scholarly journals Causes of stillbirths and neonatal deaths in Dhanusha district, Nepal: A verbal autopsy study

1970 ◽  
Vol 8 (1) ◽  
pp. 62-72 ◽  
Author(s):  
SR Manandhar ◽  
A Ojha ◽  
DS Manandhar ◽  
B Shrestha ◽  
D Shrestha ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Verbal Autopsy ◽  
Neonatal Death ◽  
Birth Asphyxia ◽  
Severe Infection ◽  
Home Delivery ◽  
Group 14 ◽  
Autopsy Study ◽  
Neonatal Deaths ◽  
Pregnancy And Delivery

Background: Perinatal (stillbirths and first week neonatal deaths) and neonatal (deaths in the first 4 weeks) mortality rates remain high in developing countries like Nepal. As most births and deaths occur in the community, an option to ascertain causes of death is to conduct verbal autopsy. Objective: The objective of this study was to classify and review the causes of stillbirths and neonatal deaths in Dhanusha district, Nepal. Materials and Methods: Births and neonatal deaths were identified prospectively in 60 village development committees of Dhanusha district. Families were interviewed at six weeks after delivery, using a structured questionnaire. Cause of death was assigned independently by two pediatricians according to a predefined algorithm; disagreement was resolved in discussion with a consultant neonatologist. Results: There were 25,982 deliveries in the 2 years from September 2006 to August 2008. Verbal autopsies were available for 601/813 stillbirths and 671/954 neonatal deaths. The perinatal mortality rate was 60 per 1000 births and the neonatal mortality rate 38 per 1000 live births. 84% of stillbirths were fresh and obstetric complications were the leading cause (67%). The three leading causes of neonatal death were birth asphyxia (37%), severe infection (30%) and prematurity or low birth weight (15%). Most infants were delivered at home (65%), 28% by relatives. Half of women received an injection (presumably an oxytocic) during home delivery to augment labour. Description of symptoms commensurate with birth asphyxia was commoner in the group of infants who died (41%) than in the surviving group (14%). Conclusion: The current high rates of stillbirth and neonatal death in Dhanusha suggest that the quality of care provided during pregnancy and delivery remains sub-optimal. The high rates of stillbirth and asphyxial mortality imply that, while efforts to improve hygiene need to continue, intrapartum care is a priority. A second area for consideration is the need to reduce the uncontrolled use of oxytocic for augmentation of labour. Key words: Stillbirth; neonatal death; verbal autopsy; Nepal. DOI: 10.3126/kumj.v8i1.3224 Kathmandu University Medical Journal (2010), Vol. 8, No. 1, Issue 29, 62-72

scholarly journals Causes and age of neonatal death and associations with maternal and newborn care characteristics in Nepal: a verbal autopsy study

2022 ◽  
Vol 80 (1) ◽  
Author(s):  
Daniel J. Erchick ◽  
Johanna B. Lackner ◽  
Luke C. Mullany ◽  
Nitin N. Bhandari ◽  
Purusotam R. Shedain ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Verbal Autopsy ◽  
Neonatal Death ◽  
Birth Asphyxia ◽  
Multiple Birth ◽  
Care Seeking ◽  
Autopsy Study ◽  
Training Centre ◽  
Neonatal Deaths ◽  
Risk Of Death

Abstract Background In Nepal, neonatal mortality fell substantially between 2000 and 2018, decreasing 50% from 40 to 20 deaths per 1,000 live births. Nepal’s success has been attributed to a decreasing total fertility rate, improvements in female education, increases in coverage of skilled care at birth, and community-based child survival interventions. Methods A verbal autopsy study, led by the Integrated Rural Health Development Training Centre (IRHDTC), conducted interviews for 338 neonatal deaths across six districts in Nepal between April 2012 and April 2013. We conducted a secondary analysis of verbal autopsy data to understand how cause and age of neonatal death are related to health behaviors, care seeking practices, and coverage of essential services in Nepal. Results Sepsis was the leading cause of neonatal death (n=159/338, 47.0%), followed by birth asphyxia (n=56/338, 16.6%), preterm birth (n=45/338, 13.3%), and low birth weight (n=17/338, 5.0%). Neonatal deaths occurred primarily on the first day of life (27.2%) and between days 1 and 6 (64.8%) of life. Risk of death due birth asphyxia relative to sepsis was higher among mothers who were nulligravida, had <4 antenatal care visits, and had a multiple birth; risk of death due to prematurity relative to sepsis was lower for women who made ≥1 delivery preparation and higher for women with a multiple birth. Conclusions Our findings suggest cause and age of death distributions typically associated with high mortality settings. Increased coverage of preventive antenatal care interventions and counseling are critically needed. Delays in care seeking for newborn illness and quality of care around the time of delivery and for sick newborns are important points of intervention with potential to reduce deaths, particularly for birth asphyxia and sepsis, which remain common in this population.

