Verbal autopsy analysis of childhood deaths in rural Gambia

Wutor, Baleng Mahama; Osei, Isaac; Galega, Lobga Babila; Ezeani, Esu; Adefila, Williams; Hossain, Ilias; Sarwar, Golam; Mackenzie, Grant

doi:10.1371/journal.pone.0277377

Cited by 3 publications

(1 citation statement)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Given that half of the deaths occurring among children under-5 within the two HDSSs occur at home, death identification through the HDSSs has been an important safety element during studies. 23 In both HDSSs, a robust system is in place to determine under-5 deaths. This system has relied on a close collaboration between HDSS field workers, project field workers, village reporters (VRs) and community chiefs (‘Alkalos’).…”

Section: Approach To Under-5 Mortality Surveillancementioning

confidence: 99%

Under-5 mortality surveillance in low-income and middle-income countries: insights from two Health and Demographic Surveillance Systems in rural Gambia

Wutor,

Osei,

Sarwar

et al. 2024

BMJ Glob Health

Self Cite

View full text Add to dashboard Cite

Without complete data on under-5 mortality, tracking progress towards achieving Sustainable Development Goal 3.2 will be challenging. Such data are also needed to ensure proper planning and prioritisation of scarce resources in low-income and middle-income countries. However, most low-income and middle-income countries have weak Civil Registration and Vital Statistics (CRVS) systems, leaving a critical gap in understanding under-5 mortality dynamics. This paper outlines a community-based approach to enhance under-5 mortality surveillance in low-income countries, using The Gambia as a case study. The methodology involves Health and Demographic Surveillance Systems (HDSSs) in Basse and Fuladu West, employing unique identification numbers, periodical household visits and collaboration with communities, village reporters and project field workers to ensure comprehensive data collection. Verbal autopsies (VAs) are conducted by trained field workers, and causes of death are determined using the physician-certified VA method. Between 1 September 2019 and 1 September 2023, 1333 deaths were detected, for which causes of death were determined for 97.1% (1294 of 1333). The most common causes of death detected were acute respiratory infections including pneumonia, sepsis, diarrhoeal diseases and birth asphyxia. Challenges include the cost of maintaining the HDSSs, poor road infrastructure, Electronic Data Capture transition challenges, and the need for national integration of HDSS data into the CRVS system. The success of this model highlights its potential for scalable and adaptable under-5 mortality surveillance in resource-limited settings.

show abstract

Section: Approach To Under-5 Mortality Surveillancementioning

confidence: 99%

Under-5 mortality surveillance in low-income and middle-income countries: insights from two Health and Demographic Surveillance Systems in rural Gambia

Wutor,

Osei,

Sarwar

et al. 2024

BMJ Glob Health

Self Cite

View full text Add to dashboard Cite

show abstract

Children develop Immunity to cryptosporidiosis in a high transmission intensity area

Petri

Hossain²,

Kabir

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: Cryptosporidium is one of the top causes of diarrhea in Bangladesh infants. Cryptosporidium infections lead to the production of antibody immune responses, which were associated with a decrease in parasite burden and decreased disease severity in subsequent infections. Methods: We conducted a longitudinal study of cryptosporidiosis from birth to five years of age in an urban slum of Dhaka Bangladesh. We then retrospectively tested all available samples from the stool collected during 0-3 years from 54 children by enzyme-linked immunosorbent assay (ELISA). We also assessed the concentration of anti-Cryptosporidium Cp17 or Cp23 IgA and IgG antibodies in the childrens plasma (1- 5 years). Results: The seroprevalence of both anti- Cp23 and Cp17 antibodies was high at greater than one year of age and reflected the exposure of these children in this community to cryptosporidiosis. Elevated levels of the antibodies against the antigens were associated with protection from reinfection but gradually decreased over the study period. In Bangladesh, the prevalence of cryptosporidiosis is high during the rainy season (June to October) but decreases during the dry season. Fecal anti-Cp23 and anti-Cp17 levels were unchanged irrespective of seasonality however in younger infants plasma anti-Cp17 and Cp23 IgG and anti-Cp17 IgA levels were markedly higher during the rainy season. Conclusions: In Bangladeshi children, infection resulted in anti-Cp23 and anti-Cp17 IgA and IgG antibodies. independent of the number of subsequent Cryptosporidium reinfections. This was associated with a decrease in both the number of reinfections and the amount of oocyst shed in child feces.

show abstract

Starvation remains the leading cause of death in Tigray, northern Ethiopia, after the Pretoria deal: a call for expedited action

Haileselassie,

Kahsay,

Teklemariam

et al. 2024

BMC Public Health

View full text Add to dashboard Cite

Background People in war-affected areas are more likely to experience excess mortality with hunger. However, information on the causes of death associated with hunger is often nonexistent. The purpose of this study was to verify and investigate hunger and hunger-related deaths after the Pretoria deal in Tigray, northern Ethiopia. Methods A cross-sectional study was conducted in nine districts and 53 IDP sites, which were randomly selected. All households with deceased family members were included and screened for perceived causes of death between November 2, 2022, and August 30, 2023. Suspected starvation deaths were further verified by the WHO-adapted verbal autopsy questionnaire to establish cause-specific mortality. Using a standardized cause-of-death list, three physicians assigned the causes of death, and disagreements over-diagnoses were settled by consensus. The Food and Nutrition Technical Assistance guidelines were also used to quantify household hunger status. Results Verbal autopsies were conducted for 72.2% (1946/2694) of deaths. Of these deaths, 201 (7.5%) in under-five children and 1205 (44.7%) in females were recorded. Deaths increased from 8.6% in March to 16.4% in July. A total of 90.6% of deaths occurred at home. Starvation was the predominant cause of death across all ages (49.3%, n = 1329). About 94/155 (60.3%) in the IDP center and 1235/2539 (48.6%) in the community died due to starvation. Children under five had a higher risk of starvation-related deaths (OR = 1.7; 95% CI: 1.22–2.34). Females were also more likely to die by starvation than males. Large proportions of households (60.1%) had moderate or severe hunger. Conclusion Starvation was the leading cause of death across all ages in the study group. This reflects an expedited humanitarian response from aid agencies to prevent more deaths. Interventions, including the return of the displaced communities to their original homes, are needed to rescue those facing moderate to severe hunger. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-024-20932-9.

show abstract

Verbal autopsy analysis of childhood deaths in rural Gambia

Cited by 3 publications

References 34 publications

Under-5 mortality surveillance in low-income and middle-income countries: insights from two Health and Demographic Surveillance Systems in rural Gambia

Under-5 mortality surveillance in low-income and middle-income countries: insights from two Health and Demographic Surveillance Systems in rural Gambia

Children develop Immunity to cryptosporidiosis in a high transmission intensity area

Starvation remains the leading cause of death in Tigray, northern Ethiopia, after the Pretoria deal: a call for expedited action

Contact Info

Product

Resources

About