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Title: An autopsy study of maternal mortality in Mozambique: the contribution of infectious diseases
Author: Menéndez, Clara
Romagosa Pérez-Portabella, Cleofé
Ismail, Mamudo R.
Carrilho, Carla
Saute, Francisco
Osman, Nafissa
Machungo, Fernanda
Bardají, Azucena
Quintó, Llorenç
Mayor Aparicio, Alfredo Gabriel
Naniche, Denise
Dobaño, Carlota, 1969-
Alonso, Pedro
Ordi i Majà, Jaume
Keywords: Mortalitat
Malalties infeccioses
VIH (Virus)
Salut pública
Communicable diseases
HIV (Viruses)
Public health
Issue Date: 19-Feb-2008
Publisher: Public Library of Science (PLoS)
Abstract: Background Maternal mortality is a major health problem concentrated in resource-poor regions. Accurate data on its causes using rigorous methods is lacking, but is essential to guide policy-makers and health professionals to reduce this intolerable burden. The aim of this study was to accurately describe the causes of maternal death in order to contribute to its reduction, in one of the regions of the world with the highest maternal mortality ratios. Methods and Findings We conducted a prospective study between October 2002 and December 2004 on the causes of maternal death in a tertiary-level referral hospital in Maputo, Mozambique, using complete autopsies with histological examination. HIV detection was done by virologic and serologic tests, and malaria was diagnosed by histological and parasitological examination. During 26 mo there were 179 maternal deaths, of which 139 (77.6%) had a complete autopsy and formed the basis of this analysis. Of those with test results, 65 women (52.8%) were HIV-positive. Obstetric complications accounted for 38.2% of deaths; haemorrhage was the most frequent cause (16.6%). Nonobstetric conditions accounted for 56.1% of deaths; HIV/AIDS, pyogenic bronchopneumonia, severe malaria, and pyogenic meningitis were the most common causes (12.9%, 12.2%, 10.1% and 7.2% respectively). Mycobacterial infection was found in 12 (8.6%) maternal deaths. Conclusions In this tertiary hospital in Mozambique, infectious diseases accounted for at least half of all maternal deaths, even though effective treatment is available for the four leading causes, HIV/AIDS, pyogenic bronchopneumonia, severe malaria, and pyogenic meningitis. These observations highlight the need to implement effective and available prevention tools, such as intermittent preventive treatment and insecticide-treated bed-nets for malaria, antiretroviral drugs for HIV/AIDS, or vaccines and effective antibiotics for pneumococcal and meningococcal diseases. Deaths due to obstetric causes represent a failure of health-care systems and require urgent improvement.
Note: Reproducció del document publicat a:
It is part of: PLoS Medicine, 2008, vol. 5, num. 2, p. e44
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ISSN: 1549-1277
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (ISGlobal)

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