scholarly journals Use of Verbal Autopsy as a Proxy to Determine the Possible Cause of Neonatal Deaths

2011 ◽  
Vol 31 (1) ◽  
pp. 44-48 ◽  
Author(s):  
B Baghel ◽  
AK Bansal
Keyword(s):  
Verbal Autopsy ◽  
Neonatal Death ◽  
Birth Asphyxia ◽  
Field Research ◽  
Cost Effective ◽  
Good Method ◽  
Next Of Kin ◽  
Neonatal Deaths ◽  
Care Givers ◽  
Total Death

Introduction: Information on causes of death is extremely important for policy making, planning, monitoring, field research, future management statergies and epidemic awareness. The best method of finding the cause of death is by post mortem examination but since this is difficult, post death analysis by verbal autopsy is a good method to determine the same. Objective: To asses the role of verbal autopsy method in the investigation of neonatal death and to determine the probable, causes of neonatal death. Materials and Methods: A pre-tested questionnaire in Hindi was administered to 50 mothers and/or next of kin or other care givers of the deceased residing in villages around 200 Kms. of Bhopal and in urban slums of Municipal Corporation, Bhopal. Results: 84 % of the total death occurred with in seven days of birth, 88 % of death occurred in villages where health facilities were available. As per verbal autopsy 36 % and 20 % of the infants died because of Birth asphyxia and Respiratory Distress Syndrome respectively and further 2%, 4% and 6% because of neonatal tetanus, hypothermia and other causes respectively. Conclusion: Verbal autopsy could be one of the possible cost effective and a reliable tool for determining the causes of neonatal deaths at present. Key words: Verbal Autopsy; Neonatal death; Reliable respondents and category of villages. DOI: 10.3126/jnps.v31i1.2942J Nep Paedtr Soc 2010;31(1):44-48

scholarly journals A comparative analysis of the InterVA model versus physician review in determining causes of neonatal deaths using verbal autopsy data from Nepal

2021 ◽  
Author(s):  
Dinesh Dharel ◽  
Penny Dawson ◽  
Daniel Adeyinka ◽  
Nazeem Muhajarine ◽  
Dinesh Neupane
Keyword(s):  
Cause Of Death ◽  
Verbal Autopsy ◽  
Neonatal Sepsis ◽  
Neonatal Death ◽  
Birth Asphyxia ◽  
Neonatal Infection ◽  
Proximate Cause ◽  
Neonatal Deaths ◽  
Physician Review ◽  
Autopsy Data

Abstract Background: Verbal autopsy is a common method of ascertaining the cause of neonatal death in low resource settings where majority of causes of deaths remain unregistered. We aimed to compare the causes of neonatal deaths assigned by computer algorithm-based model, InterVA (Interpreting Verbal Autopsy) with the usual standard of Physician Review of Verbal Autopsy (PRVA) using the verbal autopsy data collected by Morang Innovative Neonatal Intervention (MINI) study in Nepal. Methods: MINI was a prospective community intervention study aimed at managing newborn illnesses at household level. Trained field staff conducted a verbal autopsy of all neonatal deaths during the study period. The cause of death was assigned by two pediatricians, and by using InterVA version 5. Cohen's kappa coefficient was calculated to compare the agreement between InterVA and PRVA assigned proximate cause of death, using STATATM software version 16.1. Results: Among 381 verbal autopsies for neonatal deaths, only 311 (81.6%) were assigned one of birth asphyxia, neonatal infection, congenital anomalies or preterm-related complications as the proximate cause of death by both InterVA and PRVA, while the remaining 70 (18.4%) were assigned other or non-specific causes. The overall agreement between InterVA and PRVA-assigned cause of death categories was moderate (66.5% agreement, kappa=0.47). Moderate agreement was observed for neonatal infection (kappa=0.48) and congenital malformations (kappa=0.49), while it was fair for birth asphyxia (kappa=0.39), and preterm-related complications (kappa=0.31); but there was only slight agreement for neonatal sepsis (kappa=0.19) and neonatal pneumonia (kappa=0.16) as specific causes of death within neonatal infections. Conclusions: We observed moderate overall agreement for major categories of causes of neonatal death assigned by InterVA and PRVA. The moderate agreement was sustained for the classification of neonatal infection but poor for neonatal sepsis and neonatal pneumonia as distinct categories of neonatal infection. Further studies should investigate the comparative effectiveness of an updated version of InterVA with the current standard of assigning the cause of neonatal death through longitudinal and experimental designs.

