Verbal autopsy analysis of childhood deaths in rural Gambia.
Verbal autopsy analysis of childhood deaths in rural Gambia.
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DOI：
10.1371/journal.pone.0277377
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
在资源匮乏的环境中，很难确定5岁以下儿童死亡的负担和原因，因为许多死亡发生在卫生设施之外。我们的目的是确定冈比亚农村儿童死亡的原因，使用口头尸检（VA）。我们使用WHO VA问卷对2019年9月1日至2021年12月31日期间冈比亚农村Basse和Fuladu West健康和人口监测系统（HDSS）中5岁以下死亡的儿童进行了VA。使用标准化的死亡原因列表，两位医生指定的死亡原因和不一致的诊断通过协商一致解决。对89%（647/727）的死亡进行了VA。在这些死亡中，49.5%（n = 319）发生在家中，50.1%（n = 324）发生在女性，32.3%（n = 209）发生在新生儿。急性呼吸道感染包括肺炎（ARIP）（33.7%，n = 137）和呼吸道疾病（23.3%，n = 95）是新生儿后期最常见的主要死亡原因。在新生儿期，未指明的围产期死亡原因（34.0%，n = 71）和出生窒息死亡（27.3%，n = 57）是最常见的死亡原因。严重营养不良（28.6%，n = 185）是最常见的潜在死亡原因。在新生儿期，由于出生窒息（p值<0.001）和严重贫血（p值= 0.03）而导致的死亡更有可能发生在医院，而未指明的围产期死亡（p值= 0.01）更有可能发生在家中。在新生儿后期，ARIP（p值= 0.04）和胰腺疾病（p值= 0.001）导致的死亡更可能分别发生在1-11个月和12-23个月的儿童中。根据退伍军人事务部对冈比亚农村地区两个卫生和社会保障部确定的死亡情况进行的分析，冈比亚农村地区5岁以下儿童的死亡有一半发生在家中。急性呼吸道感染性肺炎和腹泻以及严重营养不良的根本原因仍然是儿童死亡的主要原因。在冈比亚农村地区，改善保健和寻求保健的行为可能会减少儿童死亡。
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). 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. 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. 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.
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影响因子：
2.5
作者：
Mackenzie GA;Osei I;Salaudeen R;Hossain I;Young B;Secka O;D'Alessandro U;Palmu AA;Jokinen J;Hinds J;Flasche S;Mulholland K;Nguyen C;Greenwood B
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通讯作者：
Franca-Koh, Ana Claudia
影响因子：
7.7
作者：
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通讯作者：
CAMPBELL, H
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3.7
作者：
Ceesay, Serign J.;Casals-Pascual, Climent;Conway, David J.
通讯作者：
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