BackgroundInfant birth weight, which is classified into low birth weight, normal birth weight and macrosomia, is associated with short and long-term health consequences, such as neonatal mortality and chronic disease in life. Macrosomia and low birth weight are double burden problems in developing counties, such as Ethiopia, but the paucity of evidence has made it difficult to assess the extent of this situation. As a result there has been inconsistency in the reported prevalence of low birth weight and macrosomia in Ethiopia. This study aimed to determine the incidence and predictors of low birth weight and macrosomia in Tigray, Northern Ethiopia.MethodWe conducted a cross-sectional survey among a cohort of 1152 neonates delivered in Tigray Region at randomly selected hospitals between April and July 2014. We used the birth weight category described previously as an outcome variable. Data were collected using structured questionnaire by midwives. We entered and analyzed data using STATA™ Version 11.0. Data were described using a frequency, percentage, relative risk ratio, and 95% confidence interval. Multinomial logistic regression was conducted to identify independent predictors of low birth weight and macrosomia.ResultIn this study, we found a 10.5% and 6.68% incidence of low birth weight and macrosomia, respectively. Seventy (57.8%) of all low birth weight neonates were term births. The predictors for low birth weight were: early marriage (<18 year) (RRR: 0.59, CI: 0.35–0.97); rural residence (RRR: 0.53, CI: 0.32–0.9); prematurity (RRR: 15.4, CI: 9.18–25.9); no antenatal follow-up (RRR: 6.78, CI: 2.39–19.25); and female sex (RRR: 1.77, CI: 1.13–2.77). Predictors for macrosomia were: female gender (RRR: 0.58, CI: 0.35–0.9); high body mass index (RRR: 5.0, CI: 1.56–16); post-maturity (RRR: 2.23, CI: 1.06–4.6); and no maternal complication (RRR: 0.46, CI: 0.27–0.8).ConclusionIn this study, we found gestational age and gender of the neonate to be common risk factors for both low birth weight and macrosomia. Strengthening antenatal follow up, prevention of pre and post maturity, controlling body mass index, and improving socioeconomic status of mothers are recommendations to prevent the double burden (low birth weight and macrosomia) and associated short and long-term consequences.

In the rural district, mortality due to chronic non-communicable diseases was very high. The observed magnitude of death from chronic non-communicable disease is unlikely to be unique to this district. Thus, formulation of chronic disease prevention and control strategies is recommended.

BackgroundEthiopia has made large-scale healthcare investments to improve child health and survival. However, there is insufficient population level data on the current estimates of infant mortality rate (IMR) in the country. The aim of this study was to measure infant mortality rate, investigate risk factors for infant deaths and identify causes of death in a rural population of northern Ethiopia.MethodsLive births to a cohort of mothers under the Kilite Awlaelo Health and Demographic Surveillance System were followed up to their first birthday or death, between September 11, 2009 and September 10, 2013. Maternal and infant characteristics were collected at baseline and during the regular follow-up visit. Multiple-Cox regression was used to investigate risk factors for infant death. Causes of infant death were identified using physician review verbal autopsy method.ResultsOf the total 3684 infants followed, 174 of them died before their first birthday, yielding an IMR of 47 per 1000 live births (95 % CI: 41, 54) over the four years of follow-up. About 96 % of infants survived up to their first birthday, and 56 % of infant deaths occurred during the neonatal period. Infants born to mothers aged 15–19 years old had higher risk of death (HR = 2.68, 95 % CI: 1. 74, 4.87) than those born to 25–29 years old. Infants of mothers who attained a secondary school and above had 56 % lower risk of death (HR = 0.44, 95 % CI: 0.24, 0.81) compared to those whose mothers did not attend formal education. Sepsis, prematurity and asphyxia and acute lower respiratory tract infections were the commonest causes of death.ConclusionThe IMR for the four-year period was lower than the national and regional estimates. Our findings suggest the need to improve the newborn care, and empower teenagers to delay teenage pregnancy and attain higher levels of education.

BackgroundBecause most deaths in Africa and Asia are not well documented, estimates of mortality are often made using scanty data. The INDEPTH Network works to alleviate this problem by collating detailed individual data from defined Health and Demographic Surveillance sites. By registering all deaths over time and carrying out verbal autopsies to determine cause of death across many such sites, using standardised methods, the Network seeks to generate population-based mortality statistics that are not otherwise available.ObjectiveTo build a large standardised mortality database from African and Asian sites, detailing the relevant methods, and use it to describe cause-specific mortality patterns.DesignIndividual demographic and verbal autopsy (VA) data from 22 INDEPTH sites were collated into a standardised database. The INDEPTH 2013 population was used for standardisation. The WHO 2012 VA standard and the InterVA-4 model were used for assigning cause of death.ResultsA total of 111,910 deaths occurring over 12,204,043 person-years (accumulated between 1992 and 2012) were registered across the 22 sites, and for 98,429 of these deaths (88.0%) verbal autopsies were successfully completed. There was considerable variation in all-cause mortality between sites, with most of the differences being accounted for by variations in infectious causes as a proportion of all deaths.ConclusionsThis dataset documents individual deaths across Africa and Asia in a standardised way, and on an unprecedented scale. While INDEPTH sites are not constructed to constitute a representative sample, and VA may not be the ideal method of determining cause of death, nevertheless these findings represent detailed mortality patterns for parts of the world that are severely under-served in terms of measuring mortality. Further papers explore details of mortality patterns among children and specifically for NCDs, external causes, pregnancy-related mortality, malaria, and HIV/AIDS. Comparisons will also be made where possible with other findings on mortality in the same regions. Findings presented here and in accompanying papers support the need for continued work towards much wider implementation of universal civil registration of deaths by cause on a worldwide basis.