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Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

Cause of neonatal deaths in Northern Ethiopia: a prospective cohort study

Authors: Hayelom Gebrekirstos Mengesha, Berhe W. Sahle

Published in: BMC Public Health | Issue 1/2017

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Abstract

Background

Despite the significant reduction in childhood mortality, neonatal mortality has shown little or no concomitant decline worldwide. The dilemma arises in that the lack of documentation of cause of death in developing countries, where registration of vital events is virtually nonexistent. Understanding of the causes of death in neonates is important to guide public health interventions. The present study identifies the common causes of neonatal death in Ethiopia.

Methods

A prospective cohort study was conducted among neonates born between April 2014 and July 2014 in seven hospitals, in Tigray region, Ethiopia. Mothers were interviewed by midwifes respecting risk factors and infant survival. For neonates who died in hospital, causes of death were extracted from medical records, whereas a verbal autopsy method provided presumptive assignment of cause of death for those infants who died at home.

Results

Of the1152 live births, there were 68 deaths (63 per 1000 live births). Two thirds of deaths were attributable to prematurity 23 (34%) or asphyxia 21 (31%). Slight variance was seen between the morality patterns in early and late neonatal periods. In the early neonatal period, 37% were due to prematurity, while asphyxia (35%) was more common in the late neonatal period. All infection-related deaths occurred in neonate-mother dyads from rural areas.

