Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

The high burden of infant deaths in rural Burkina Faso: a prospective community-based cohort study

Authors: Abdoulaye Hama Diallo, Nicolas Meda, Halvor Sommerfelt, Germain S Traore, Simon Cousens, Thorkild Tylleskar, for the PROMISE-EBF study group

Published in: BMC Public Health | Issue 1/2012

Login to get access

Abstract

Background

Infant mortality rates (IMR) remain high in many sub-Saharan African countries, especially in rural settings where access to health services may be limited. Studies in such communities can provide relevant data on the burden of and risk factors for infant death. We measured IMR and explored risk factors for infant death in a cohort of children born in Banfora Health District, a rural area in South-West Burkina Faso.

Methods

A prospective community-based cohort study was nested within the PROMISE-EBF trial (NCT00397150) in 24 villages of the study area. Maternal and infant baseline characteristics were collected at recruitment and after birth, respectively. Home visits were conducted at weeks 3, 6, 12, 24 and 52 after birth. Descriptive statistics were calculated using robust standard errors to account for cluster sampling. Cox multivariable regression was used to investigate potential risk factors for infant death.

Results

Among the 866 live born children included in the study there were 98 infant deaths, yielding an IMR of 113 per 1000 live births (95% CI: 89–143). Over 75% of infant deaths had occurred by 6 months of age and the post neonatal infant mortality rate was 67 per 1000 live births (95% CI: 51–88). Infections (35%) and preterm births complications (23%) were the most common probable causes of death by 6 months. Multivariable analyses identified maternal history of child death, polygyny, twin births and poor anthropometric z-scores at week-3 as factors associated with increased risk of infant death.

