Magnitude, trend, and causes of under-five mortality from Kilite-Awlaelo health demographic surveillance database, northern Ethiopia, 2009–2017

Abstract

Background Globally, neonatal and child mortality remains still high. Under-five mortality accounts for four-fifth of child and young adolescent deaths. In Ethiopia, though there has been a remarkable progress over the past years, under-five mortality is still high. Evidence from population-based longitudinal studies on under-five mortality is limited. Thus, this study aims to investigate the magnitude, trend, and causes of under-five mortality in the Kilite-Awlaelo Health Demographic Surveillance System, Northern Ethiopia. Methods Kilite-Awlaelo health and demographic surveillance system was established in 2009 in the northern part of Ethiopia. Population-based longitudinal study design was carried out through extracting data for nine consecutive years (2009–2017). After smoothing the data revealed a visually decreasing trend. Linear, quadratic, exponential, and autoregressive time-series models were checked. Accordingly, the exponential trend model provided the best fit with the lowest standard error of estimate, lowest sum square error and highest adjusted R2 value. Cause-specific mortality was determined by cross tabulating cause of death with specific age death. Results The overall under-five mortality rate was 35.62 per 1000 livebirths. The under-five mortality rate of rural and urban residents was 37.58 and 12.99 deaths per 1000 livebirths respectively. The exponential trend model showed the under-five mortality rate was declining exponentially. Bacterial sepsis 67(20.6%), prematurity 37(11.08%), intestinal infection disease 30(8.98%), acute lower respiratory infections 26(7.78%), and birth asphyxia 24(7.19%) were the major causes of under-five mortality. Conclusion The overall under-five mortality rate for the surveillance period was comparatively lower. A statistically significant difference in under-five mortality rate was observed between urban and rural residents. A statistically significant declining trend in the under-five mortality rate was observed. Bacterial sepsis, prematurity, intestinal infection disease, acute lower respiratory infections, and birth asphyxia were the major causes of under-five mortality. We recommend the huge discrepancy in under-five mortality rate between urban and rural dwellers could be narrowed to some level by increasing healthcare access for rural residents.

Uncertainties in the path to 2030: Increasing trends of under-five mortality in the aftermath of Millennium Development Goal in Eastern Ethiopia

“…Similar finding was also observed in a study conducted in Arbaminch HDSS in Ethiopia which reported 43 death per 1000 live birth [ 22 ]. However, the U5MR in this study is slightly higher than the reported 35.6 deaths per 1000 live births in study conducted in Kilite-Awlaelo HDSS site, Tigray Ethiopia [ 23 ].…”

Time to under-five mortality and its predictors in rural Ethiopia: Cox-gamma shared frailty model

“…The association could be due to the fact that unimproved latrines were a source of infections such as intestinal parasites and other diarrheal diseases. Diarrheal diseases are the third leading cause of child mortality in the country [ 60 ]. So, enhancing improved latrine and its utilization must be one focus of child mortality programs in the country.…”

“…Moreover, they lack natural antibodies (i.e., antibodies passed through breast milk) for infection prevention. This implies that in the countries like Ethiopia where infectious diseases are the leading cause of child mortality [ 60 ], breastfeeding is an option-less intervention in child mortality. The hazard ratio (risk of death) of multiple pregnancies was increased by 3.5 times as compared to a single.…”

“…It was again supported by a study conducted in Rwanda [ 62 ]. It is obvious that most multiple births are premature and which is the second cause of child mortality next to sepsis [ 60 ]. The possible reason for this association may be that different medical assistance during labour and postpartum may increase the risk of death as most of the Ethiopian health facilities are not fully equipped with all the necessary materials [ 63 ].…”

Spatial Distribution of Rotavirus Immunization Coverage in Ethiopia

“…Diarrheal diseases are the second leading cause of death among under-ve children globally (1)(2)(3)(4)(5)(6)(7), claiming more than 128, 500 death and 2.6 million illness in 2016 (8). Rotavirus is the most common cause of severe diarrheal disease.…”