Conclusion

Prematurity, asphyxia, and infections were the leading causes of neonatal deaths in Tigray region during the study period. Causes of deaths identified during early and late neonatal mortality differed, which clearly indicates the need for responsive and evidence-based interventions and policies.
Literature
1.
go back to reference UNICEF World Health Organization, World Bank, and United Nations Population Division. Levels and trends in child mortality – report 2013. Estimates developed by the UN inter-agency group for child mortality estimation. New York: UNICEF; 2013. UNICEF World Health Organization, World Bank, and United Nations Population Division. Levels and trends in child mortality – report 2013. Estimates developed by the UN inter-agency group for child mortality estimation. New York: UNICEF; 2013.
2.
go back to reference UNICEF, World Health Organization, World Bank, and United Nations Population Division. Levels & trends in child mortality: estimates developed by the UN Inter-agency Group for child mortality estimation (UN IGME). UN IGME; 2014. UNICEF, World Health Organization, World Bank, and United Nations Population Division. Levels & trends in child mortality: estimates developed by the UN Inter-agency Group for child mortality estimation (UN IGME). UN IGME; 2014.
3.
go back to reference Lawn JE, Blencowe H, Oza S, You D, Lee AC, Waiswa P, et al. Every Newborn: progress, priorities and potential beyond survival. Lancet. 2014;384(9938):189–205.CrossRefPubMed Lawn JE, Blencowe H, Oza S, You D, Lee AC, Waiswa P, et al. Every Newborn: progress, priorities and potential beyond survival. Lancet. 2014;384(9938):189–205.CrossRefPubMed
4.
go back to reference Shefali O, Joy EL, Daniel RH, Colin M, Simon NC. Neonatal cause of death estimates for the early and late neonatal periods for 194 countries: 2000–2013. Bull World Health Organ. 2015;93:19–28.CrossRef Shefali O, Joy EL, Daniel RH, Colin M, Simon NC. Neonatal cause of death estimates for the early and late neonatal periods for 194 countries: 2000–2013. Bull World Health Organ. 2015;93:19–28.CrossRef
5.
go back to reference Federal Democratic Republic of Ethiopia. Ministry of Health Sector Development Programme IV 2010/11 – 2014/15. Federal Democratic Republic of Ethiopia. Ministry of Health Sector Development Programme IV 2010/11 – 2014/15.
6.
go back to reference Central Statistical Agency [Ethiopia] and ICF International. Ethiopia demographic and health survey 2011. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2012. Central Statistical Agency [Ethiopia] and ICF International. Ethiopia demographic and health survey 2011. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2012.
7.
go back to reference Central Statistical Agency [Ethiopia]. Ethiopia mini demographic and health survey Addis Ababa, Ethiopia. 2014. Central Statistical Agency [Ethiopia]. Ethiopia mini demographic and health survey Addis Ababa, Ethiopia. 2014.
8.
go back to reference Central Statistical Agency [Ethiopia] and ICF International. Ethiopia demographic and health survey 2005. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2006. Central Statistical Agency [Ethiopia] and ICF International. Ethiopia demographic and health survey 2005. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2006.
9.
go back to reference Debelew GT, Afework MF, Yalew AW. Determinants and causes of neonatal mortality in Jimma Zone, South west Ethiopia: a multilevel analysis of prospective follow up study. PLoS ONE. 2014;9(9):e107184.CrossRefPubMedPubMedCentral Debelew GT, Afework MF, Yalew AW. Determinants and causes of neonatal mortality in Jimma Zone, South west Ethiopia: a multilevel analysis of prospective follow up study. PLoS ONE. 2014;9(9):e107184.CrossRefPubMedPubMedCentral
10.
go back to reference Getachew B, Yifru B. Perinatal mortality and associated risk factors: a case control study. Ethiopian J Health Sci. 2012;22(3):153–61. Getachew B, Yifru B. Perinatal mortality and associated risk factors: a case control study. Ethiopian J Health Sci. 2012;22(3):153–61.
11.
go back to reference Weldearegawi B, Yohannes AM, Semaw FA, Yemane A, Fisaha H, Afework M. Infant mortality and causes of infant deaths in rural Ethiopia: a population-based cohort of 3684 births. BMC Public Health. 2015;15:770.CrossRefPubMedPubMedCentral Weldearegawi B, Yohannes AM, Semaw FA, Yemane A, Fisaha H, Afework M. Infant mortality and causes of infant deaths in rural Ethiopia: a population-based cohort of 3684 births. BMC Public Health. 2015;15:770.CrossRefPubMedPubMedCentral
12.