Conclusions

We observed a very high IMR in a rural area of Burkina Faso, a country where 75% of the population lives in rural settings. Community-based health interventions targeting mothers and children at high risk are urgently needed to reduce the high burden of infant deaths in these areas.
Appendix
Available only for authorised users
Literature
1.
United Nations: The Millennium Development Goals Report 2009. UN Reports. 2009, New York: United Nations Department of Economic and Social Affairs
2.
Rajaratnam JK, Marcus JR, Flaxman AD, Wang H, Levin-Rector A, Dwyer L, Costa M, Lopez AD, Murray CJ: Neonatal, postneonatal, childhood, and under-5 mortality for 187 countries, 1970–2010: a systematic analysis of progress towards Millennium Development Goal 4. Lancet. 2010, 375 (9730): 1988-2008.CrossRefPubMed
3.
UNICEF: The State of the World's Children 2011: Adolescence an age of opportunity. UNICEF-Publications. 2011, New York: UNICEF, 148-
4.
Bhutta AZ, Chopra M, Axelson H, Berman P, Boerma JT, Bryce J, Bustreo F, Cavagnero E, Cometto G, Daelmans B: Countdown to 2015 decade report (2000–10): taking stock of maternal, newborn, and child survival. Lancet. 2032, 2010: 375-
5.
Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, Jha P, Campbell H, Walker CF, Cibulskis R, et al: Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010, 375 (9730): 1969-1987.CrossRefPubMed
6.
Lozano R, Wang H, Foreman KJ, Rajaratnam JK, Naghavi M, Marcus JR, Dwyer-Lindgren L, Lofgren KT, Phillips D, Atkinson C, et al: Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. Lancet. 2011, 378 (9797): 1139-1165.CrossRefPubMed
7.
You D, Wardlaw T, Salama P, Jones G: Levels and trends in under-5 mortality, 1990–2008. Lancet. 2010, 375 (9709): 100-103.CrossRefPubMed
8.
United Nations Inter-Agency Group for Child Mortality Estimation (IAGCME): Levels and Trends in Child Mortality: Report 2010. Levels and Trends in Child Mortality. 2010, New York: UN/WHO/UNICEF
9.
Bhutta ZA, Lassi ZS: Empowering communities for maternal and newborn health. Lancet. 2010, 375 (9721): 1142-1144.CrossRefPubMed
10.
Byass P, Graham WJ: Grappling with uncertainties along the MDG trail. Lancet. 2011, 378 (9797): 1119-1120.CrossRefPubMed
11.
INSD MEF/Burkina Faso: Recensement General de la Population et de l'Habitat, 2006 (General Population Census, 2006). RGPH. 2009, Ouagadougou (Burkina Faso): MEF/INSD, 586-Accessible at URL http://​www.​insd.​bf,
12.
INSD MEF/Burkina Faso: La Région des Cascades en chiffres (Statistics of the Cascades Region in 2010). Annuaires Statistiques Régionales. 2010, Ouagadougou (Burkina Faso): MEF/INSD, 96-Accessible at URL http://​www.​insd.​bf/​,
13.
Institut National de la Statistique et de la Démographie (INSD) et ICF Macro: Enquête démographique et de santé (EDS-IV) et à indicateurs multiples (MICS), Burkina Faso 2010: Rapport préliminaire (BF, DHS-2010 & MICS-2010). DHS-2010. Edited by Measure DHS IMeIB. 2011, Calverton:INSD/MEF, Burkina Faso, Accessible at URL http://​www.​insd.​bf/​,
14.
Diallo AH, Meda N, Zabsonré E, Sommerfelt H, Cousens S, Tylleskar T: Perinatal mortality in rural Burkina Faso: a prospective community-based cohort study. BMC Pregnancy Childbirth. 2010, 10 (45): 1-9.
15.
Tylleskar T, Jackson D, Meda N, Engebretsen IM, Chopra M, Diallo AH, Doherty T, Ekstrom EC, Fadnes LT, Goga A, et al: Exclusive breastfeeding promotion by peer counsellors in sub-Saharan Africa (PROMISE-EBF): a cluster-randomised trial. Lancet. 2011, 378 (9789): 420-427.CrossRefPubMed
16.
Diallo AH, Meda N, Ouedraogo WT, Cousens S, Tylleskar T: 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 (10): 656-663.CrossRefPubMedPubMedCentral
17.
World Health Organization: Standard neonatal verbal autopsy questionnaire. Revised version. WHO/JHU/SNL. 2003, Geneva (Switzerland): WHO Publications
18.
Winbo IG, Serenius FH, Dahlquist GG, Kallen BA: NICE, a new cause of death classification for stillbirths and neonatal deaths Neonatal and Intrauterine Death Classification according to Etiology. Int J Epidemiol. 1998, 27 (3): 499-504.CrossRefPubMed
19.
Mosley WH, Chen LC: An analytical framework for the study of child survival in developing countries. 1984. Bull World Health Organ. 2003, 81 (2): 140-145.PubMedPubMedCentral
20.
21.
Diallo DA, Cousens SN, Cuzin-Ouattara N, Nebie I, Ilboudo-Sanogo E, Esposito F: Child mortality in a West African population protected with insecticide-treated curtains for a period of up to 6 years. Bull World Health Organ. 2004, 82 (2): 85-91.PubMedPubMedCentral
22.
Schoeps A, Gabrysch S, Niamba L, Sie A, Becher H: The effect of distance to health-care facilities on childhood mortality in rural Burkina Faso. Am J Epidemiol. 2011, 173 (5): 492-498.CrossRefPubMed
23.
Diallo DA, Sutherland C, Nebie I, Konate AT, Ord R, Ilboudo-Sanogo E, Greenwood BM, Cousens SN: Children in Burkina Faso who are protected by insecticide-treated materials are able to clear drug-resistant parasites better than unprotected children. J Infect Dis. 2007, 196 (1): 138-144.CrossRefPubMed
24.
Diallo DA, Sutherland C, Nebie I, Konate AT, Ord R, Pota H, Roper C, Ilboudo-Sanogo E, Greenwood BM, Cousens SN: Sustained use of insecticide-treated curtains is not associated with greater circulation of drug-resistant malaria parasites, or with higher risk of treatment failure among children with uncomplicated malaria in Burkina Faso. Am J Trop Med Hyg. 2007, 76 (2): 237-244.PubMed
25.
Kouyate B, Some F, Jahn A, Coulibaly B, Eriksen J, Sauerborn R, Gustafsson L, Tomson G, Becher H, Mueller O: Process and effects of a community intervention on malaria in rural Burkina Faso: randomized controlled trial. Malar J. 2008, 7: 50-CrossRefPubMedPubMedCentral
26.
