Causes of death identified in neonates enrolled through Child Health and Mortality Prevention Surveillance (CHAMPS), December 2016 –December 2021

Each year, 2.4 million children die within their first month of life. Child Health and Mortality Prevention Surveillance (CHAMPS) established in 7 countries aims to generate accurate data on why such deaths occur and inform prevention strategies. Neonatal deaths that occurred between December 2016 a...

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Published in:	PLOS global public health Vol. 3; no. 3; p. e0001612
Main Authors:	Mahtab, Sana, Madhi, Shabir A., Baillie, Vicky L., Els, Toyah, Thwala, Bukiwe Nana, Onyango, Dickens, Tippet-Barr, Beth A., Akelo, Victor, Igunza, Kitiezo Aggrey, Omore, Richard, Arifeen, Shams El, Gurley, Emily S., Alam, Muntasir, Chowdhury, Atique Iqbal, Rahman, Afruna, Bassat, Quique, Mandomando, Inacio, Ajanovic, Sara, Sitoe, Antonio, Varo, Rosauro, Sow, Samba O., Kotloff, Karen L., Badji, Henry, Tapia, Milagritos D., Traore, Cheick B., Ogbuanu, Ikechukwu U., Bunn, James, Luke, Ronita, Sannoh, Sulaiman, Swarray-Deen, Alim, Assefa, Nega, Scott, J. Anthony G., Madrid, Lola, Marami, Dadi, Fentaw, Surafel, Diaz, Maureen H., Martines, Roosecelis B., Breiman, Robert F., Madewell, Zachary J., Blau, Dianna M., Whitney, Cynthia G.
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 20.03.2023 Public Library of Science (PLoS)
Subjects:	Biology and Life Sciences Medicine and Health Sciences
ISSN:	2767-3375, 2767-3375
Online Access:	Get full text
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Abstract	Each year, 2.4 million children die within their first month of life. Child Health and Mortality Prevention Surveillance (CHAMPS) established in 7 countries aims to generate accurate data on why such deaths occur and inform prevention strategies. Neonatal deaths that occurred between December 2016 and December 2021 were investigated with MITS within 24–72 hours of death. Testing included blood, cerebrospinal fluid and lung cultures, multi-pathogen PCR on blood, CSF, nasopharyngeal swabs and lung tissue, and histopathology examination of lung, liver and brain. Data collection included clinical record review and family interview using standardized verbal autopsy. The full set of data was reviewed by local experts using a standardized process (Determination of Cause of Death) to identify all relevant conditions leading to death (causal chain), per WHO recommendations. For analysis we stratified neonatal death into 24-hours of birth, early (1-<7 days) and late (7-<28 days) neonatal deaths. We analyzed 1458 deaths, 41% occurring within 24-hours, 41% early and 18% late neonatal deaths. Leading underlying causes of death were complications of intrapartum events (31%), complications of prematurity (28%), infections (17%), respiratory disorders (11%), and congenital malformations (8%). In addition to the underlying cause, 62% of deaths had additional conditions and 14% had ≥3 other conditions in the causal chain. The most common causes considering the whole causal chain were infection (40%), prematurity (32%) and respiratory distress syndrome (28%). Common maternal conditions linked to neonatal death were maternal hypertension (10%), labour and delivery complications (8%), multiple gestation (7%), placental complications (6%) obstructed labour and chorioamnionitis (5%, each). CHAMPS’ findings showing the full causal chain of events that lead to death, in addition to maternal factors, highlights the complexities involved in each death along with the multiple opportunities for prevention. Highlighting improvements to prenatal and obstetric care and infection prevention are urgently needed in high-mortality settings.
