy interview. Advanced spatial-temporal clustering techniques (both regular (Kulldorff) and irregular (FleXScan)) will be used to identify mortality ‘hotspots’. Various advanced statistical modelling approaches will be tested and used to identify significant risk factors for child and maternal mortality. Differences in attributability and risk factors profiles in identified ‘hotspots’ will be assessed to enable tailored intervention guidance/development. This multicomponent study will enable a refined intervention model to be developed for typical rural populations with a high HIV burden.EthicsEthical approval was received from the Biomedical Research Ethics Committee (BREC) of the University of KwaZulu-Natal (BE 169/15).