Under-five mortality pattern and associated risk factors: a case-control study at the Princess Marie Louise Children’s Hospital in Accra, Ghana

Tette, Edem M. A.; Nyarko, Mame Yaa; Nartey, Edmund T.; Neizer, Margaret L; Egbefome, Adolph; Akosa, Fredua; Biritwum, Richard B.

doi:10.1186/s12887-016-0682-y

Cited by 27 publications

(33 citation statements)

References 26 publications

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“…On the other hand, other studies showed that more than the half of the deaths had one or multiple problems at the same time implying mainly severe asphyxia at birth, congenital defects, little weight at birth and prematurity [10,13]. Bad nutrition and diarrhea were also comorbidities in Africa [8,24]. This wasn't found in our study.…”

Section: Discussioncontrasting

confidence: 72%

Mortality at the Pediatric Emergency Unit of the Mohammed VI Teaching Hospital of Marrakech

Lahmini

Bourrous

2020

Preprint

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Background : The death of a child at the emergency ward is one of the most difficult problems that the clinicians of these wards have to deal with. In our country the published data concerning the causes and the factors related to pediatric mortality especially in the pediatric emergency wards is very rare. This study aimed to study the epidemiology of the pediatric mortality in the pediatric emergency department (PED), to determine its rate and identify its most frequent causes. Methods : It is a retrospective and descriptive study, over five years (1st January 2012 and 31st December 2016) including all children aged from 0 to 15 years old who died at the PED in the Mohamed VI Hospital in Marrakech. Results : During the period of the study a total of 172.691 patients presented to the PED, among which 628 died (pediatric mortality rate : 3.63%). The masculine gender was predominant (n=383) with a gender ratio of 1.59. Two-thirds of the patients died in the first 24 hours (n=421). The median of time from admission to death was around 12 hours. Majority of the deceased children (n=471, 75%) were from a low socioeconomic status. The most frequent cause of admissions for deceased patients in the PED was respiratory distress (n=296, 47%) followed by neurological disorders (n=70, 11%). Neonatal mortality (≤ 1 month of age) was predominant (n=472, 75.1%), followed by postnatal mortality (1 month to 1 year old) (n=73, 11.6%). The most frequent causes of pediatric mortality, whatever the age range, were dominated by neonatal pathologies (n=391, 62.3%), followed by infecious causes bronchopulmonary infections included (n=49, 7.7%), birth deformities (n=46, 7.3%) while traumas were merely at 0.9% (n=6). The most frequent causes of neonatal mortality were neonatal infections (n=152, 32.2%) and prematurity (n=115, 24.4%). Conclusion : Our data once again underline the crucial importance of prevention. This requires correct follow-up of the pregnancies, an adequate assistance of births, and perfecting healthcare provision to newborns in order to attain proper assistance.

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Section: Discussioncontrasting

confidence: 72%

Mortality at the Pediatric Emergency Unit of the Mohammed VI Teaching Hospital of Marrakech

Lahmini

Bourrous

2020

Preprint

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“…The study was part of a bigger child mortality investigation at the hospital which also looked at the causes of death, the main diagnostic categories and the place of residence and mortality [15,16]. We examined clinical characteristics in more detail and risk factors for mortality in a case-control study which compared children who died in 2011 with children who survived in the same year [17]. …”