AbstractList	Each year, 2.4 million children die within their first month of life. Child Health and Mortality Prevention Surveillance (CHAMPS) established in 7 countries aims to generate accurate data on why such deaths occur and inform prevention strategies. Neonatal deaths that occurred between December 2016 and December 2021 were investigated with MITS within 24-72 hours of death. Testing included blood, cerebrospinal fluid and lung cultures, multi-pathogen PCR on blood, CSF, nasopharyngeal swabs and lung tissue, and histopathology examination of lung, liver and brain. Data collection included clinical record review and family interview using standardized verbal autopsy. The full set of data was reviewed by local experts using a standardized process (Determination of Cause of Death) to identify all relevant conditions leading to death (causal chain), per WHO recommendations. For analysis we stratified neonatal death into 24-hours of birth, early (1-<7 days) and late (7-<28 days) neonatal deaths. We analyzed 1458 deaths, 41% occurring within 24-hours, 41% early and 18% late neonatal deaths. Leading underlying causes of death were complications of intrapartum events (31%), complications of prematurity (28%), infections (17%), respiratory disorders (11%), and congenital malformations (8%). In addition to the underlying cause, 62% of deaths had additional conditions and 14% had ≥3 other conditions in the causal chain. The most common causes considering the whole causal chain were infection (40%), prematurity (32%) and respiratory distress syndrome (28%). Common maternal conditions linked to neonatal death were maternal hypertension (10%), labour and delivery complications (8%), multiple gestation (7%), placental complications (6%) obstructed labour and chorioamnionitis (5%, each). CHAMPS' findings showing the full causal chain of events that lead to death, in addition to maternal factors, highlights the complexities involved in each death along with the multiple opportunities for prevention. Highlighting improvements to prenatal and obstetric care and infection prevention are urgently needed in high-mortality settings. Each year, 2.4 million children die within their first month of life. Child Health and Mortality Prevention Surveillance (CHAMPS) established in 7 countries aims to generate accurate data on why such deaths occur and inform prevention strategies. Neonatal deaths that occurred between December 2016 and December 2021 were investigated with MITS within 24-72 hours of death. Testing included blood, cerebrospinal fluid and lung cultures, multi-pathogen PCR on blood, CSF, nasopharyngeal swabs and lung tissue, and histopathology examination of lung, liver and brain. Data collection included clinical record review and family interview using standardized verbal autopsy. The full set of data was reviewed by local experts using a standardized process (Determination of Cause of Death) to identify all relevant conditions leading to death (causal chain), per WHO recommendations. For analysis we stratified neonatal death into 24-hours of birth, early (1-<7 days) and late (7-<28 days) neonatal deaths. We analyzed 1458 deaths, 41% occurring within 24-hours, 41% early and 18% late neonatal deaths. Leading underlying causes of death were complications of intrapartum events (31%), complications of prematurity (28%), infections (17%), respiratory disorders (11%), and congenital malformations (8%). In addition to the underlying cause, 62% of deaths had additional conditions and 14% had ≥3 other conditions in the causal chain. The most common causes considering the whole causal chain were infection (40%), prematurity (32%) and respiratory distress syndrome (28%). Common maternal conditions linked to neonatal death were maternal hypertension (10%), labour and delivery complications (8%), multiple gestation (7%), placental complications (6%) obstructed labour and chorioamnionitis (5%, each). CHAMPS' findings showing the full causal chain of events that lead to death, in addition to maternal factors, highlights the complexities involved in each death along with the multiple opportunities for prevention. Highlighting improvements to prenatal and obstetric care and infection prevention are urgently needed in high-mortality settings.Each year, 2.4 million children die within their first month of life. Child Health and Mortality Prevention Surveillance (CHAMPS) established in 7 countries aims to generate accurate data on why such deaths occur and inform prevention strategies. Neonatal deaths that occurred between December 2016 and December 2021 were investigated with MITS within 24-72 hours of death. Testing included blood, cerebrospinal fluid and lung cultures, multi-pathogen PCR on blood, CSF, nasopharyngeal swabs and lung tissue, and histopathology examination of lung, liver and brain. Data collection included clinical record review and family interview using standardized verbal autopsy. The full set of data was reviewed by local experts using a standardized process (Determination of Cause of Death) to identify all relevant conditions leading to death (causal chain), per WHO recommendations. For analysis we stratified neonatal death into 24-hours of birth, early (1-<7 days) and late (7-<28 days) neonatal deaths. We analyzed 1458 deaths, 41% occurring within 24-hours, 41% early and 18% late neonatal deaths. Leading underlying causes of death were complications of intrapartum events (31%), complications of prematurity (28%), infections (17%), respiratory disorders (11%), and congenital malformations (8%). In addition to the underlying cause, 62% of deaths had additional conditions and 14% had ≥3 other conditions in the causal chain. The most common causes considering the whole causal chain were infection (40%), prematurity (32%) and respiratory distress syndrome (28%). Common maternal conditions linked to neonatal death were maternal hypertension (10%), labour and delivery complications (8%), multiple gestation (7%), placental complications (6%) obstructed labour and chorioamnionitis (5%, each). CHAMPS' findings showing the full causal chain of events that lead to death, in addition to maternal factors, highlights the complexities involved in each death along with the multiple opportunities for prevention. Highlighting improvements to prenatal and obstetric care and infection prevention are urgently needed in high-mortality settings.
