Causes of Morbidity and Mortality among Neonates and Children in Post-Conflict Burundi: A Cross-Sectional Retrospective Study

Moise, Imelda K.

doi:10.3390/children5090125

Cited by 21 publications

(21 citation statements)

References 39 publications

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“…The focus of most community-based neonatal studies is the determination of sociodemographic risk factors for neonatal mortality [ 15 – 19 ]. On the other hand, hospital-based studies have the potential to identify specific causes of neonatal mortality [ 5 , 20 – 22 ]. These two types of research studies complement each other in providing comprehensive data for holistic neonatal interventions.…”

Section: Introductionmentioning

confidence: 99%

Determination of neonatal case-specific fatality rates in a tertiary health institution in North Central Nigeria

et al. 2021

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Background The current neonatal mortality rate in Nigeria (37/1000) is among the highest in the world and the major causes have consistently been reported as sepsis, perinatal asphyxia and prematurity. However, case-specific fatality which defines the risk of dying from these and other neonatal morbidities is rarely emphasized. Determination of case-specific fatality rates (CSFR) may inform a change in our current approach to neonatal care interventions which may eventually bring about the much-needed reduction in our neonatal mortality rate. Our aim was to determine the case-specific fatality rates for the common causes of mortality among hospitalized neonates at the National Hospital Abuja (NHA). Methods Relevant demographic and clinical data on all neonates admitted into the NICU at the NHA over a period of 13 months (January 2017 to February 2018) were extracted from the Neonatal Registry database and analyzed using appropriate statistical methods with the SPSS version 20 software. The case-specific fatality rates were computed for the predominant morbidities in addition to determination of the neonatal mortality rates and associated risk factors. Results and conclusion A total of 730 neonates were admitted, out of which 391 (53.6%) were females, 396 (54.5%) were inborn and 396 (54.2%) were term. The three most prevalent morbidities were prematurity 272(37.2%), neonatal Jaundice 208(28.4%) and perinatal asphyxia 91(12.5%) while the most common causes of mortality were prematurity 47/113(41.6%), congenital malformations 27/113(23.9%) and perinatal asphyxia 26/113(23%). Congenital malformations had the highest case-specific fatality 27/83(32.5%) followed by Perinatal Asphyxia 26/91(28.6%) and prematurity 47/272(20.7%). The mortality pattern differed between inborn and out born babies. Implications of these case-specific fatality rates for targeted interventions are discussed.

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Section: Introductionmentioning

confidence: 99%

Determination of neonatal case-specific fatality rates in a tertiary health institution in North Central Nigeria

et al. 2021

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“…Burundi has a NMR of 25 deaths per 1000 live births and is one of the highest in SSA [9]. A previous facility-based study in Burundi revealed that, nearly 50% of the neonatal deaths were caused by early neonatal infection, and the remaining 50% by prematurity, fetal acute, and lung disease respectively, with variations across geographic area (urban-rural) and based on newborn's sex [10]. More recently, the call to promote health among disadvantaged populations has been echoed through other important global initiatives, notably the Commission on Social Determinants of Health [11] and the Rio Political Declaration on Social Determinants of Health [12].…”

Section: Introductionmentioning

confidence: 99%

Time trends, geographical, socio-economic, and gender disparities in neonatal mortality in Burundi: evidence from the demographic and health surveys, 2010–2016