scholarly journals Neonatal Deaths in Rural Southern Tanzania: Care-Seeking and Causes of Death

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Mwifadhi Mrisho ◽  
David Schellenberg ◽  
Fatuma Manzi ◽  
Marcel Tanner ◽  
Hassan Mshinda ◽  
...  
Keyword(s):  
Verbal Autopsy ◽  
Birth Asphyxia ◽  
Household Survey ◽  
Care Seeking ◽  
Neonatal Deaths ◽  
Rural Districts ◽  
Common Causes ◽  
Large Household ◽  
Quantitative Results ◽  
At Home

Introduction. We report cause of death and care-seeking prior to death in neonates based on interviews with relatives using a Verbal Autopsy questionnaire. Materials and Methods. We identified neonatal deaths between 2004 and 2007 through a large household survey in 2007 in five rural districts of southern Tanzania. Results. Of the 300 reported deaths that were sampled, the Verbal Autopsy (VA) interview suggested that 11 were 28 days or older at death and 65 were stillbirths. Data was missing for 5 of the reported deaths. Of the remaining 219 confirmed neonatal deaths, the most common causes were prematurity (33%), birth asphyxia (22%) and infections (10%). Amongst the deaths, 41% (90/219) were on the first day and a further 20% (43/219) on day 2 and 3. The quantitative results matched the qualitative findings. The majority of births were at home and attended by unskilled assistants. Conclusion. Caregivers of neonates born in health facility were more likely to seek care for problems than caregivers of neonates born at home. Efforts to increase awareness of the importance of early care-seeking for a premature or sick neonate are likely to be important for improving neonatal health.

scholarly journals The Pattern and Causes of Neonatal Mortality in a Tertiary Hospital in the Southwest of Nigeria

2020 ◽  
Vol 24 (4) ◽  
Author(s):  
Kareem Abiodun John ◽  
Fasoranti Ifedayo Olabisi ◽  
Alonge Abel Olumuyiwa ◽  
Kareem Adesola Olawumi ◽  
Bewaji Temitayo Olubunmi ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Medical Center ◽  
Birth Asphyxia ◽  
Tertiary Hospital ◽  
Neonatal Mortality Rate ◽  
Female Ratio ◽  
Neonatal Deaths ◽  
Southwest Nigeria ◽  
Causes Of Mortality

Background: The neonatal mortality rate remains high in developing countries despite the significant reduction in under-five mortality globally. Therefore, periodic evaluations on the causes of mortality are an aspect of health status, which could be performed to improve the neonatal mortality rate. Objectives: The present study aimed to determine the pattern and causes of neonatal mortality in the Federal Medical Center in Owo, Ondo State, Southwest Nigeria. Methods: This retrospective study was conducted using the hospital records of the neonates admitted over a five-year period from 1st of January 2015 to 31st of December 2019. Results: In total, 2,065 neonates were admitted, including 208 cases of neonatal deaths. Mortality occurred in 127 males (61.1%) and 81 females (38.9%), with the male-to-female ratio of 1.6:1. Among the recorded deaths, 114 cases (54.8%) occurred within the first 24 hours of admission, while 94 neonates (45.2%) died after 24 hours of admission. In addition, the mortality rate was higher among outborn neonates (n = 120; 57.7%) compared to inborn neonates (n = 88; 42.3%). The major causes of neonatal deaths included birth asphyxia (46.6%), prematurity (23.1%), and sepsis (17.8%). The overall mortality rate over the five-year period was 10.1%, which is equivalent to 19 deaths per 1,000 live births. Conclusions: According to the results, preventable diseases such as birth asphyxia, prematurity, and sepsis remain the major causes of neonatal mortality, of which neonatal deaths occur mostly within 24 hours of admission.

scholarly journals A community based study of neonatal mortality in Aligarh by using verbal autopsy

2018 ◽  
Vol 5 (6) ◽  
pp. 2491
Author(s):  
Ambren Chauhan ◽  
M. Salman Shah ◽  
Najam Khalique ◽  
Uzma Eram
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Verbal Autopsy ◽  
Birth Asphyxia ◽  
Survival Strategies ◽  
Biological Factors ◽  
Neonatal Mortality Rate ◽  
Community Based ◽  
Cross Sectional ◽  
Live Births

