Rank, number of deaths, percentage of deaths, and age-specific mortality rates for the leading causes of death, by age group and sex, 2000 to most recent year.

Rank, number of deaths, percentage of deaths, and mortality rates for the leading causes of infant death (under one year of age), by sex, 2000 to most recent year.

Sepsis is a life-threatening dysfunction of the immune system leading to multiorgan failure that is precipitated by infectious diseases and is a leading cause of death in children under 5 years of age. It is necessary to be able to identify a sick child at risk of developing sepsis at the earliest point of presentation to a healthcare facility so that appropriate care can be provided as soon as possible. Our study objective was to generate a list of consensus-driven predictor variables for the derivation of a prediction model that will be incorporated into a mobile device and operated by low-skilled healthcare workers at triage. By conducting a systematic literature review and examination of global guideline documents, a list of 72 initial candidate predictor variables was generated. A two-round modified Delphi process involving 26 experts from both resource-rich and resource-limited settings, who were also encouraged to suggest new variables, yielded a final list of 45 predictor variables after evaluating each variable based on three domains: predictive potential, measurement reliability, and level of training and resources required. The final list of predictor variables will be used to collect data and contribute to the derivation of a prediction model.

UNICEF's country profile for Nigeria, including under-five mortality rates, child health, education and sanitation data.

Background: The Smart Discharges studies in Uganda have enrolled over 10,000 children under-five with sepsis and have shown that death after hospital discharge occurs in 5-8% of patients, which is as common as death during the primary admission. The Smart Discharges evidence-based risk-prediction tool guides clinical interventions focused on education and post-discharge follow-up and improves healthcare-seeking behaviors and essential medical interventions among vulnerable children. Most importantly, these studies have preliminarily demonstrated that the prediction tool paired with these clinical interventions may substantially reduce post-discharge mortality up to 20-30%; however, these findings have not been validated outside of Uganda. The Smart Discharges project is now ready to expand the project borders and begin external validation research of the prediction tool in Rwanda. Objective(s): This study aims to: (1) characterize the epidemiology of post-discharge mortality among a representative cohort of 1000 children under 5 years of age from two hospitals in Rwanda; and (2) externally validate the Smart Discharges risk-prediction tool in a representative cohort of children from Rwanda. Methods: This study is a prospective observational cohort study that will be conducted between February 2022 and May 2023 at 2 hospitals in Northern and Central Rwanda, the University Teaching Hospital of Kigali (CHUK) in Nyarugenge District and Ruhengeri Referral Hospital in Musanze District. The study will enroll 1,000 children under 5 years of age between the two study sites. Following enrollment a research nurse will obtain and record clinical and demographic variables required for model validation including vital signs, oxygen saturation, anthropometric data, prior care seeking, co-morbidities and diagnoses. A rapid diagnostic test using blood, which will require a finger prick to collect < 0.5ml of blood, will be conducted to assess the patient's HIV status, malaria parasitemia, lactate, and hemoglobin (hemocue). All enrolled children will receive phone follow-up from study staff at 2-, 4- and 6 months following hospital discharge for research purposes. Verbal autopsies, often used in this context to determine cause of death, will be conducted for all children who die following discharge. Ethics Declaration: Institutional review boards at the University of British Columbia (H21-02795), the University of California San Francisco (21-34663), the University Teaching Hospital of Kigali (EC/CHUK/1/005/2022), and the University of Uganda (No 573/CMHS IRB/2022) approved the study. NOTE for restricted files: If you are not yet a CoLab member, please complete our membership application survey to gain access to restricted files within 2 business days. Some files may remain restricted to CoLab members. These files are deemed more sensitive by the file owner and are meant to be shared on a case-by-case basis. Please contact the CoLab coordinator at sepsiscolab@bcchr.ca or visit our website.

Top 10 causes of death among children 5–14 year of age in Kersa HDSS, 2008–2013.

The 2011 Bangladesh Demographic and Health Survey (BDHS) is the sixth DHS undertaken in Bangladesh, following those implemented in 1993-94, 1996-97, 1999-2000, 2004, and 2007. The main objectives of the 2011 BDHS are to: • Provide information to meet the monitoring and evaluation needs of health and family planning programs, and • Provide program managers and policy makers involved in these programs with the information they need to plan and implement future interventions. The specific objectives of the 2011 BDHS were as follows: • To provide up-to-date data on demographic rates, particularly fertility and infant mortality rates, at the national and subnational level; • To analyze the direct and indirect factors that determine the level of and trends in fertility and mortality; • To measure the level of contraceptive use of currently married women; • To provide data on knowledge and attitudes of women and men about sexually transmitted infections and HIV/AIDS; • To assess the nutritional status of children (under age 5), women, and men by means of anthropometric measurements (weight and height), and to assess infant and child feeding practices; • To provide data on maternal and child health, including antenatal care, assistance at delivery, breastfeeding, immunizations, and prevalence and treatment of diarrhea and other diseases among children under age 5; • To measure biomarkers, such as hemoglobin level for women and children, and blood pressure, and blood glucose for women and men 35 years and older; • To measure key education indicators, including school attendance ratios and primary school grade repetition and dropout rates; • To provide information on the causes of death among children under age 5; • To provide community-level data on accessibility and availability of health and family planning services; • To measure food security. The 2011 BDHS was conducted under the authority of the National Institute of Population Research and Training (NIPORT) of the Ministry of Health and Family Welfare. The survey was implemented by Mitra and Associates, a Bangladeshi research firm located in Dhaka. ICF International of Calverton, Maryland, USA, provided technical assistance to the project as part of its international Demographic and Health Surveys program (MEASURE DHS). Financial support was provided by the U.S. Agency for International Development (USAID).

