The impacts of maternal mortality and cause of death on children’s risk of dying in rural South Africa: evidence from a population based surveillance study (1992-2013)
Identifieur interne : 001325 ( Main/Merge ); précédent : 001324; suivant : 001326The impacts of maternal mortality and cause of death on children’s risk of dying in rural South Africa: evidence from a population based surveillance study (1992-2013)
Auteurs : Brian Houle [Australie, États-Unis, Afrique du Sud] ; Samuel J. Clark [États-Unis, Afrique du Sud, Ghana] ; Kathleen Kahn [États-Unis, Afrique du Sud, Ghana, Suède] ; Stephen Tollman [États-Unis, Afrique du Sud, Ghana, Suède] ; Alicia Ely Yamin [États-Unis]Source :
- Reproductive Health [ 1742-4755 ] ; 2015.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Cause de décès, Décès maternel (), Décès maternel (économie), Enfant, Enfant d'âge préscolaire, Enfant orphelin (), Facteurs socioéconomiques, Femelle, Humains, Infections à VIH (mortalité), Jeune adulte, Mortalité de l'enfant, Mortalité infantile, Mortalité maternelle, Nourrisson, Nouveau-né, République d'Afrique du Sud (épidémiologie), Santé en zone rurale (), Surveillance de la population, Tuberculose (mortalité), Âge maternel.
- MESH :
- mortalité : Infections à VIH, Tuberculose.
- économie : Décès maternel.
- épidémiologie : République d'Afrique du Sud.
- Adolescent, Adulte, Adulte d'âge moyen, Cause de décès, Décès maternel, Enfant, Enfant d'âge préscolaire, Enfant orphelin, Facteurs socioéconomiques, Femelle, Humains, Jeune adulte, Mortalité de l'enfant, Mortalité infantile, Mortalité maternelle, Nourrisson, Nouveau-né, Santé en zone rurale, Surveillance de la population, Âge maternel.
- Wicri :
- geographic : Afrique du Sud.
English descriptors
- KwdEn :
- Adolescent, Adult, Cause of Death, Child, Child Mortality, Child, Orphaned (statistics & numerical data), Child, Preschool, Female, HIV Infections (mortality), Humans, Infant, Infant Mortality, Infant, Newborn, Maternal Age, Maternal Death (economics), Maternal Death (statistics & numerical data), Maternal Mortality, Middle Aged, Population Surveillance, Rural Health (statistics & numerical data), Socioeconomic Factors, South Africa (epidemiology), Tuberculosis (mortality), Young Adult.
- MESH :
- geographic , epidemiology : South Africa.
- economics : Maternal Death.
- mortality : HIV Infections, Tuberculosis.
- statistics & numerical data : Child, Orphaned, Maternal Death, Rural Health.
- Adolescent, Adult, Cause of Death, Child, Child Mortality, Child, Preschool, Female, Humans, Infant, Infant Mortality, Infant, Newborn, Maternal Age, Maternal Mortality, Middle Aged, Population Surveillance, Socioeconomic Factors, Young Adult.
Abstract
Maternal mortality, the HIV/AIDS pandemic, and child survival are closely linked. This study contributes evidence on the impact of maternal death on children’s risk of dying in an HIV-endemic population in rural South Africa.
We used data for children younger than 10 years from the Agincourt health and socio-demographic surveillance system (1992 – 2013). We used discrete time event history analysis to estimate children’s risk of dying when they experienced a maternal death compared to children whose mother survived (N=3,740,992 child months). We also examined variation in risk due to cause of maternal death. We defined mother’s survival status as early maternal death (during pregnancy, childbirth, or within 42 days of most recent childbirth or identified cause of death), late maternal death (within 43-365 days of most recent childbirth), any other death, and mothers who survived.
Children who experienced an early maternal death were at 15 times the risk of dying (RRR 15.2; 95% CI 8.3–27.9) compared to children whose mother survived. Children under 1 month whose mother died an early (p=0.002) maternal death were at increased risk of dying compared to older children. Children whose mothers died of an HIV/AIDS or TB-related early maternal death were at 29 times the risk of dying compared to children with surviving mothers (RRR 29.2; 95% CI 11.7–73.1). The risk of these children dying was significantly higher than those children whose mother died of a HIV/AIDS or TB-related non-maternal death (p=0.017).
This study contributes further evidence on the impact of a mother’s death on child survival in a poor, rural setting with high HIV prevalence. The intersecting epidemics of maternal mortality and HIV/AIDS – especially in sub-Saharan Africa – have profound implications for maternal and child health and well-being. Such evidence can help guide public and primary health care practice and interventions.
