Assefa Nega, Lakew Yihune, Belay Betelhem, Kedir Haji, Zelalem Desalew, Baraki Negga, Damena Melake, Oljira Lemessa, Ashenafi Wondimye, Dedefo Melkamu
College of Health and Medical Sciences, Haramaya University, P.O.Box 1494, Harar, Ethiopia.
Ethiopian Public Health Association, Addis Ababa, Ethiopia.
Matern Health Neonatol Perinatol. 2016 Jul 19;2:7. doi: 10.1186/s40748-016-0035-8. eCollection 2016.
In the world, Neonatal mortality accounts for 40 % of death of children under the age of 5 years. Majority of neonatal deaths occur in developing countries outside of formal health system, among which death in the first hour of first day of their life constitute the huge bulk. This analysis is intended to estimate neonatal mortality rates and identify the leading causes of death based on the surveillance data over 6 years period in Kersa health and demographic surveillance system (Kersa HDSS) site, Eastern Ethiopia.
Kersa HDSS is an open dynamic cohort of population established in 2007. The surveillance started after conducting a baseline census followed by population update and events registration on house-to-house visits every 6 months. Data were collected using verbal autopsy (VA) questionnaire from close relatives (usually mothers in this case) and causes of deaths were assigned by 2 to 3 physicians. This analysis was done based on 301 neonatal deaths and 10,934 live births occurred during 2008 to 2013.
The overall neonatal death rate during the study period was 27.5 per 1000 live births. Nearly all neonatal deaths (94 %) occurred at home. More than four-fifth (82.4 %) of the deaths was occurred in the first week of life. More than 80 % of the deaths were due to perinatal causes. Bacterial sepsis of the newborn accounted for 31.2 % followed by birth asphyxia and perinatal respiratory disorder (28.2 %), and prematurity (17.3 %). Higher number of death was observed in Tolla and Bereka sub-districts located at the southern parts of the study site which are away from the main road network.
The overall neonatal mortality over 6 years is the same to the national average (27 per 1000 live births). The leading causes of neonatal death were bacterial sepsis of newborn and birth asphyxia. Community-based skilled health care delivery during birth should be emphasized.
在全球范围内,新生儿死亡占5岁以下儿童死亡人数的40%。大多数新生儿死亡发生在发展中国家的正规卫生系统之外,其中出生后第一天第一个小时内的死亡占了很大比例。本分析旨在根据埃塞俄比亚东部克尔萨卫生和人口监测系统(Kersa HDSS)站点6年期间的监测数据,估计新生儿死亡率并确定主要死因。
Kersa HDSS是2007年建立的一个开放的动态人群队列。在进行基线人口普查后开始监测,随后每6个月进行一次人口更新和逐户事件登记。通过口头尸检(VA)问卷从近亲(在这种情况下通常是母亲)收集数据,死亡原因由2至3名医生确定。本分析基于2008年至2013年期间发生的301例新生儿死亡和10934例活产。
研究期间的总体新生儿死亡率为每1000例活产27.5例。几乎所有新生儿死亡(94%)都发生在家中。超过五分之四(82.4%)的死亡发生在生命的第一周。超过80%的死亡是由于围产期原因。新生儿细菌性败血症占31.2%,其次是出生窒息和围产期呼吸障碍(28.2%),以及早产(17.3%)。在研究站点南部远离主要道路网络的托拉和贝雷卡分区观察到较高的死亡人数。
6年期间的总体新生儿死亡率与全国平均水平相同(每1000例活产27例)。新生儿死亡的主要原因是新生儿细菌性败血症和出生窒息。应强调在分娩期间提供基于社区的熟练医疗服务。