Neonatal mortality in a rural area of The Gambia

Childhood mortality in Upper River Division, The Gambia is high, 99 per 1000 mid-year population, and 27% of deaths occur in the neonatal period. 1 The aims of the present study were to describe patterns of neonatal death and to identify risk factors. Cause of death was investigated using a neonatal...

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Bibliographic Details
Published in:	Annals of tropical paediatrics Vol. 19; no. 1; pp. 33 - 43
Main Authors:	Leach, A., Mcardle, T. F., Banya, W. A. S., Krubally, O., Greenwood, A. M., Rands, C., Adegbola, R., De Francisco, A., Greenwood, B. M.
Format:	Journal Article
Language:	English
Published:	Leeds Taylor & Francis 01-03-1999 Maney Taylor & Francis Ltd
Subjects:	Analysis. Health state Biological and medical sciences Case-Control Studies Cause of Death Developing Countries Epidemiology Female Gambia - epidemiology General aspects Humans Infant Mortality Infant, Newborn Male Medical sciences Patient Acceptance of Health Care - statistics & numerical data Public health. Hygiene Public health. Hygiene-occupational medicine Risk Factors Rural Population - statistics & numerical data Seasons Sex Distribution Tropical medicine Gambia Africa Human Newborn Etiology Epidemiology Mortality
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Summary:	Childhood mortality in Upper River Division, The Gambia is high, 99 per 1000 mid-year population, and 27% of deaths occur in the neonatal period. 1 The aims of the present study were to describe patterns of neonatal death and to identify risk factors. Cause of death was investigated using a neonatal post-mortem questionnaire, and a population-based, matched case-control study was conducted to identify potential risk factors. The neonatal mortality rate in Upper River Division was 39 per 1000 live births (95% CI 36.8-41.2). The rates in the early and late neonatal periods were 21.0 (19.4-22.6) and 18.0 (16.5-19.5), respectively. Infection accounted for 57% of all deaths. In the early neonatal period, 30% of deaths were due to prematurity. Only 55% of babies who died presented for treatment and 84% died at home. Risk factors for neonatal death were primiparity (OR 2.18), previous stillbirth (OR 3.19), prolonged labour (OR 2.80) and pre-lacteal feeding (OR 3.38). A protective effect was seen in association with delivery by a trained traditional birth attendant (OR 0.34) and the application of shea nut butter, a traditional medicine, to the cord stump (OR 0.07). This study has identified the need to understand the reasons underlying the widespread use of pre-lacteal feeds and the barriers to health service use in this community in order to plan effective interventions.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0272-4936 2046-9047 1465-3281 2046-9055
DOI:	10.1080/02724939992617