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
. 2018 Oct 15:31:114.
doi: 10.11604/pamj.2018.31.114.16725. eCollection 2018.

Predictors of post neonatal mortality in Western Kenya: a cohort study

Grace Kaguthi  1   2 , Videlis Nduba  1   2 , Martien Wilhelm Borgdorff  2 , Suzanne Verver  2   3   4
Affiliations

Predictors of post neonatal mortality in Western Kenya: a cohort study

Grace Kaguthi et al. Pan Afr Med J. .

Abstract

Introduction: to determine the predictors of mortality in infants in Siaya, western Kenya, ahead of novel tuberculosis (TB) vaccine trials in the same population.

Methods: in a study to determine tuberculosis incidence, 2900 infants aged 0-45 days, weighing ≥ 1700g were enrolled. Four monthly follow up visits were conducted for at least 12 months. HIV testing was done at six weeks of age. Free ancillary care was provided. Deaths were reported by parents, study staff and community workers. Cox proportional Hazard analysis was used to identify risk factors. The period of analysis commenced at six weeks old and was censored at 12 months of age.

Results: included in the analysis were 2528 infants with 2020 person years of follow up (pyo). There were 117 deaths (4.6 %). The post-neonatal mortality rate was 58 (95% CI: 48, 69) per 1000 pyo. In multivariate analysis, health facility births were protective against mortality (Hazard Ratio (HR) 0.54; 95% CI: 0.34, 0.84) and infant HIV infection at baseline was associated with increased mortality (HR 10.3; 95% CI: 6.40, 16.7). HIV uninfected infants born to HIV infected mothers had increased hazards of mortality (HR 1.73; 95% CI: 1.03, 2.90). Gender, weight at six weeks, maternal education and occupation were not significant predictors of mortality.

Conclusion: infant mortality was high and was associated with being born outside a health facility, maternal HIV infection and HIV infection of the infant. Measures to decrease mother to child transmission and other HIV control measures need to be strengthened further to see incremental reductions in infant mortality.

Keywords: Mortality; infant; post-neonatal; tuberculosis; vaccine.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
immediate causes of death (n = 88/117)
Figure 2
Figure 2
underlying causes of death (n = 110/117)
See this image and copyright information in PMC

References

    1. Boschi-Pinto C, Bahl R, Martines J. Limited progress in increasing coverage of neonatal and child-health interventions in Africa and Asia. J Health Popul Nutr. 2009 Dec;27(6):755–62. - PMC - PubMed
    1. Streatfield PK, Khan WA, Bhuiya A, Hanifi SM, Alam N, Ouattara M, et al. Cause-specific childhood mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites. Glob Health Action. 2014;7:25363. - PMC - PubMed
    1. Pelletier DL, Frongillo EA, Jr, Schroeder DG, Habicht JP. The effects of malnutrition on child mortality in developing countries. Bull World Health Organ. 1995;73(4):443–8. - PMC - PubMed
    1. Wang H, Liddell CA, Coates MM, Mooney MD, Levitz CE, Schumacher AE, et al. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014 Sep 13;384(9947):957–79. - PMC - PubMed
    1. Central Bureau of Statistics (CBS) [Kenya] MoHMK . Kenya Demographic and Health Survey. 2003.