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. 2020 Jun 4:48:43.
doi: 10.1186/s41182-020-00233-8. eCollection 2020.

Risk factors for mortality among Tanzanian infants and children

Rodrick R Kisenge  1 , Chris A Rees  2 , Jacqueline M Lauer  3 , Enju Liu  4 , Wafaie W Fawzi  5 , Karim P Manji  1 , Christopher P Duggan  1   6   7
Affiliations

Risk factors for mortality among Tanzanian infants and children

Rodrick R Kisenge et al. Trop Med Health. .

Abstract

Background: During the era of the Millennium Development Goals, under 5 mortality rates decreased significantly worldwide; however, reductions were not equally distributed. Children in sub-Saharan Africa still account for more than 50% of the world's annual childhood deaths among children under 5 years of age. Understanding upstream risk factors for mortality among children may reduce the large burden of childhood mortality in sub-Saharan Africa. Our objective was to identify risk factors for mortality among infants and children in Tanzania.

Methods: We conducted a secondary analysis of data pooled from two randomized-controlled micronutrient supplementation trials. A total of 4787 infants were enrolled in the two trials (n = 2387 HIV-exposed and n = 2400 HIV-unexposed). Predictors of mortality were assessed using unadjusted and adjusted hazard ratios (aHRs).

Results: There were 307 total deaths, 262 (11%) among children who were HIV-exposed and 45 (2%) among children who were HIV-unexposed (P < 0.001). The most common cause of death was respiratory diseases (n = 109, 35.5%). Causes of death did not significantly differ between HIV-exposed and HIV-unexposed children. In adjusted regression analyses, children with birth weight <2500 g (aHR 1.75, 95% CI 1.21-2.54), Apgar score of ≤7 at 5 min (aHR 2.16, 95% CI 1.29-3.62), or who were HIV-exposed but not infected (aHR 3.35, 95% CI 2.12-5.28) or HIV-infected (aHR 27.56, 95% CI 17.43-43.58) had greater risk of mortality.

Conclusions: Infection with HIV, low birthweight, or low Apgar scores were associated with higher mortality risk. Early identification and modification of determinants of mortality among infants and children may be the first step to reducing such deaths.

Keywords: HIV; Infants; Mortality; Pediatric; Tanzania.

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Conflict of interest statement

Competing interestsThe authors do not have any potential, perceived, or real conflicts of interest relating to this work.

Figures

Fig. 1
Fig. 1
Survival curves of HIV-infected, HIV-exposed but uninfected, and HIV-unexposed children
See this image and copyright information in PMC

References

    1. You D, Hug L, Ejdemyr S, Idele P, Hogan D, Mathers C, et al. Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: A systematic analysis by the un Inter-Agency Group for Child Mortality Estimation. Lancet. 2015;386(10010):2275–2286. doi: 10.1016/S0140-6736(15)00120-8. - DOI - PubMed
    1. Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: An updated systematic analysis. Lancet. 2015;385(9966):430–440. doi: 10.1016/S0140-6736(14)61698-6. - DOI - PubMed
    1. Global Burden of Disease 2017 HIV Collaborators Global; regional; and national incidence; prevalence; and mortality of HIV; 1980-2017; and forecasts to 2030; for 195 countries and territories: a systematic analysis for the Global Burden of Diseases; Injuries; and Risk Factors Study 2017. Lancet HIV. 2019;6(12):e831–e859. doi: 10.1016/S2352-3018(19)30196-1. - DOI - PMC - PubMed
    1. Forde I, Tripathi V. Association of place of residence and under-five mortality in middle- and low-income countries: a meta-analysis. Child (Basel). 2018;5(4). - PMC - PubMed
    1. Kinney MV, Kerber KJ, Black RE, Cohen B, Nkrumah F, Coovadia H, et al. Sub-Saharan Africa’s mothers, newborns, and children: Where and why do they die? PLoS Med. 2010;7(6):e1000294. doi: 10.1371/journal.pmed.1000294. - DOI - PMC - PubMed

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