go back to reference Imtiaz J, Hillary H, Sohail S, Zeb A, Mobeen N, Pasha O. Neonatal mortality, risk factors and causes: a prospective population-based cohort study in urban Pakistan. World Health Organ. 2009;87(2):130–8.CrossRef Imtiaz J, Hillary H, Sohail S, Zeb A, Mobeen N, Pasha O. Neonatal mortality, risk factors and causes: a prospective population-based cohort study in urban Pakistan. World Health Organ. 2009;87(2):130–8.CrossRef
13.
go back to reference Tachiweyika E, Gombe N, Shambira G, Chadambuka A, Mufta T, Zizhou S. Determinants of perinatal mortality in Marondera district, Mashonaland East Province of Zimbabwe, a case control study. 2009. Tachiweyika E, Gombe N, Shambira G, Chadambuka A, Mufta T, Zizhou S. Determinants of perinatal mortality in Marondera district, Mashonaland East Province of Zimbabwe, a case control study. 2009.
14.
go back to reference Linked Birth/Infant Death Records for 2007–2010 with ICD10 codes [Internet]. Atlanta: Centers for Disease Control and Prevention; 2013. Linked Birth/Infant Death Records for 2007–2010 with ICD10 codes [Internet]. Atlanta: Centers for Disease Control and Prevention; 2013.
15.
go back to reference Chowdhury HR, Thompson S, Ali M, Alam N, Yunus M, Streatfeld PK. Causes of neonatal deaths in a rural sub district of Bangladesh: implications for intervention. J Health Popul Nutr. 2010;28(4):375–82.CrossRefPubMedPubMedCentral Chowdhury HR, Thompson S, Ali M, Alam N, Yunus M, Streatfeld PK. Causes of neonatal deaths in a rural sub district of Bangladesh: implications for intervention. J Health Popul Nutr. 2010;28(4):375–82.CrossRefPubMedPubMedCentral
16.
go back to reference Landina TM, Rolv TL, Raimos O, Michael JM, Gunnar K, Anne KD. Cause-specific neonatal mortality in a neonatal care unit in Northern Tanzania: a registry based cohort study. BMC Pediatr. 2012;12:116.CrossRef Landina TM, Rolv TL, Raimos O, Michael JM, Gunnar K, Anne KD. Cause-specific neonatal mortality in a neonatal care unit in Northern Tanzania: a registry based cohort study. BMC Pediatr. 2012;12:116.CrossRef
17.
go back to reference Baiden F, Hodgson A, Adjuik M, Adongo P, Ayaga B, Binka F. Trend and causes of neonatal mortality in the Kassena–Nankana district of northern Ghana, 1995–2002. Tropical Medicine and International Health. 2006;11(4):532–539. Baiden F, Hodgson A, Adjuik M, Adongo P, Ayaga B, Binka F. Trend and causes of neonatal mortality in the Kassena–Nankana district of northern Ghana, 1995–2002. Tropical Medicine and International Health. 2006;11(4):532–539.
18.
go back to reference Government of the National State of Tigray. Report on the health status of Tigray region. 2014. Government of the National State of Tigray. Report on the health status of Tigray region. 2014.
20.
go back to reference Hayelom GM, Alem DW, Wondwossen TL, Tesfay HT. Survival of neonates and predictors of their mortality in Tigray region, Northern Ethiopia: prospective cohort study. BMC Pregnancy Child birth. 2016;16:202.CrossRef Hayelom GM, Alem DW, Wondwossen TL, Tesfay HT. Survival of neonates and predictors of their mortality in Tigray region, Northern Ethiopia: prospective cohort study. BMC Pregnancy Child birth. 2016;16:202.CrossRef
21.
go back to reference World Health Organization. 2007 Version International Statistical Classification of Diseases and Related Health Problems. World Health Organization. 2007 Version International Statistical Classification of Diseases and Related Health Problems.
22.
go back to reference Federal Ministry of Health, Ethiopia. Integrated management of newborn and childhood illness for health workers. 2011. Federal Ministry of Health, Ethiopia. Integrated management of newborn and childhood illness for health workers. 2011.
23.
go back to reference Winbo I, Serenius F, Dahlquist G, Kallen B. NICE, a new cause of death classification for stillbirths and neonatal deaths. Int J Epidemiol. 1998;27(3):499–504.CrossRefPubMed Winbo I, Serenius F, Dahlquist G, Kallen B. NICE, a new cause of death classification for stillbirths and neonatal deaths. Int J Epidemiol. 1998;27(3):499–504.CrossRefPubMed
24.
go back to reference Wigglesworth J. Monitoring perinatal mortality: a patho-physiological approach. Lancet. 1980;2(8196):684–6.CrossRefPubMed Wigglesworth J. Monitoring perinatal mortality: a patho-physiological approach. Lancet. 1980;2(8196):684–6.CrossRefPubMed
25.
go back to reference Lawn JE, Wilczynska-Ketende K, Cousens SN. Estimating the causes of 4 million neonatal deaths in the year 2000. Int J Epidemiol. 2006;35(3):706–18.CrossRefPubMed Lawn JE, Wilczynska-Ketende K, Cousens SN. Estimating the causes of 4 million neonatal deaths in the year 2000. Int J Epidemiol. 2006;35(3):706–18.CrossRefPubMed