Author	Bunn, James Blau, Dianna M. Assefa, Nega Kotloff, Karen L. Badji, Henry Ogbuanu, Ikechukwu U. Madewell, Zachary J. Mandomando, Inacio Luke, Ronita Tippet-Barr, Beth A. Chowdhury, Atique Iqbal Martines, Roosecelis B. Mahtab, Sana Breiman, Robert F. Baillie, Vicky L. Igunza, Kitiezo Aggrey Scott, J. Anthony G. Madhi, Shabir A. Sow, Samba O. Rahman, Afruna Akelo, Victor Onyango, Dickens Tapia, Milagritos D. Ajanovic, Sara Marami, Dadi Bassat, Quique Swarray-Deen, Alim Whitney, Cynthia G. Gurley, Emily S. Madrid, Lola Sannoh, Sulaiman Fentaw, Surafel Omore, Richard Sitoe, Antonio Els, Toyah Arifeen, Shams El Alam, Muntasir Varo, Rosauro Diaz, Maureen H. Traore, Cheick B. Thwala, Bukiwe Nana
AuthorAffiliation	14 Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, United States of America 2 Kenya County Department of Health, Kisumu, Kenya 10 Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain 9 Institutó Catalana de Recerca I Estudis Avançats [ICREA], Barcelona, Spain 25 Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America 11 Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública [CIBERESP], Madrid, Spain 12 Instituto Nacional de Saúde [INS], Maputo, Mozambique 7 ISGlobal—Hospital Clínic, Unversitat de Barcelona, Barcelona, Spain 19 St. Luke’s University Health Network, Easton, Pennsylvania, United States of America 13 Centre pour le Développement des Vaccins (CVD-Mali), Mini
AuthorAffiliation_xml	– name: 16 Crown Agents, Freetown, Sierra Leone – name: 20 University of Ghana Medical School, Accra, Ghana – name: 28 Emory Global Health Institute, Emory University, Atlanta, Georgia, United States of America – name: 22 Department of Infectious Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom – name: 4 Kenya Medical Research Institute-Center for Global Health Research (KEMRI-CGHR), Kisumu, Kenya – name: Jhpiego, UNITED STATES – name: 11 Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública [CIBERESP], Madrid, Spain – name: 15 Department of Pathological Anatomy and Cytology, University Hospital of Point G, Bamako, Mali – name: 19 St. Luke’s University Health Network, Easton, Pennsylvania, United States of America – name: 12 Instituto Nacional de Saúde [INS], Maputo, Mozambique – name: 18 Ola During Children’s Hospital, Freetown, Sierra Leone – name: 25 Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America – name: 8 Centro de Investigação em Saúde de Manhiça [CISM], Maputo, Mozambique – name: 13 Centre pour le Développement des Vaccins (CVD-Mali), Ministère de la Santé, Bamako, Mali – name: 24 Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America – name: 6 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America – name: 7 ISGlobal—Hospital Clínic, Unversitat de Barcelona, Barcelona, Spain – name: 23 Bacterial and Mycology Unit, Ethiopian Public Health Institute, Addis Ababa, Ethiopia – name: 26 Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America – name: 1 South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa – name: 17 World Health Organization–Sierra Leone, Freetown, Sierra Leone – name: 3 Centers for Disease Control and Prevention, Kisumu, Kenya – name: 9 Institutó Catalana de Recerca I Estudis Avançats [ICREA], Barcelona, Spain – name: 2 Kenya County Department of Health, Kisumu, Kenya – name: 14 Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, United States of America – name: 21 College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia – name: 27 Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America – name: 5 International Center for Diarrhoeal Diseases Research (icddr,b), Dhaka, Bangladesh – name: 10 Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
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Copyright	Copyright: © 2023 Mahtab et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 2023 Mahtab et al 2023 Mahtab et al
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Snippet	Each year, 2.4 million children die within their first month of life. Child Health and Mortality Prevention Surveillance (CHAMPS) established in 7 countries...
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SubjectTerms	Biology and Life Sciences Medicine and Health Sciences
Title	Causes of death identified in neonates enrolled through Child Health and Mortality Prevention Surveillance (CHAMPS), December 2016 –December 2021
URI	https://www.ncbi.nlm.nih.gov/pubmed/36963040 https://www.proquest.com/docview/2791381019 https://pubmed.ncbi.nlm.nih.gov/PMC10027211 https://doaj.org/article/597ac256dd7f4d9aaca13eca5fead733
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