Under-Five Mortality in Buea Health District, Southwest Cameroon: Evidence from a Community-Based Birth Cohort Study of Rate, Causes, and Age-Specific Patterns.

Ettamba Agborndip,Julius Atashili,Lawrence Tanyi Mbuagbaw,Domin Sone Majunda Ekaney,Benjamin Momo Kadia,Marie Therese Obama

doi:10.1155/2020/9605492

Abstract

Background Updating the knowledge base on the causes and patterns of under-five mortality (U5M) is crucial for the design of suitable interventions to improve survival of children under five. Objectives To assess the rate, causes, and age-specific patterns of U5M in Buea Health District, Cameroon. Methods A retrospective cohort study involving 2000 randomly selected households was conducted. Live births registered between September 2004 and September 2009 were recorded. The under-five mortality rate (U5MR) was defined by the number of deaths that occurred on or before 5 years of age per 1000 live births. Causes of death were assigned using the InterVA-4 software. Results A total of 2210 live births were recorded. There were 92 deaths, and the U5MR was 42 per 1000 live births. The mean age at death was 11 ± 15.9 months. The most frequent causes of death were neonatal causes (37%), malaria (28%), and pneumonia (15%). Deaths during infancy accounted for 64.1% of U5M, with 43.5% neonatal (86% occurring within the first 24 hours of life) and 20.7% postneonatal. The main causes of death in infancy were birth asphyxia (37.5%), pneumonia (17.5%), complications of prematurity (10%), and malaria (10%). Child deaths accounted for 35.8% of U5M. Malaria, pneumonia, and diarrhoeal illnesses accounted for the majority of child deaths. Conclusions Almost half of U5M occurred during the neonatal period. Improvements in intrapartum care and the prevention and effective treatment of neonatal conditions, malaria, and pneumonia could considerably reduce U5M in Buea.

Highlights

Updating the knowledge base on the causes and patterns of under-five mortality (U5M) is crucial for the design of suitable interventions to improve survival of children under five
The under-five mortality rate was highest among male children, children born to mothers aged less than 20 years, and children whose mothers had no education
Child deaths accounted for a little more than a third of under-five deaths, with malaria, pneumonia, and diarrhoeal illnesses accounting for the majority of deaths in this age group

Summary

Introduction

Updating the knowledge base on the causes and patterns of under-five mortality (U5M) is crucial for the design of suitable interventions to improve survival of children under five. The under-five mortality rate (U5MR) was defined by the number of deaths that occurred on or before 5 years of age per 1000 live births. Deaths during infancy accounted for 64.1% of U5M, with 43.5% neonatal (86% occurring within the first 24 hours of life) and 20.7% postneonatal. The main causes of death in infancy were birth asphyxia (37.5%), pneumonia (17.5%), complications of prematurity (10%), and malaria (10%). Pneumonia, and diarrhoeal illnesses accounted for the majority of child deaths. Improvements in intrapartum care and the prevention and effective treatment of neonatal conditions, malaria, and pneumonia could considerably reduce U5M in Buea. Despite the global progress in reducing child mortality over the past few decades, an estimated 5.4 million children under age five died in 2017, and about half of these deaths occurred in sub-Saharan Africa [3]. Infant deaths account for approximately 65% of all under-five deaths (34% neonatal deaths and 31% postneonatal deaths) [4]

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