Background:Neonatal mortality rate is regarded as an important and sensitive indicator of the health status of a community. Children face the highest risk of dying in their first month of life. The present study was aimed to 1) determine the prevalence of neonatal mortality rate 2) identify socio-biological factors in relation to neonatal mortality.3) determine the causes of neonatal mortality. Methods:A community based cross sectional study was conducted in the field practice areas of Department of Community Medicine, AMU, Aligarh. All the live births and all neonatal deaths were taken for one year from June 2016 to May 2017. A standard Verbal autopsy questionnaire (WHO 2012) was used as a study tool. Results:The prevalence of neonatal mortality rate was38.2/1000 live births. The early neonatal mortality rate was 28.3/1000 live births and late neonatal mortality rate was 9.9/1000 live births. The associated socio –biological factors were gender [OR-2.381, 95% CI-1.037-5.468], birth order [OR-4.090, 95% CI-1.119-14.946] and gestational age [OR-12.62, 95% CI-3.26-48.82]. The leading causes of deaths among newborns were preterm births (22.2%), birth asphyxia (22.2%), other causes (19%), ARI (14.3%), congenital anomalies (14.3%) and diarrhoeaandneonatal sepsis accounted for (4.8%) each. Conclusions: The neonatal mortality rate assessed by verbal autopsy is higher than nationally reported. Most of the deaths were in early neonatal period. There is a need for programs encouraging the use of antenatal care, encouraging institutional deliveries and care of LBW neonates; as well as implementation of community-based newborn survival strategies.

scholarly journals Trends, patterns and cause-specific neonatal mortality in Tanzania: a hospital-based retrospective survey

2020 ◽  
Author(s):  
Chacha D Mangu ◽  
Susan F Rumisha ◽  
Emanuel P Lyimo ◽  
Irene R Mremi ◽  
Isolide S Massawe ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Neonatal Death ◽  
Birth Asphyxia ◽  
International Classification Of Diseases ◽  
Mortality Rates ◽  
Data Availability ◽  
Mortality Data ◽  
Neonatal Deaths ◽  
Over Time

Abstract Background Globally, large numbers of children die shortly after birth and many of them within the first 4 wk of life. This study aimed to determine the trends, patterns and causes of neonatal mortality in hospitals in Tanzania during 2006–2015. Methods This retrospective study involved 35 hospitals. Mortality data were extracted from inpatient registers, death registers and International Classification of Diseases-10 report forms. Annual specific hospital-based neonatal mortality rates were calculated and discussed. Two periods of 2006–2010 and 2011–2015 were assessed separately to account for data availability and interventions. Results A total of 235 689 deaths were recorded and neonatal deaths accounted for 11.3% (n=26 630) of the deaths. The majority of neonatal deaths (87.5%) occurred in the first week of life. Overall hospital-based neonatal mortality rates increased from 2.6 in 2006 to 10.4 deaths per 1000 live births in 2015, with the early neonates contributing 90% to this rate constantly over time. The neonatal mortality rate was 3.7/1000 during 2006–2010 and 10.4/1000 during 2011–2015, both periods indicating a stagnant trend in the years between. The leading causes of early neonatal death were birth asphyxia (22.3%) and respiratory distress (20.8%), while those of late neonatal death were sepsis (29.1%) and respiratory distress (20.0%). Conclusion The majority of neonatal deaths in Tanzania occur among the early newborns and the trend over time indicates a slow improvement. Most neonatal deaths are preventable, hence there are opportunities to reduce mortality rates with improvements in service delivery during the first 7 d and maternal care.

Neonatal Mortality Rate in Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital in Missan Province From 2011 to 2014

2016 ◽  
Vol 12 (27) ◽  
pp. 55
Author(s):  
Esraa Abd Al-Muhsen Ali
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Teaching Hospital ◽  
Causes Of Death ◽  
Neonatal Period ◽  
Birth Asphyxia ◽  
Neonatal Care ◽  
Neonatal Mortality Rate ◽  
Neonatal Deaths ◽  
Neonatal Care Unit

Background: The neonatal mortality rate is a key outcome indicator for newborn care and directly reflects prenatal, natal, and postnatal care. Early neonatal deaths are more closely associated with pregnancy-related factors and maternal health, whereas late neonatal deaths are associated more with factors in the newborn‘s environment. Objectives: To estimate the neonatal mortality rate in Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital in Missan Province during period (2011-2014). To determine the most common causes of death in the neonatal period. Patients and methods: A hospital-based study was done depending on data collected from records of the Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital in Missan Province to calculate the number of deaths within the neonatal period (0-28 days) that was conducted from 2011 to 2014. The other line of data was collected from Obstetrical Ward by calculating number of live births for the same period. Then Neonatal Mortality Rate is calculated and conducted for each year according to the method recommended by WHO. Results: The neonatal mortality rates were 12.15, 13.51, 16.37 and16.11 in 2011 to 2014 respectively in which there was an increment in mortality rate. The main causes of death were respiratory distress syndrome, birth asphyxia and congenital anomalies. Conclusion: Neonatal mortality rate was high in the Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital, but it was less than the previous period in Iraq since 1990. These results suggest, that to decrease neonatal mortality, improved health service quality is crucial.

