@article{Imran Nisar_Ilyas_Naeem_Fatima_Jehan_2017, title={Cause of death in under 5 children in a demographic surveillance site in Pakistan}, volume={9}, url={https://ojphi.org/ojs/index.php/ojphi/article/view/7772}, DOI={10.5210/ojphi.v9i1.7772}, abstractNote={<div style="left: 79.8182px; top: 302.208px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.08117);" data-canvas-width="56.563006734006734">Objective</div><div style="left: 93.1212px; top: 315.467px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03027);" data-canvas-width="336.35012289562275">To identify Cause of deaths among children below age of 5years</div><div style="left: 79.8182px; top: 330.249px; font-size: 12.564px; font-family: serif; transform: scaleX(0.988064);" data-canvas-width="348.68794444444444">from a prospective cohort of women in one urban and four peri-urban</div><div style="left: 79.8182px; top: 345.03px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00106);" data-canvas-width="143.76954377104377">settings of Karachi, Pakistan</div><div style="left: 79.8182px; top: 373.157px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.11744);" data-canvas-width="73.28565488215487">Introduction</div><div style="left: 93.1212px; top: 386.417px; font-size: 12.564px; font-family: serif; transform: scaleX(0.971203);" data-canvas-width="335.0811616161615">Pakistan ranks 26th in Childhood mortality rates, globally. Pakistan,</div><div style="left: 79.8182px; top: 401.198px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03786);" data-canvas-width="349.94811094276076">with other 4 countries is responsible for about half of the deaths of</div><div style="left: 79.8182px; top: 415.979px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03391);" data-canvas-width="349.979520875421">children age under 5. Despite such burden vital registration system</div><div style="left: 79.8182px; top: 430.76px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01934);" data-canvas-width="349.60134528619517">is not well established, health facilities are not easily accessible and</div><div style="left: 79.8182px; top: 445.541px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00093);" data-canvas-width="348.9756594276094">mostly deaths occur at home, making identification of cause of death</div><div style="left: 79.8182px; top: 460.323px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0098);" data-canvas-width="78.51226767676766">(COD) difficult</div><div style="left: 79.8182px; top: 488.45px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.0727);" data-canvas-width="51.65049326599326">Methods</div><div style="left: 93.1212px; top: 501.71px; font-size: 12.564px; font-family: serif; transform: scaleX(1.05859);" data-canvas-width="339.45342424242426">From Jan 2007-Dec 2012 under-5 mortality was identified</div><div style="left: 79.8182px; top: 516.491px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02934);" data-canvas-width="352.1731905723906">by CHWs during their 3-monthly visits. A Research Assistant</div><div style="left: 79.8182px; top: 531.272px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0391);" data-canvas-width="349.84759915824895">conducted Verbal Autopsies (VA). Each VA form was analyzed by</div><div style="left: 79.8182px; top: 546.053px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04536);" data-canvas-width="349.7935740740743">2 physicians, independently, and assigned a cause. VA is analyzed</div><div style="left: 79.8182px; top: 560.834px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02163);" data-canvas-width="349.5171666666666">by a third physician in case two physicians do not agree on a cause.</div><div style="left: 79.8182px; top: 575.616px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00227);" data-canvas-width="349.0058129629629">Cause Specific Mortality Fractions (CSMF) were calculated for each</div><div style="left: 79.8182px; top: 590.397px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00992);" data-canvas-width="80.9622424242424">identified COD.</div><div style="left: 79.8182px; top: 618.524px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.08437);" data-canvas-width="45.38107070707071">Results</div><div style="left: 93.1212px; top: 631.784px; font-size: 12.564px; font-family: serif; transform: scaleX(0.969735);" data-canvas-width="335.1565454545455">833(58%) neonatal deaths and 591(42%) Under-5 deaths (excluding</div><div style="left: 79.8182px; top: 646.565px; font-size: 12.564px; font-family: serif; transform: scaleX(0.988756);" data-canvas-width="350.6127451178453">neonates) were identified. Among neonates most common CODs</div><div style="left: 79.8182px; top: 661.346px; font-size: 12.564px; font-family: serif; transform: scaleX(0.997103);" data-canvas-width="350.64792424242404">were perinatal asphyxia(30.4%), neonatal sepsis/meningitis(28%),</div><div style="left: 79.8182px; top: 676.127px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01648);" data-canvas-width="351.43191616161613">pre-term birth complication(11%) and neonatal pneumonia(6%).</div><div style="left: 79.8182px; top: 690.908px; font-size: 12.564px; font-family: serif; transform: scaleX(0.964564);" data-canvas-width="350.23331313131314">For Post-neonatal deaths most common CODs were sepsis (19%),</div><div style="left: 79.8182px; top: 705.69px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00089);" data-canvas-width="324.85408754208737">diarrheal disease (17%), Pneumonia (17%) and meningitis (8%).</div><div style="left: 79.8182px; top: 733.817px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.10256);" data-canvas-width="75.39640235690236">Conclusions</div><div style="left: 93.1212px; top: 747.077px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03541);" data-canvas-width="336.5762744107744">We describe the CSMF for different CODs among neonated and</div><div style="left: 79.8182px; top: 761.858px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02884);" data-canvas-width="349.7697025252527">children under 5. Strategies for prevention of most common causes</div><div style="left: 79.8182px; top: 776.639px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01226);" data-canvas-width="351.47212087542044">and making health facilities easily accessible will decrease this</div><div style="left: 79.8182px; top: 791.42px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00082);" data-canvas-width="38.03114646464646">burden.</div>}, number={1}, journal={Online Journal of Public Health Informatics}, author={Imran Nisar, Muhammad and Ilyas, Muhammad and Naeem, Komal and Fatima, Urooj and Jehan, Fyezah}, year={2017}, month={May} }