Predicting the distribution of under-five deaths by cause in countries without adequate vital registration systems


Morris, SS; Black, RE; Tomaskovic, L; (2003) Predicting the distribution of under-five deaths by cause in countries without adequate vital registration systems. International journal of epidemiology, 32 (6). pp. 1041-1051. ISSN 0300-5771 DOI: https://doi.org/10.1093/ije/dyg241

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Abstract

Background The absence of complete vital registration and atypical nature of the locations where epidemiological studies of cause of death in children are conducted make it difficult to know the true distribution of child deaths by cause in developing countries. A credible method is needed for generating valid estimates of this distribution for countries without adequate vital registration systems. Methods A systematic review was undertaken of all studies published since 1980 reporting under-5 mortality by cause. Causes of death were standardized across studies, and information was collected on the characteristics of each study and its population. A meta- regression model was used to relate these characteristics to the various proportional mortality outcomes, and predict the distribution in national populations of known characteristics. In all, 46 studies met the inclusion criteria. Results Proportional mortality outcomes were significantly associated with region, mortality level, and exposure to malaria; coverage of measles vaccination, safe delivery care, and safe water; study year, age of children under surveillance, and method used to establish definitive cause of death. In sub-Saharan Africa and in South Asia, the predicted distribution of deaths by cause was: pneumonia (23% and 23%), malaria (24% and <1%), diarrhoea (22% and 23%), 'neonatal and other' (29% and 52%), measles (2% and 1%). Conclusions For countries without adequate vital registration, it is possible to estimate the proportional distribution of child deaths by cause by exploiting systematic associations between this distribution and the characteristics of the populations in which it has been studied, controlling for design features of the studies themselves.

Item Type: Article
Keywords: cause of death, mortality, preschool child, infant mortality, Sub-Saharan Africa Asia, Acute respiratory-infections, early-childhood mortality, upper, river division, infant-mortality, verbal autopsy, south-africa, children, morbidity, district, malaria
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Nutrition and Public Health Interventions Research (2003-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
PubMed ID: 14681271
Web of Science ID: 187463200033
URI: http://researchonline.lshtm.ac.uk/id/eprint/15220

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