Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Jul;16(7):894-901.
doi: 10.1111/j.1365-3156.2011.02776.x. Epub 2011 Apr 7.

Causes of stillbirth, neonatal death and early childhood death in rural Zambia by verbal autopsy assessments

Eleanor Turnbull  1 , Mwila K Lembalemba, M Brad Guffey, Carolyn Bolton-Moore, Mwangelwa Mubiana-Mbewe, Namwinga Chintu, Mark J Giganti, Mutinta Nalubamba-Phiri, Elizabeth M Stringer, Jeffrey S A Stringer, Benjamin H Chi
Affiliations

Causes of stillbirth, neonatal death and early childhood death in rural Zambia by verbal autopsy assessments

Eleanor Turnbull et al. Trop Med Int Health. 2011 Jul.

Abstract

Objectives: To describe specific causes of the high rates of stillbirth, neonatal death and early child childhood death in Zambia.

Methods: We conducted a household-based survey in rural Zambia. Socio-demographic and delivery characteristics were recorded, alongside a maternal HIV test. Verbal autopsy questionnaires were administered to elicit mortality-related information and independently reviewed by three experienced paediatricians who assigned a cause and contributing factor to death. For this secondary analysis, deaths were categorized into: stillbirths (foetal death ≥28 weeks of gestation), neonatal deaths (≤28 days) and early childhood deaths (>28 days to <2 years).

Results: Among 1679 households, information was collected on 148 deaths: 34% stillbirths, 26% neonatal and 40% early childhood deaths. Leading identifiable causes of stillbirth were intrauterine infection (26%) and birth asphyxia (18%). Of 32 neonatal deaths, 38 (84%) occurred within the first week of life, primarily because of infections (37%) and prematurity (34%). The majority of early childhood deaths were caused by suspected bacterial infections (82%). HIV prevalence was significantly higher in mothers who reported an early childhood death (44%) than mothers who did not (17%; P < 0.01). Factors significantly associated with mortality were lower socio-economic status (P < 0.01), inadequate water or sanitation facilities (P < 0.01), home delivery (P = 0.04) and absence of a trained delivery attendant (P < 0.01).

Conclusion: We provide community-level data about the causes of death among children under 2 years of age. Infectious etiologies for mortality ranked highest. At a public health level, such information may have an important role in guiding prevention and treatment strategies to address perinatal and early childhood mortality.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Contributing factors to stillbirth, neonatal death and early childhood death in Kafue, Zambia from households surveyed between November 2008 and May 2009 (N = 148).
See this image and copyright information in PMC

References

    1. Anker M, Black R, Coldham C, Kalter H, Quigley M, Ross D. A standard verbal autopsy method for investigating causes of death in infants and children. 1999.
    1. Baiden F, Bawah A, Biai S, et al. Setting international standards for verbal autopsy. Bulletin of the World Health Organization. 2007;85:570–571. - PMC - PubMed
    1. Banda Y, Chapman V, Goldenberg RL, et al. Use of traditional medicine among pregnant women in Lusaka, Zambia. Journal of Alternative and Complementary Medicine. 2007;13:123–127. - PubMed
    1. Carlo WA, Goudar SS, Jehan I, et al. Newborn-care training and perinatal mortality in developing countries. New England Journal of Medicine. 2010;362:614–623. - PMC - PubMed
    1. Central Statistical Office, Ministry of Health, Tropical Diseases Research Centre, University of Zambia & Inc. M. I. Zambia demographic and health survey 2007. 2009.

Publication types