Muller O, Becher H, van Zweeden AB, Ye Y, Diallo DA, Konate AT, Gbangou A, Kouyate B, Garenne M: Effect of zinc supplementation on malaria and other causes of morbidity in west African children: randomised double blind placebo controlled trial. BMJ. 2001, 322 (7302): 1567-CrossRefPubMedPubMedCentral
27.
Muller O, Garenne M, Kouyate B, Becher H: The association between protein-energy malnutrition, malaria morbidity and all-cause mortality in West African children. Trop Med Int Health. 2003, 8 (6): 507-511.CrossRefPubMed
28.
Muller O, Traore C, Becher H, Kouyate B: Malaria morbidity, treatment-seeking behaviour, and mortality in a cohort of young children in rural Burkina Faso. Trop Med Int Health. 2003, 8 (4): 290-296.CrossRefPubMed
29.
Muller O, Traore C, Kouyate B, Ye Y, Frey C, Coulibaly B, Becher H: Effects of insecticide-treated bednets during early infancy in an African area of intense malaria transmission: a randomized controlled trial. Bull World Health Organ. 2006, 84 (2): 120-126.CrossRefPubMedPubMedCentral
30.
Hounton S, Chapman G, Menten J, De Brouwere V, Ensor T, Sombie I, Meda N, Ronsmans C: Accessibility and utilisation of delivery care within a Skilled Care Initiative in rural Burkina Faso. Trop Med Int Health. 2008, 13 (Suppl 1): 44-52.CrossRefPubMed
31.
Nikiema L, Kameli Y, Capon G, Sondo B, Martin-Prevel Y: Quality of antenatal care and obstetrical coverage in rural Burkina Faso. J Health Popul Nutr. 2010, 28 (1): 67-75.CrossRefPubMedPubMedCentral
32.
INSD MEF/Burkina Faso: Analyse des résultats de l'enquête annuelle sur les conditions de vie des ménages en 2007 (Annual survey on households living conditions in 2007). EA/QUIBB 2007. 2007, Ouagadougou (Burkina Faso): INSD, MEF/Burkina Faso
33.
Becher H, Kynast-Wolf G, Sie A, Ndugwa R, Ramroth H, Kouyate B, Muller O: Patterns of malaria: cause-specific and all-cause mortality in a malaria-endemic area of west Africa. Am J Trop Med Hyg. 2008, 78 (1): 106-113.PubMed
34.
Becher H, Muller O, Jahn A, Gbangou A, Kynast-Wolf G, Kouyate B: Risk factors of infant and child mortality in rural Burkina Faso. Bull World Health Organ. 2004, 82 (4): 265-273.PubMedPubMedCentral
35.
Hammer GP, Some F, Muller O, Kynast-Wolf G, Kouyate B, Becher H: Pattern of cause-specific childhood mortality in a malaria endemic area of Burkina Faso. Malar J. 2006, 5: 47-CrossRefPubMedPubMedCentral
36.
Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Rudan I, Campbell H, Cibulskis R, Li M: Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012, 379 (9832): 2151-2161.CrossRefPubMed
37.
Muller O, Becher H: Malnutrition and childhood mortality in developing countries. Lancet. 2006, 367 (9527): 1978-CrossRefPubMed
38.
Lang T, Lafaix C, Fassin D, Arnaut I, Salmon B, Baudon D, Ezekiel J: Acute respiratory infections: a longitudinal study of 151 children in Burkina-Faso. Int J Epidemiol. 1986, 15 (4): 553-560.CrossRefPubMed
39.
Amey FK: Polygyny and child survival in West Africa. Soc Biol. 2002, 49 (1–2): 74-89.PubMed
40.
Gyimah SO: Polygynous marital structure and child survivorship in sub-Saharan Africa: some empirical evidence from Ghana. Soc Sci Med. 2009, 68 (2): 334-342.CrossRefPubMed
41.
Ukwuani AF, Cornwell TG, Suchindran MC: Polygyny and child survival in Nigeria: age-dependant effects. J Popul Res. 2002, 19 (2): 17-CrossRef
42.
Prazuck T, Tall F, Roisin AJ, Konfe S, Cot M, Lafaix C: Risk factors for preterm delivery in Burkina Faso (west Africa). Int J Epidemiol. 1993, 22 (3): 489-494.CrossRefPubMed
43.
Hammer GP, Kouyate B, Ramroth H, Becher H: Risk factors for childhood mortality in sub-saharan africa.A comparison of data from a demographic and health survey and from a demographic surveillance system. Acta Trop. 2006, 98 (3): 212-218.CrossRefPubMed
44.
Jahn A, Kynast-Wolf G, Kouyate B, Becher H: Multiple pregnancy in rural Burkina Faso: frequency, survival, and use of health services. Acta Obstet Gynecol Scand. 2006, 85 (1): 26-32.CrossRefPubMed
45.
Edmond KM, Quigley MA, Zandoh C, Danso S, Hurt C, Owusu Agyei S, Kirkwood BR: Aetiology of stillbirths and neonatal deaths in rural Ghana: implications for health programming in developing countries. Paediatr Perinat Epidemiol. 2008, 22 (5): 430-437.CrossRefPubMed
46.
Lawn JE, Cousens S, Zupan J: 4 million neonatal deaths: when? Where? Why?. Lancet. 2005, 365 (9462): 891-900.CrossRefPubMed
47.
Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E, Haider BA, Kirkwood B, Morris SS, Sachdev HP, et al: What works? Interventions for maternal and child undernutrition and survival. Lancet. 2008, 371 (9610): 417-440.CrossRefPubMed
48.
Black RE, Morris SS, Bryce J: Where and why are 10 million children dying every year?. Lancet. 2003, 361 (9376): 2226-2234.CrossRefPubMed
Metadata
Title
The high burden of infant deaths in rural Burkina Faso: a prospective community-based cohort study
Authors
Abdoulaye Hama Diallo
Nicolas Meda
Halvor Sommerfelt
Germain S Traore
Simon Cousens
Thorkild Tylleskar
for the PROMISE-EBF study group
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-739

Other articles of this Issue 1/2012

BMC Public Health 1/2012 Go to the issue

Research article

Impact of genital warts on health related quality of life in men and women in mainland China: a multicenter hospital-based cross-sectional study

Research article

Towns with extremely low mortality due to ischemic heart disease in Spain

Research article

Idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF): A systematic review of identifying criteria

Research article

Identification of the factors associated with outcomes in a Condition Management Programme

Study protocol

The Prevention Of WEight Regain in diabetes type 2 (POWER) study: the effectiveness of adding a combined psychological intervention to a very low calorie diet, design and pilot data of a randomized controlled trial

Research article

Association between sedentary behaviour and socioeconomic factors, diet and lifestyle among the Balearic Islands adolescents