Yaya

Zegeye²,

Ameyaw

et al. 2020

Arch Public Health

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Background Programmatic and research agendas surrounding neonatal mortality are important to help countries attain the child health related 2030 Sustainable Development Goal (SDG). In Burundi, the Neonatal Mortality Rate (NMR) is 25 per 1000 live births. However, high quality evidence on the over time evolution of inequality in NMR is lacking. This study aims to address the knowledge gap by systematically and comprehensively investigating inequalities in NMR in Burundi with the intent to help the country attain SDG 3.2 which aims to reduce neonatal mortality to at least as low as 12 per 1000 live births by 2030. Methods The Burundi Demographic and Health Survey (BDHS) data for the periods of 2010 and 2016 were used for the analyses. The analyses were carried out using the WHO’s HEAT version 3.1 software. Five equity stratifiers: economic status, education, residence, sex and subnational region were used as benchmark for measuring NMR inequality with time over 6 years. To understand inequalities from a broader perspective, absolute and relative inequality measures, namely Difference, Population Attributable Risk (PAR), Ratio, and Population Attributable Fraction (PAF) were calculated. Statistical significance was measured by computing corresponding 95% Confidence Intervals (CIs). Results NMR in Burundi in 2010 and 2016 were 36.7 and 25.0 deaths per 1000 live births, respectively. We recorded large wealth-driven (PAR = -3.99, 95% CI; − 5.11, − 2.87, PAF = -15.95, 95% CI; − 20.42, − 11.48), education related (PAF = -6.64, 95% CI; − 13.27, − 0.02), sex based (PAR = -1.74, 95% CI; − 2.27, − 1.21, PAF = -6.97, 95% CI; − 9.09, − 4.86), urban-rural (D = 15.44, 95% CI; 7.59, 23.29, PAF = -38.78, 95% CI; − 45.24, − 32.32) and regional (PAR = -12.60, 95% CI; − 14.30, − 10.90, R = 3.05, 95% CI; 1.30, 4.80) disparity in NMR in both survey years, except that urban-rural disparity was not detected in 2016. We found both absolute and relative inequalities and significant reduction in these inequalities over time - except at the regional level, where the disparity remained constant during the study period. Conclusion Large survival advantage remains to neonates of women who are rich, educated, residents of urban areas and some regions. Females had higher chance of surviving their 28th birthday than male neonates. More extensive work is required to battle the NMR gap between different subgroups in the country.

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“…Diverse factors have been reported, such as limited access to appropriate health care often due to financial issues, undernutrition, geographic inaccessibility, shortage of reliable access to safe water, and sanitation [ 4 ]. In Burundi, after malaria and pneumonia, diarrhea is the third leading cause of mortality among children under 5 years [ 5 ]. In 2016, it was estimated that the mortality rate due to diarrhea was 7 per 1,000 live births in Burundi [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Economic burden of childhood diarrhea in Burundi

Niyibitegeka

Riewpaiboon

Youngkong

et al. 2021

glob health res policy

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Background In 2016, diarrhea killed around 7 children aged under 5 years per 1000 live births in Burundi. The objective of this study was to estimate the economic burden associated with diarrhea in Burundi and to examine factors affecting the cost to provide economic evidence useful for the policymaking about clinical management of diarrhea. Methods The study was designed as a prospective cost-of-illness study using an incidence-based approach from the societal perspective. The study included patients aged under 5 years with acute non-bloody diarrhea who visited Buyenzi health center and Prince Regent Charles hospital from November to December 2019. Data were collected through interviews with patients’ caregivers and review of patients’ medical and financial records. Multiple linear regression was performed to identify factors affecting cost, and a cost model was used to generate predictions of various clinical and care management costs. All costs were converted into international dollars for the year 2019. Results One hundred thirty-eight patients with an average age of 14.45 months were included in this study. Twenty-one percent of the total patients included were admitted. The average total cost per episode of diarrhea was Int$109.01. Outpatient visit and hospitalization costs per episode of diarrhea were Int$59.87 and Int$292, respectively. The costs were significantly affected by the health facility type, patient type, health insurance scheme, complications with dehydration, and duration of the episode before consultation. Our model indicates that the prevention of one case of dehydration results in savings of Int$16.81, accounting for approximately 11 times of the primary treatment cost of one case of diarrhea in the community-based management program for diarrhea in Burundi. Conclusion Diarrhea is associated with a substantial economic burden to society. Evidence from this study provides useful information to support health interventions aimed at prevention of diarrhea and dehydration related to diarrhea in Burundi. Appropriate and timely care provided to patients with diarrhea in their communities and primary health centers can significantly reduce the economic burden of diarrhea. Implementing a health policy to provide inexpensive treatment to prevent dehydration can save significant amount of health expenditure.

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Causes of Morbidity and Mortality among Neonates and Children in Post-Conflict Burundi: A Cross-Sectional Retrospective Study

Cited by 21 publications

References 39 publications

Determination of neonatal case-specific fatality rates in a tertiary health institution in North Central Nigeria

Determination of neonatal case-specific fatality rates in a tertiary health institution in North Central Nigeria

Time trends, geographical, socio-economic, and gender disparities in neonatal mortality in Burundi: evidence from the demographic and health surveys, 2010–2016

Economic burden of childhood diarrhea in Burundi

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