Background:Endemic human coronaviruses (HCoV-229E, HKU1, NL63, and OC43) are common causes of mild or asymptomatic respiratory infections in children but are considered rare causes of death.Methods:We evaluated pediatric deaths from January 2017 through December 2022. A panel of experts determined the cause of death (CoD) by reviewing available data, including pathological and molecular findings from […]
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Use of minimally invasive tissue sampling to determine the contribution of diarrheal diseases to under-five mortality and associated co-morbidities and co-infections in children with fatal diarrheal diseases in Africa and Bangladesh
Achieving the Sustainable Development Goal of reducing child mortality to <25 deaths per 1000 live births by 2030 requires strategies to prevent diarrheal disease-related morbidity and mortality. Accurate etiological diagnosis is essential. This study used postmortem diagnostics to investigate the contribution of diarrhea to under-5 mortality and examine co-morbidities and co-infections in Africa and South […]
Adherence to Perinatal Asphyxia or Sepsis Management Guidelines in Low- and Middle-Income Countries
Importance: Most of the 2.3 million annual neonatal deaths occur in sub-Saharan Africa and South Asia, with perinatal asphyxia and neonatal sepsis being the leading causes of neonatal mortality. Most neonatal deaths are considered preventable through high-quality clinical care, which includes adherence to clinical care guidelines. Objective: To assess adherence to World Health Organization clinical […]
A retrospective assessment of COVID-19 vulnerability index indicators and mortality rates pre-COVID-19 (2018–2020) and during COVID-19 (2020–2022) in a health and demographic surveillance site, Soweto, South Africa
BackgroundBefore COVID-19, knowledge on pandemic vulnerability and mortality in South Africa was largely limited to the context of HIV/AIDS. We evaluated mortality rates and risk of death, prior to and during the COVID-19 pandemic, in relation to an individual’s COVID-19 vulnerability, based on a scoring algorithm developed in South Africa. MethodsThe analysis was undertaken using […]
Making sense of the unexpected: neural tube defects in Ethiopia
Abstract Neural tube defects are severe birth defects with visible and devastating malformations in babies, and can lead to death before, during or soon after birth. Neural tube defects are preventable, and in many countries there has been an increasing ‘responsibilization’ of pregnant women in terms of taking folic acid before and during pregnancy to […]
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Adherence to Perinatal Asphyxia or Sepsis Management Guidelines in Low- and Middle-Income Countries
Key Points Question Do neonates who die of perinatal asphyxia or sepsis in low- and middle-income countries receive guideline-adherent clinical care? Findings In this cross-sectional study of 1194 neonates who died, less than 5% of those who died with perinatal asphyxia received all recommended clinical care, and 61% of those who died from sepsis were given recommended […]
Contribution of malnutrition to infant and child deaths in Sub-Saharan Africa and South Asia
Introduction: Malnutrition contributes to 45% of all childhood deaths globally, but these modelled estimates lack direct measurements in countries with high malnutrition and under-5 mortality rates. We investigated malnutrition’s role in infant and child deaths in the Child Health and Mortality Prevention Surveillance (CHAMPS) network. Methods: We analysed CHAMPS data from seven sites (Bangladesh, Ethiopia, […]
Impact of anthropometry training and feasibility of 3D imaging on anthropometry data quality among children under five years in a postmortem setting
Background: The Child Health and Mortality Prevention Surveillance Network (CHAMPS) identifies causes of under-5 mortality in high-mortality countries. Objective: To address challenges in postmortem nutritional assessment, we evaluated the impact of anthropometry training and the feasibility of 3D imaging on data quality within the CHAMPS Kenya site. Design: Staff were trained using World Health Organization […]
Hepatic Vitamin A Concentrations and Association with Infectious Causes of Child Death
Objectives: To assess postmortem vitamin A (VA) concentrations in children under 5 years of age and evaluate the association between VA deficiency (VAD) and infectious causes of death (CoD). Study design: In this cross-sectional study from the Child Health and Mortality Prevention Surveillance (CHAMPS) Network, liver biopsies collected within 72 hours of death were analyzed from 405 […]
Importance of postmortem anthropometric evaluation in defining the role of malnutrition as a cause of infant and child deaths in Sub-Saharan Africa and South Asia: a cohort study
Objectives: To evaluate how postmortem anthropometric malnutrition (PAM) measures align with expert panel attribution of malnutrition as a causal or significant condition in under-5 mortality (U5M). Design: Cohort study using data from the Child Health and Mortality Prevention Surveillance network, incorporating clinical records, postmortem anthropometrics, minimally invasive tissue sampling, clinical abstraction and verbal autopsy to determine multiple […]