# name
Initial findings from a novel population-based child mortality
                surveillance approach: a descriptive study.

# metadata.dc.description.abstract[].value
--- - Label: BACKGROUND NlmCategory: BACKGROUND content:
                "Sub-Saharan Africa and south Asia contributed 81% of 5\xC2\xB79
                million under-5 deaths and 77% of 2\xC2\xB76 million stillbirths
                worldwide in 2015. Vital registration and verbal autopsy data
                are mainstays for the estimation of leading causes of death, but
                both are non-specific and focus on a single underlying cause. We
                aimed to provide granular data on the contributory causes of
                death in stillborn fetuses and in deceased neonates and children
                younger than 5 years, to inform child mortality prevention
                efforts." - Label: METHODS NlmCategory: METHODS content: "The
                Child Health and Mortality Prevention Surveillance (CHAMPS)
                Network was established at sites in seven countries (Baliakandi,
                Bangladesh; Harar and Kersa, Ethiopia; Siaya and Kisumu, Kenya;
                Bamako, Mali; Manhi\xC3\xA7a, Mozambique; Bombali, Sierra Leone;
                and Soweto, South Africa) to collect standardised,
                population-based, longitudinal data on under-5 mortality and
                stillbirths in sub-Saharan Africa and south Asia, to improve the
                accuracy of determining causes of death. Here, we analysed data
                obtained in the first 2 years after the implementation of CHAMPS
                at the first five operational sites, during which surveillance
                and post-mortem diagnostics, including minimally invasive tissue
                sampling (MITS), were used. Data were abstracted from all
                available clinical records of deceased children, and relevant
                maternal health records were also extracted for stillbirths and
                neonatal deaths, to incorporate reported pregnancy or delivery
                complications. Expert panels followed standardised procedures to
                characterise causal chains leading to death, including
                underlying, intermediate (comorbid or antecedent causes), and
                immediate causes of death for stillbirths, neonatal deaths, and
                child (age 1-59 months) deaths." - Label: FINDINGS NlmCategory:
                RESULTS content: Between Dec 10, 2016, and Dec 31, 2018, MITS
                procedures were implemented at five sites in Mozambique, South
                Africa, Kenya, Mali, and Bangladesh. We screened 2385 death
                notifications for inclusion eligibility, following which 1295
                families were approached for consent; consent was provided for
                MITS by 963 (74%) of 1295 eligible cases approached. At least
                one cause of death was identified in 912 (98%) of 933 cases (180
                stillbirths, 449 neonatal deaths, and 304 child deaths); two or
                more conditions were identified in the causal chain for 585
                (63%) of 933 cases. The most common underlying causes of
                stillbirth were perinatal asphyxia or hypoxia (130 [72%] of 180
                stillbirths) and congenital infection or sepsis (27 [15%]). The
                most common underlying causes of neonatal death were preterm
                birth complications (187 [42%] of 449 neonatal deaths),
                perinatal asphyxia or hypoxia (98 [22%]), and neonatal sepsis
                (50 [11%]). The most common underlying causes of child deaths
                were congenital birth defects (39 [13%] of 304 deaths), lower
                respiratory infection (37 [12%]), and HIV (35 [12%]). In 503
                (54%) of 933 cases, at least one contributory pathogen was
                identified. Cytomegalovirus, Escherichia coli, group B
                Streptococcus, and other infections contributed to 30 (17%) of
                180 stillbirths. Among neonatal deaths with underlying
                prematurity, 60% were precipitated by other infectious causes.
                Of the 275 child deaths with infectious causes, the most common
                contributory pathogens were Klebsiella pneumoniae (86 [31%]),
                Streptococcus pneumoniae (54 [20%]), HIV (40 [15%]), and
                cytomegalovirus (34 [12%]), and multiple infections were common.
                Lower respiratory tract infection contributed to 174 (57%) of
                304 child deaths. - Label: INTERPRETATION NlmCategory:
                CONCLUSIONS content: Cause of death determination using MITS
                enabled detailed characterisation of contributing conditions.
                Global estimates of child mortality aetiologies, which are
                currently based on a single syndromic cause for each death, will
                be strengthened by findings from CHAMPS. This approach adds
                specificity and provides a more complete overview of the chain
                of events leading to death, highlighting multiple potential
                interventions to prevent under-5 mortality and stillbirths. -
                Label: FUNDING NlmCategory: BACKGROUND content: Bill &
                Melinda Gates Foundation.

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Initial findings from a novel population-based child mortality
                surveillance approach: a descriptive study.