Estimating the causes of 4 million neonatal deaths in the year 2000

Lawn, Joy E; Wilczynska-Ketende, Katarzyna; Cousens, Simon

doi:10.1093/ije/dyl043

Cited by 448 publications

(365 citation statements)

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“…In view of these differences, the data for cause of death presented here are based on South Africa's national burden of disease study [33] and [36] with use of population-based proportionate data for cause of death from 1996, updated for 2000, and revised to use programmatically relevant causes of death categories in the neonatal period rather than the perinatal causes. [37] and [38] Neonatal causes, childhood infections such as pneumonia and diarrhoea, and HIV/AIDS each account for roughly 30% of all child deaths. Deaths during the first month of life, the time of highest risk for child death, are due to three main causes: infections, complications of preterm birth, and birth asphyxia.…”

Section: Figure 2 Cause Of Death In South Africamentioning

confidence: 99%

Every death counts: use of mortality audit data for decision making to save the lives of mothers, babies, and children in South Africa

Bradshaw¹,

Chopra²,

Kerber³

et al. 2008

The Lancet

100

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Section: Figure 2 Cause Of Death In South Africamentioning

confidence: 99%

Every death counts: use of mortality audit data for decision making to save the lives of mothers, babies, and children in South Africa

Bradshaw¹,

Chopra²,

Kerber³

et al. 2008

The Lancet

100

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“…The Child Health Epidemiology Research Group (CHERG) has identified a commonly used hierarchy (congenital abnormality-neonatal tetanus-preterm-birth asphyxia-sepsis/pneumoniadiarrhea-other) to estimate the cause distribution of neonatal deaths. 36 Conditions like congenital malformation and neonatal tetanus with highly specific symptoms (for example malformation, for the former and spasms, stiff neck and jaw for the latter) can be diagnosed by VA with reasonable certainty 16 and are therefore often placed high in the hierarchy. As each cause of death is identified, cases assigned to the cause are sequentially removed from the sample and cannot be assigned another cause of death.…”

Section: Va Cause Of Death Assignmentmentioning

confidence: 99%

“…Currently, there are six recognized direct causes of neonatal deaths identifiable by VA: (1) serious infection (including sepsis, pneumonia), (2) birth asphyxia, (3) prematurity, (4) tetanus, (5) congenital malformation and (6) diarrhea. 36,45 The ICD-10 specifies the listing of the following information on causes of death on the standard International Form of Medical Certification of Death: 46 (1) disease or condition directly leading to death, generally known as the direct cause of death, (2) antecedent causes (morbid conditions, if any, giving rise to the direct cause), otherwise known as the underlying cause(s), and (3) other significant conditions contributing to the death, but not related to the disease or conditions causing it, also known as the contributory cause(s). 47 These definitions can be difficult to interpret when we consider causes of neonatal death.…”

Section: Lack Of Standardized Death Classification Terminologymentioning

confidence: 99%

“…Limitations of hierarchy to assign causes of death Use of a hierarchy has limitations, as the cause of death distribution can vary widely depending on how the hierarchy is selected. Using the CHERG hierarchy which was used to estimate 4 million causes of neonatal deaths 36 (congenital abnormalityneonatal tetanus-preterm-birth asphyxia-sepsis/ pneumonia-diarrhea-other), Baqui et al 12 found a similar cause of death distribution in India. However, using the same data, and reordering the hierarchy by placing prematurity last, we found that the percentage of deaths due to preterm birth decreased from 27 to 9%.…”