Url:
DOI: 10.1186/1742-4755-12-S1-S7
PubMed: 26000547
PubMed Central: 4423728
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PMC:4423728Le document en format XML
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Cause of Death</term>
<term>Child</term>
<term>Child Mortality</term>
<term>Child, Orphaned (statistics & numerical data)</term>
<term>Child, Preschool</term>
<term>Female</term>
<term>HIV Infections (mortality)</term>
<term>Humans</term>
<term>Infant</term>
<term>Infant Mortality</term>
<term>Infant, Newborn</term>
<term>Maternal Age</term>
<term>Maternal Death (economics)</term>
<term>Maternal Death (statistics & numerical data)</term>
<term>Maternal Mortality</term>
<term>Middle Aged</term>
<term>Population Surveillance</term>
<term>Rural Health (statistics & numerical data)</term>
<term>Socioeconomic Factors</term>
<term>South Africa (epidemiology)</term>
<term>Tuberculosis (mortality)</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Cause de décès</term>
<term>Décès maternel ()</term>
<term>Décès maternel (économie)</term>
<term>Enfant</term>
<term>Enfant d'âge préscolaire</term>
<term>Enfant orphelin ()</term>
<term>Facteurs socioéconomiques</term>
<term>Femelle</term>
<term>Humains</term>
<term>Infections à VIH (mortalité)</term>
<term>Jeune adulte</term>
<term>Mortalité de l'enfant</term>
<term>Mortalité infantile</term>
<term>Mortalité maternelle</term>
<term>Nourrisson</term>
<term>Nouveau-né</term>
<term>République d'Afrique du Sud (épidémiologie)</term>
<term>Santé en zone rurale ()</term>
<term>Surveillance de la population</term>
<term>Tuberculose (mortalité)</term>
<term>Âge maternel</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>South Africa</term>
</keywords>
<keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Maternal Death</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>HIV Infections</term>
<term>Tuberculosis</term>
</keywords>
<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Infections à VIH</term>
<term>Tuberculose</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Child, Orphaned</term>
<term>Maternal Death</term>
<term>Rural Health</term>
</keywords>
<keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Décès maternel</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>République d'Afrique du Sud</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Cause of Death</term>
<term>Child</term>
<term>Child Mortality</term>
<term>Child, Preschool</term>
<term>Female</term>
<term>Humans</term>
<term>Infant</term>
<term>Infant Mortality</term>
<term>Infant, Newborn</term>
<term>Maternal Age</term>
<term>Maternal Mortality</term>
<term>Middle Aged</term>
<term>Population Surveillance</term>
<term>Socioeconomic Factors</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Cause de décès</term>
<term>Décès maternel</term>
<term>Enfant</term>
<term>Enfant d'âge préscolaire</term>
<term>Enfant orphelin</term>
<term>Facteurs socioéconomiques</term>
<term>Femelle</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Mortalité de l'enfant</term>
<term>Mortalité infantile</term>
<term>Mortalité maternelle</term>
<term>Nourrisson</term>
<term>Nouveau-né</term>
<term>Santé en zone rurale</term>
<term>Surveillance de la population</term>
<term>Âge maternel</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Afrique du Sud</term>
</keywords>
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</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Maternal mortality, the HIV/AIDS pandemic, and child survival are closely linked. This study contributes evidence on the impact of maternal death on children’s risk of dying in an HIV-endemic population in rural South Africa.</p>
</sec>
<sec><title>Methods</title>
<p>We used data for children younger than 10 years from the Agincourt health and socio-demographic surveillance system (1992 – 2013). We used discrete time event history analysis to estimate children’s risk of dying when they experienced a maternal death compared to children whose mother survived (N=3,740,992 child months). We also examined variation in risk due to cause of maternal death. We defined mother’s survival status as early maternal death (during pregnancy, childbirth, or within 42 days of most recent childbirth or identified cause of death), late maternal death (within 43-365 days of most recent childbirth), any other death, and mothers who survived.</p>
</sec>
<sec><title>Results</title>
<p>Children who experienced an early maternal death were at 15 times the risk of dying (RRR 15.2; 95% CI 8.3–27.9) compared to children whose mother survived. Children under 1 month whose mother died an early (p=0.002) maternal death were at increased risk of dying compared to older children. Children whose mothers died of an HIV/AIDS or TB-related early maternal death were at 29 times the risk of dying compared to children with surviving mothers (RRR 29.2; 95% CI 11.7–73.1). The risk of these children dying was significantly higher than those children whose mother died of a HIV/AIDS or TB-related non-maternal death (p=0.017).</p>
</sec>
<sec><title>Conclusions</title>
<p>This study contributes further evidence on the impact of a mother’s death on child survival in a poor, rural setting with high HIV prevalence. The intersecting epidemics of maternal mortality and HIV/AIDS – especially in sub-Saharan Africa – have profound implications for maternal and child health and well-being. Such evidence can help guide public and primary health care practice and interventions.</p>
</sec>
</div>
</front>
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