BackgroundDiarrhea is the second leading cause of death in children < 5 years globally and the parasite genus Cryptosporidium is a leading cause of that diarrhea. The global disease burden attributable to cryptosporidiosis is substantial and the only approved chemotherapeutic, nitazoxanide, has poor efficacy in HIV positive children. Chemotherapeutic development is dependent on the calf model of cryptosporidiosis, which is the best approximation of human disease. However, the model is not consistently applied across research studies. Data collection commonly occurs using two different methods: Complete Fecal Collection (CFC), which requires use of confinement housing, and Interval Collection (IC), which permits use of box stalls. CFC mimics human challenge model methodology but it is unknown if confinement housing impacts study end-points and if data gathered via this method is suitable for generalization to human populations.MethodsUsing a modified crossover study design we compared CFC and IC and evaluated the impact of housing on study end-points. At birth, calves were randomly assigned to confinement (n = 14) or box stall housing (n = 9), or were challenged with 5 x 107 C. parvum oocysts, and followed for 10 days. Study end-points included fecal oocyst shedding, severity of diarrhea, degree of dehydration, and plasma cortisol.FindingsCalves in confinement had no significant differences in mean log oocysts enumerated per gram of fecal dry matter between CFC and IC samples (P = 0.6), nor were there diurnal variations in oocyst shedding (P = 0.1). Confinement housed calves shed significantly more oocysts (P = 0.05), had higher plasma cortisol (P = 0.001), and required more supportive care (P = 0.0009) than calves in box stalls.ConclusionHousing method confounds study end-points in the calf model of cryptosporidiosis. Due to increased stress data collected from calves in confinement housing may not accurately estimate the efficacy of chemotherapeutics targeting C. parvum.

Major specific causes of death by year among children aged 5–14 years, Kersa HDSS, 2008–2013.

BackgroundIn low-resource settings, it is challenging to ascertain the burden and causes of under-5 mortality as many deaths occur outside health facilities. We aimed to determine the causes of childhood deaths in rural Gambia using verbal autopsies (VA).MethodologyWe used WHO VA questionnaires to conduct VAs for deaths under-5 years of age in the Basse and Fuladu West Health and Demographic Surveillance Systems (HDSS) in rural Gambia between September 01, 2019, and December 31, 2021. Using a standardized cause of death list, two physicians assigned causes of death and discordant diagnoses were resolved by consensus.ResultsVAs were conducted for 89% (647/727) of deaths. Of these deaths, 49.5% (n = 319) occurred at home, 50.1% (n = 324) in females, and 32.3% (n = 209) in neonates. Acute respiratory infection including pneumonia (ARIP) (33.7%, n = 137) and diarrhoeal diseases (23.3%, n = 95) were the commonest primary causes of death in the post-neonatal period. In the neonatal period, unspecified perinatal causes of death (34.0%, n = 71) and deaths due to birth asphyxia (27.3%, n = 57) were the commonest causes of death. Severe malnutrition (28.6%, n = 185) was the commonest underlying cause of death. In the neonatal period, deaths due to birth asphyxia (p-value

Number of deaths and mortality rates, by age group, sex, and place of residence, 1991 to most recent year.

Deaths with diarrheal disease on the causal pathway to death stratified by site, age group, and categorization of whether diarrheal disease was the underlying, antecedent, or immediate cause of death, CHAMPS Network, 2016–2023 (N = 1517).

b Maternal conditions identified for CHAMPS deaths that occurred in the neonatal period, by WHO ICD 10 PM underlying cause of the death for the newborn, 2016–2021. Bold text is groupings for underlying causes of death in neonates according to WHO ICD PM and Italic text shows the associated maternal conditions found in those deaths. (ZIP)

Knowledge of caregivers on malnutrition in urban and rural communitiesb'**'.

Characteristics of deaths enrolled in CHAMPS that occurred during the neonatal period, by age at death (2016–2021).

Maternal conditions identified for CHAMPS deaths that occurred in the neonatal period, by WHO ICD 10 PM underlying cause of the death for the newborn (2016–2021).