Section: Lack Of Standardized Death Classification Terminologymentioning

confidence: 99%

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Ascertaining causes of neonatal deaths using verbal autopsy: current methods and challenges

et al. 2008

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Objective: 'Verbal autopsy' (VA) is used to ascertain cause of death in countries where vital registration systems are lacking. Current VA methods for neonatal deaths vary widely and suffer from several limitations. We aimed to: (1) review current neonatal VA methods, (2) identify gaps and limitations, (3) illustrate some limitations using VA data and (4) identify new approaches in methodology and analysis.Study Design: Rolling techniques and database search terms were used to identify articles that described neonatal VA administration, validation and cause of death assignment.Result: Current VA interviews include open and close-ended modules and are administered by trained interviewers. Causes of death are determined using physician review and/or computer algorithms for various neonatal causes of death. Challenges include lack of a standardized VA instrument and administration of methods, difficulty in identifying gold standards for validation studies, lack of validated algorithms for causes of death, poor existing algorithms, lack of standardized death classification terminology and the use of hierarchy to assign causes of death. Newer probabilistic methods of analysis such as Bayes Theorem or the Symptom Pattern method may improve accuracy for cause of death estimation and alleviate some of the challenges with traditional physician and algorithmic approaches, although additional research is needed.Conclusion: Given the continued reliance on VA to determine cause of death in settings with inadequate registration systems, it is important to understand the gaps in current VA methods and explore how methods can be improved to accurately reflect neonatal disease burden in the global community. Journal of Perinatology (2009) 29, 187-194; doi:10.1038/jp.2008 published online 25 December 2008 Keywords: verbal autopsy; cause of death; neonatal mortality; algorithms; hierarchy; challenges Background Data on causes of death are important for health sector planning, including assessing programmatic needs, monitoring progress of interventions and reassessing health priorities. However, little is known about causes of death in many developing countries because vital registration systems are lacking. Many deaths occur at home, outside the formal health sector, and few are attended by qualified medical professionals. Verbal autopsy (VA) has been used to assign cause of death in such settings.VA is a post-mortem in-depth interview with the primary caregiver of the deceased. In the case of child deaths, this is usually the mother. Underlying assumptions are that (1) each cause of death investigated has a set of observable symptoms that can be recognized and recalled by the primary caregiver, and (2) the characteristics of one cause of death can be distinguished from those of all others.The majority of the estimated 4 million annual global neonatal deaths occur in developing countries outside of the formal health care system. 1 Previous research on cause of death for children <5 often excluded neonatal cases due to poor rep...

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“…Examples include Eberstein et al (1990), who used eight categorical and continuous independent variables, including marital status, education, and birth weight, to model five infant cause-specific mortality rates. Lawn et al (2006) applied the multinomial logistic framework to model the distribution of neonatal deaths in countries with poor data; see Johnson et al (2010) and Liu et al (2012) for related work. Bradshaw et al (2003) and Shahraz et al (2012) employed a multinomial model to redistribute unknown or ill-defined deaths; see Murray et al (2006) for a related application to ill-defined causes.…”

Section: Introductionmentioning

confidence: 99%

Modelling Cause-of-Death Mortality and the Impact of Cause-Elimination

2013

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The analysis of causal mortality provides rich insight into changes in mortality trends that are hidden in population level data. Therefore, we develop and apply a multinomial logistic framework to model causal mortality. We use internationally classified cause-of-death categories and data obtained from the World Health Organization. Inherent dependence amongst the competing causes is accounted for in the framework, which also allows us to investigate the effects of improvements in, or the elimination of, cause-specific mortality. This has applications to scenario-based forecasting often used to assess the impact of changes in mortality. The multinomial model is shown to be more conservative than commonly used approaches based on the force of mortality. We use the model to demonstrate the impact of cause-elimination on aggregate mortality using residual life expectancy and apply the model to a French case study.

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Estimating the causes of 4 million neonatal deaths in the year 2000

Abstract: This exercise highlights the lack of reliable cause-of-death data in the settings in which most neonatal deaths occur. Complex statistical models are not a panacea. Representative data with comparable case definitions and consistent hierarchical cause-of-death attribution are required.

Cited by 448 publications

References 44 publications

Every death counts: use of mortality audit data for decision making to save the lives of mothers, babies, and children in South Africa

Every death counts: use of mortality audit data for decision making to save the lives of mothers, babies, and children in South Africa

Ascertaining causes of neonatal deaths using verbal autopsy: current methods and challenges

Modelling Cause-of-Death Mortality and the Impact of Cause-Elimination

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