Section: Methodsmentioning

confidence: 99%

Observations from Mortality Trends at The Children’s Hospital, Accra, 2003-2013

Tette¹,

Neizer²,

Nyarko³

et al. 2016

PLoS ONE

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ObjectiveFacility-based studies provide an unparalleled opportunity to assess interventions deployed in hospitals to reduce child mortality which is not easily captured in the national data. We examined mortality trends at the Princess Marie Louise Children’s Hospital (PML) and related it to interventions deployed in the hospital and community to reduce child mortality and achieve the Millennium Development Goal 4 (MDG 4).MethodsThe study was a cross-sectional review of data on consecutive patients who died at the hospital over a period of 11 years, between 2003 and 2013. The total admissions for each year, the major hospital-based and population-based interventions, which took place within the period, were also obtained.ResultsOut of a total of 37,012 admissions, 1,314 (3.6%) deaths occurred and admissions tripled during the period. The average annual change in mortality was -7.12% overall, -7.38% in under-fives, and -1.47% in children ≥5 years. The majority of the deaths, 1,187 (90.3%), occurred in under-fives. The observed decrease in under-five (and overall) mortality rate occurred in a specific and peculiar pattern. Most of the decrease occurred during the period between 2003 and 2006. After that there was a noticeable increase from 2006 to 2008. Then, the rate slowly decreased until the end of the study period in 2013. There was a concomitant decline in malaria mortality following a pattern similar to the decline observed in other parts of the continent during this period. Several interventions might have contributed to the reduction in mortality including the change in malaria treatment policy, improved treatment of malnutrition and increasing paediatric input.ConclusionUnder-fives mortality at PML has declined considerably; however, the reduction in mortality in older children has been minimal and thus requires special attention. Data collection for mortality reviews should be planned and commissioned regularly in hospitals to assess the effects of interventions and understand the context in which they occur. This will provide benchmarks and an impetus for improving care, identify shortfalls and ensure that the gains in child survival are maintained.

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“…Using trend analysis to identify key factors associated with child mortality has become relevant for targeted intervention. The generalisability of some findings from previous studies was limited as most studies in Ghana restricted their analysis to only some selected districts7–9 or a few hospitals 10–12. For studies that pooled data from a different survey, it was not clear how they accounted for sampling weight from different surveys at different time points.…”

Section: Introductionmentioning

confidence: 99%

Understanding the determinants of infant and under-five mortality rates: a multivariate decomposition analysis of Demographic and Health Surveys in Ghana, 2003, 2008 and 2014

et al. 2019

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IntroductionDespite the decline in infant and under-five mortality rates since the last decade, Ghana did not meet the millennium development goal (MDG) 4 target. To implement effective interventions that could fast-track progress towards achieving the sustainable development goal 3 in 2030, factors contributing to the decline in child mortality throughout the MDG period and which factor(s) has/have been consistent in affecting child survival in the last decade need to be understood.MethodsThis study used Demographic and Health Surveys (DHS) from 2003, 2008 and 2014 and data from World Bank Development Indicators (2000–2018). We employed modified Poisson with robust SE and multivariate decomposition approach to assess risk factors of child mortality using DHS data from 2003, 2008 and 2014. Penalised regression was used assess the effect of 25 country-level contextual factors on child survival.ResultsThe risk of infant mortality is approximately five times higher among mothers who had multiple births compared with mothers who had single birth over the last decade (adjusted relative risk 4.6, 95% CI 3.2 to 6.6, p<0.001). An increase in the annual percentage of female labour force participation (FLFP) is associated with the reduction of approximately 10 and 18 infant and under-five annual deaths per 1000 live births, respectively.ConclusionsThis study found that multiple births and shorter birth spacing are associated with increased risk of infant and under-five deaths over the last decade. Increased in FLFP, and the proportion of children sleeping under bed-net are associated with reduced risk of both infants and under-five deaths.

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Under-five mortality pattern and associated risk factors: a case-control study at the Princess Marie Louise Children’s Hospital in Accra, Ghana

Cited by 27 publications

References 26 publications

Mortality at the Pediatric Emergency Unit of the Mohammed VI Teaching Hospital of Marrakech

Mortality at the Pediatric Emergency Unit of the Mohammed VI Teaching Hospital of Marrakech

Observations from Mortality Trends at The Children’s Hospital, Accra, 2003-2013

Understanding the determinants of infant and under-five mortality rates: a multivariate decomposition analysis of Demographic and Health Surveys in Ghana, 2003, 2008 and 2014

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