26.
go back to reference Sahlemariam Y, Berhane Y. Neonatal mortality among hospital delivered babies in Addis Ababa, Ethiopia. Ethiop J Health Dev. 1997;11(3):275–81. Sahlemariam Y, Berhane Y. Neonatal mortality among hospital delivered babies in Addis Ababa, Ethiopia. Ethiop J Health Dev. 1997;11(3):275–81.
27.
go back to reference Richard MM, Cyril ME, John DD, Justin G, Antoinette T, Elizabeth MM, et al. Challenge of reducing perinatal mortality in rural Congo: findings of prospective, population-based study. J Health Popul Nutr. 2011;29(5):532–40. Richard MM, Cyril ME, John DD, Justin G, Antoinette T, Elizabeth MM, et al. Challenge of reducing perinatal mortality in rural Congo: findings of prospective, population-based study. J Health Popul Nutr. 2011;29(5):532–40.
28.
go back to reference Adetola AO, Tongo OO. Neonatal mortality in an urban population in Ibadan, Nigeria. Pediatr Neonatal. 2011;52(5):243–50.CrossRef Adetola AO, Tongo OO. Neonatal mortality in an urban population in Ibadan, Nigeria. Pediatr Neonatal. 2011;52(5):243–50.CrossRef
29.
go back to reference Vinod PK. The current state of newborn health in low income countries and the way forward. Semin Fetal Neonatal Med. 2006;11(1):7–14.CrossRef Vinod PK. The current state of newborn health in low income countries and the way forward. Semin Fetal Neonatal Med. 2006;11(1):7–14.CrossRef
30.
go back to reference Barros F, Bhutta Z, Batra M, Hansen T, Victora C, Rubens C, et al. Global report on preterm birth and still birth (3of7): evidence for effectiveness of interventions. BMC Pregnancy Childbirth. 2010;10(11):S3.CrossRefPubMedPubMedCentral Barros F, Bhutta Z, Batra M, Hansen T, Victora C, Rubens C, et al. Global report on preterm birth and still birth (3of7): evidence for effectiveness of interventions. BMC Pregnancy Childbirth. 2010;10(11):S3.CrossRefPubMedPubMedCentral
31.
go back to reference Margaret GP, Fengxiu O, Colleen P, Matthew WG, Mandy BB, Xiumei H, et al. Pre-pregnancy body mass index and risk of preterm birth: association heterogeneity by preterm subgroups. BMC Pregnancy Childbirth. 2014;14:153.CrossRef Margaret GP, Fengxiu O, Colleen P, Matthew WG, Mandy BB, Xiumei H, et al. Pre-pregnancy body mass index and risk of preterm birth: association heterogeneity by preterm subgroups. BMC Pregnancy Childbirth. 2014;14:153.CrossRef
32.
go back to reference Amal KH, Emily SG, Aliya N. Causes of early childhood deaths in Urban Dhaka, Bangladesh. PLoS ONE. 2009;4(12):e8145.CrossRef Amal KH, Emily SG, Aliya N. Causes of early childhood deaths in Urban Dhaka, Bangladesh. PLoS ONE. 2009;4(12):e8145.CrossRef
33.
go back to reference Diallo AH, Meda N, Oue’draogo WT. A prospective study on neonatal mortality and its predictors in a rural area in Burkina Faso: Can MDG-4 be met by 2015? J Perinatol. 2011;31:656–63.CrossRefPubMedPubMedCentral Diallo AH, Meda N, Oue’draogo WT. A prospective study on neonatal mortality and its predictors in a rural area in Burkina Faso: Can MDG-4 be met by 2015? J Perinatol. 2011;31:656–63.CrossRefPubMedPubMedCentral
34.
go back to reference Edmond KM, Quigley MA, Zandoh C, Danso S, Hurt C, OwusuAgeyi S. Etiology of stillbirths and neonatal deaths in rural Ghana: implications for health programming in developing countries. Paediatr Perinat Epidemiol. 2008;22(5):430–7.CrossRefPubMed Edmond KM, Quigley MA, Zandoh C, Danso S, Hurt C, OwusuAgeyi S. Etiology of stillbirths and neonatal deaths in rural Ghana: implications for health programming in developing countries. Paediatr Perinat Epidemiol. 2008;22(5):430–7.CrossRefPubMed
35.
go back to reference Fottrell E, Osrin D, Alcock G, Azad K, Bapat U, Bondo A, et al. Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India. Arch Dis Child Fetal Neonatal Ed. 2015;100(5):F439–47.CrossRefPubMedPubMedCentral Fottrell E, Osrin D, Alcock G, Azad K, Bapat U, Bondo A, et al. Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India. Arch Dis Child Fetal Neonatal Ed. 2015;100(5):F439–47.CrossRefPubMedPubMedCentral
36.
go back to reference Faith Y, Jennifer SW, Julie B. A retrospective analysis of maternal and neonatal mortality at a teaching and referral hospital in Kenya. Reprod Health. 2013;10(1):134. Faith Y, Jennifer SW, Julie B. A retrospective analysis of maternal and neonatal mortality at a teaching and referral hospital in Kenya. Reprod Health. 2013;10(1):134.
Metadata
Title
Cause of neonatal deaths in Northern Ethiopia: a prospective cohort study
Authors
Hayelom Gebrekirstos Mengesha
Berhe W. Sahle
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3979-8

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