scholarly journals Status of neonatal death in sick newborn care unit of a tertiary care hospital

2017 ◽  
Vol 4 (5) ◽  
pp. 1638
Author(s):  
Ashish Kumar Mishra ◽  
Sadhu Charan Panda
Keyword(s):  
Neonatal Death ◽  
Tertiary Care Hospital ◽  
Care Delivery ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Newborn Care ◽  
Health Care Delivery System ◽  
Care Hospital ◽  
Neonatal Deaths ◽  
Antenatal Visits

Background: In view of clusters of death in Sick New Born Care Units of tertiary care hospitals in recent past and few studies done so far in this field necessitates a research. The aim of the present study was to assess the factors associated with neonatal mortality and the infrastructure of the SNCU.Methods: All sick neonates admitted in the SNCU during June and July 2017 were followed up till they were discharged or declared dead. Data were collected by facility observation, interview of parents/attendants and from patient case sheet with a predesigned a pretested questionnaire and were analyzed applying appropriate statistical methods.Results: Prevalence neonatal death was 12 per cent among 250 sick neonates studied. Majority of neonatal deaths occurred   among mothers having lower SE Status 25 (27.4), antenatal visits less than 4 times (22, 22%), undernourished neonates (24, 37.5%) all of which were significant. Majority of morbidity were of Prematurity, (110, 44%) followed by Birth Asphyxia (96, 38.4%) and Infections (35.2%) and leading cause of death was infection. There was a deficit of resources from 25% to 75% and no monitoring and supervision were done till date.Conclusions: Health care delivery system at block level and below needs to be strengthened in terms of   antenatal visits, improvement of nutritional status of mother. The resource constraint of SNCU at tertiary care hospital and surveillance and monitoring mechanism requires prompt action to make SNCU more effective. 

scholarly journals Verbal autopsy of neonatal and infant deaths from Bhavnagar rural and comparison with recent data

2020 ◽  
Vol 8 (1) ◽  
pp. 351
Author(s):  
Rajesh B. Patel ◽  
Hinal A. Sinol ◽  
Sonal V. Jindal ◽  
Jayendra R. Gohil
Keyword(s):  
Verbal Autopsy ◽  
Vaginal Discharge ◽  
Neonatal Period ◽  
Perinatal Care ◽  
Neonatal Resuscitation ◽  
Birth Asphyxia ◽  
Hyaline Membrane Disease ◽  
Neonatal Deaths ◽  
Infant Deaths ◽  
Hyaline Membrane

Background: Infant deaths from Bhavnagar rural areas were studied by using a verbal autopsy tool.Methods: Community visit based retrospective study of Bhavnagar rural by WHO verbal autopsy questionnaire.Results: Of the 92 deaths analyzed, 59 % (early), 12% (late), and 29% were during the post neonatal period. Male deaths were 55 (60%). The most common immediate causes were infection (39%), birth asphyxia (23%), and hyaline membrane disease (15%). Underlying causes were: maternal illness with feeding problem (45%), prematurity (26%), meconium aspiration syndrome (9%), and congenital/genetic anomalies (10%). Infant and neonatal deaths were seen more with illiteracy of mother, age of mother (25-29 years), third parity, anemia, and vaginal discharge; and non-breastfed, low birth weight and preterm. Birth asphyxia and hyaline membrane disease were during early, and meningitis and pneumonia were after the neonatal period. Verbal autopsy was accurate in 18/23 (78%) of the facility-based deaths where the cause of death was available. Ethics approval was obtained.Conclusions: Reproductive health education to adolescent girls and mothers, regarding the treatment of fever, vaginal discharge; and breastfeeding counselling with vitamin B12 should be used as more infant deaths are associated with anemia of mother. Health workers should be skilled in neonatal resuscitation, prematurity management, and referral, after stabilization, identification of congenital anomaly, antenatal screening by USG, and neonatal metabolic screen. Recent 2018 data obtained from Bhavnagar District Health Authority shows that over a period of eight years, institutional deliveries have increased and home deliveries, early neonatal deaths, HMD, and septicemia have decreased. Perinatal care should be check-list based, monitored, and mentored.

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