Declining child mortality in northern Malawi despite high rates of infection with HIV
OBJECTIVE: To determine whether routine surveys, such as the Demographic and Health Surveys (DHS), have underestimated child mortality in Malawi. METHODS: Rates and causes of child mortality were obtained from a continuous-registration demographic surveillance system (DSS) in Malawi for a population...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The World Health Organization
2010-10-01
|
| Series: | Bulletin of the World Health Organization |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862010001000011&lng=en&tlng=en |
| _version_ | 1827336584990556160 |
|---|---|
| author | A Jahn S Floyd AC Crampin H Mvula V Mwinuka E Mwaiyeghele N McGrath B Zaba PEM Fine JR Glynn |
| author_facet | A Jahn S Floyd AC Crampin H Mvula V Mwinuka E Mwaiyeghele N McGrath B Zaba PEM Fine JR Glynn |
| author_sort | A Jahn |
| collection | DOAJ |
| description | OBJECTIVE: To determine whether routine surveys, such as the Demographic and Health Surveys (DHS), have underestimated child mortality in Malawi. METHODS: Rates and causes of child mortality were obtained from a continuous-registration demographic surveillance system (DSS) in Malawi for a population of 32 000. After initial census, births and deaths were reported by village informants and updated monthly by project enumerators. Cause of death was established by verbal autopsy whenever possible. The likely impact of human immunodeficiency virus (HIV) infection on child mortality was also estimated from antenatal clinic surveillance data. Overall and age-specific mortality rates were compared with those from the 2004 Malawi DHS. FINDINGS: Between August 2002 and February 2006, 38 617 person-years of observation were recorded for 20 388 children aged < 15 years. There were 342 deaths. Re-census data, follow-up visits at 12 months of age and the ratio of stillbirths to neonatal deaths suggested that death registration by the DSS was nearly complete. Infant mortality was 52.7 per 1000 live births, under-5 mortality was 84.8 per 1000 and under-15 mortality was 99.1 per 1000. One-fifth of deaths by age 15 were attributable to HIV infection. Child mortality rates estimated with the DSS were approximately 30% lower than those from national estimates as determined by routine surveys. CONCLUSION: The fact that child mortality rates based on the DSS were relatively low in the study population is encouraging and suggests that the low mortality rates estimated nationally are an accurate reflection of decreasing rates. |
| first_indexed | 2024-03-07T18:33:51Z |
| format | Article |
| id | doaj.art-2e937feded0844b2bb8784e520732111 |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T18:33:51Z |
| publishDate | 2010-10-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-2e937feded0844b2bb8784e5207321112024-03-02T05:06:02ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862010-10-018810746753S0042-96862010001000011Declining child mortality in northern Malawi despite high rates of infection with HIVA Jahn0S Floyd1AC Crampin2H Mvula3V Mwinuka4E Mwaiyeghele5N McGrath6B Zaba7PEM Fine8JR Glynn9London School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineKaronga Prevention StudyKaronga Prevention StudyKaronga Prevention StudyLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineLondon School of Hygiene and Tropical MedicineOBJECTIVE: To determine whether routine surveys, such as the Demographic and Health Surveys (DHS), have underestimated child mortality in Malawi. METHODS: Rates and causes of child mortality were obtained from a continuous-registration demographic surveillance system (DSS) in Malawi for a population of 32 000. After initial census, births and deaths were reported by village informants and updated monthly by project enumerators. Cause of death was established by verbal autopsy whenever possible. The likely impact of human immunodeficiency virus (HIV) infection on child mortality was also estimated from antenatal clinic surveillance data. Overall and age-specific mortality rates were compared with those from the 2004 Malawi DHS. FINDINGS: Between August 2002 and February 2006, 38 617 person-years of observation were recorded for 20 388 children aged < 15 years. There were 342 deaths. Re-census data, follow-up visits at 12 months of age and the ratio of stillbirths to neonatal deaths suggested that death registration by the DSS was nearly complete. Infant mortality was 52.7 per 1000 live births, under-5 mortality was 84.8 per 1000 and under-15 mortality was 99.1 per 1000. One-fifth of deaths by age 15 were attributable to HIV infection. Child mortality rates estimated with the DSS were approximately 30% lower than those from national estimates as determined by routine surveys. CONCLUSION: The fact that child mortality rates based on the DSS were relatively low in the study population is encouraging and suggests that the low mortality rates estimated nationally are an accurate reflection of decreasing rates.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862010001000011&lng=en&tlng=en |
| spellingShingle | A Jahn S Floyd AC Crampin H Mvula V Mwinuka E Mwaiyeghele N McGrath B Zaba PEM Fine JR Glynn Declining child mortality in northern Malawi despite high rates of infection with HIV Bulletin of the World Health Organization |
| title | Declining child mortality in northern Malawi despite high rates of infection with HIV |
| title_full | Declining child mortality in northern Malawi despite high rates of infection with HIV |
| title_fullStr | Declining child mortality in northern Malawi despite high rates of infection with HIV |
| title_full_unstemmed | Declining child mortality in northern Malawi despite high rates of infection with HIV |
| title_short | Declining child mortality in northern Malawi despite high rates of infection with HIV |
| title_sort | declining child mortality in northern malawi despite high rates of infection with hiv |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862010001000011&lng=en&tlng=en |
| work_keys_str_mv | AT ajahn decliningchildmortalityinnorthernmalawidespitehighratesofinfectionwithhiv AT sfloyd decliningchildmortalityinnorthernmalawidespitehighratesofinfectionwithhiv AT accrampin decliningchildmortalityinnorthernmalawidespitehighratesofinfectionwithhiv AT hmvula decliningchildmortalityinnorthernmalawidespitehighratesofinfectionwithhiv AT vmwinuka decliningchildmortalityinnorthernmalawidespitehighratesofinfectionwithhiv AT emwaiyeghele decliningchildmortalityinnorthernmalawidespitehighratesofinfectionwithhiv AT nmcgrath decliningchildmortalityinnorthernmalawidespitehighratesofinfectionwithhiv AT bzaba decliningchildmortalityinnorthernmalawidespitehighratesofinfectionwithhiv AT pemfine decliningchildmortalityinnorthernmalawidespitehighratesofinfectionwithhiv AT jrglynn decliningchildmortalityinnorthernmalawidespitehighratesofinfectionwithhiv |