Dataset Information

Neonatal mortality and leading causes of deaths: a descriptive study in China, 2014-2018.

ABSTRACT:

Objective

The present study estimated the national and urban-rural levels and causes of neonatal deaths in China annually between 2014 and 2018 to provide data support for the further end of preventable neonatal deaths for China and other low-income and middle-income countries.

Methods

The study was based on data from the National Maternal and Child Health Surveillance System. All neonates of surveillance districts (gestational week: ?28?weeks) who died after delivery have been involved in the study. The mortality rate and the leading causes of death for neonates were analysed.

Results

The neonatal mortality rate (NMR) of China has steadily decreased from 5.9 deaths per 1000 live births in 2014 to 3.9 deaths per 1000 live births in 2018. The NMR in 2018 of urban and rural areas was 2.2 deaths per 1000 live births and 4.7 deaths per 1000 live births, respectively. The leading preventable causes of neonatal deaths are the same in the urban and rural areas were same, which were preterm birth, intrapartum complications and pneumonia. Mortality rates of these three causes fell significantly between 2014 and 2018 but contributed to a higher proportion of deaths in rural areas than urban areas. The proportion of preventable deaths accounted for 74.6% in 2018.

Conclusions

The NMR of China has decreased steadily from 2014 to 2018. However, the inequality between urban and rural areas still exists. The goal of government interventions should be to reduce the health inequality of neonates and further take targeted measures to eliminate preventable neonatal death.

SUBMITTER: Liu Y

PROVIDER: S-EPMC7868219 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Neonatal mortality and leading causes of deaths: a descriptive study in China, 2014-2018.

Liu Yuxi Y Kang Leni L He Chunhua C Miao Lei L Qiu Xiaoqiong X Xia Weipeng W Zhu Jun J Liang Juan J Li Qi Q Wang Yanping Y Liu Hanmin H

BMJ open 20210204 2

<h4>Objective</h4>The present study estimated the national and urban-rural levels and causes of neonatal deaths in China annually between 2014 and 2018 to provide data support for the further end of preventable neonatal deaths for China and other low-income and middle-income countries.<h4>Methods</h4>The study was based on data from the National Maternal and Child Health Surveillance System. All neonates of surveillance districts (gestational week: ≥28 weeks) who died after delivery have been in ...[more]

PMID: 33542043

Similar Datasets

Project description:Background: Neonatal mortality causes a substantial proportion of the under-5 mortality in low and middle-income countries (LMIC).Methods: We undertook a prospective, population-based research study of pregnant women residing in defined geographic areas in the Karnataka State of India, a research site of the Global Network for Women's and Children's Health Research. Study staff collected demographic and health care characteristics on eligible women enrolled with neonatal outcomes obtained at delivery and day 28. Cause of neonatal mortality at day 28 was assigned by algorithm using prospectively defined variables.Results: From 2014 to 2018, the neonatal mortality rate was 24.5 per 1,000 live births. The cause of the 28-day neonatal deaths was attributed to prematurity (27.9%), birth asphyxia (25.1%), infection (23.7%) and congenital anomalies (18.4%). Four or more antenatal care (ANC) visits was associated with a lower risk of neonatal death compared to fewer ANC visits. In the adjusted model, compared to liveborn infants???2500 g, infants born weighing?<?1000 g RR for mortality was 25.6 (95%CI 18.3, 36.0), for 1000-1499 g infants the RR was 19.8 (95% CI 14.2, 27.5) and for 1500-2499 g infants the RR was 3.1 (95% CI 2.7, 3.6). However, more than one-third (36.8%) of the deaths occurred among infants with a birthweight???2500 g. Infants born preterm (<?37 weeks) were also at higher risk for 28-day mortality (RR 7.9, 95% CI 6.9, 9.0) compared to infants???37 weeks. A one-week decrease in gestational age at delivery was associated with a higher risk of mortality with a RR of 1.3 (95% CI 1.3, 1.3). More than 70% of all the deliveries occurred at a hospital. Among infants who died, 50.3% of the infants had received bag/mask ventilation, 47.3% received antibiotics, and 55.6% received oxygen.Conclusions: Consistent with prior research, the study found that infants who were preterm and low-birth weight remained at highest risk for 28-day neonatal mortality in India. Although most of births now occur within health facilities, a substantial proportion are not receiving basic life-saving interventions. Further efforts to understand the impact of care on infant outcomes are needed. Study registration The trial is registered at clinicaltrials.gov. ClinicalTrial.gov Trial Registration: NCT01073475.

Project description:BACKGROUND:Rabies in China remains a public health problem. In 2014, nearly one thousand rabies-related deaths were reported while rabies geographic distribution has expanded for the recent years. This report used surveillance data to describe the epidemiological characteristics of human rabies in China including determining high-risk areas and seasonality to support national rabies prevention and control activities. METHODS:We analyzed the incidence and distribution of human rabies cases in mainland China using notifiable surveillance data from 1960-2014, which includes a detailed analysis of the recent years from 2004 to 2014. RESULTS:From 1960 to 2014, 120,913 human rabies cases were reported in mainland China. The highest number was recorded in 1981(0.7/100,000; 7037 cases), and in 2007(0.3/100,000; 3300 cases). A clear seasonal pattern has been observed with a peak in August (11.0% of total cases), Human rabies cases were reported in all provinces with a yearly average of 2198 from 1960 to 2014 in China, while the east and south regions were more seriously affected compared with other regions. From2004 to 2014, although the number of cases decreased by 65.2% since 2004 from 2651 to 924 cases, reported areas has paradoxically expanded from 162 prefectures to 200 prefectures and from southern to the central and northern provinces of China. Farmers accounted most of the cases (65.0%); 50-59 age group accounted for the highest proportion (20.5%), and cases are predominantly males with a male-to-female ratio of 2.4:1 on average. CONCLUSIONS:Despite the overall steady decline of cases since the peak in 2007, the occurrence of cases in new areas and the spread trend were obvious in China in recent years. Further investigations and efforts are warranted in the areas have high rabies incidence to control rabies by interrupting transmission from dogs to humans and in the dog population. Furthermore, elimination of rabies should be eventually the ultimate goal for China.

Project description:BackgroundVerbal autopsy is the main method used in countries with weak civil registration systems for estimating community causes of neonatal and 1-59-month-old deaths. However, validation studies of verbal autopsy methods are limited and assessment has been dependent on hospital-based studies, with uncertain implications for its validity in community settings. If the distribution of community deaths by cause was similar to that of facility deaths, or could be adjusted according to related demographic factors, then the causes of facility deaths could be used to estimate population causes.MethodsCauses of neonatal and 1-59-month-old deaths from verbal/social autopsy (VASA) surveys in four African countries were estimated using expert algorithms (EAVA) and physician coding (PCVA). Differences between facility and community deaths in individual causes and cause distributions were examined using chi-square and cause-specific mortality fractions (CSMF) accuracy, respectively. Multinomial logistic regression and random forest models including factors from the VASA studies that are commonly available in Demographic and Health Surveys were built to predict population causes from facility deaths.ResultsLevels of facility and community deaths in the four countries differed for one to four of 10 EAVA or PCVA neonatal causes and zero to three of 12 child causes. CSMF accuracy for facility compared to community deaths in the four countries ranged from 0.74 to 0.87 for neonates and 0.85 to 0.95 for 1-59-month-olds. Crude CSMF accuracy in the prediction models averaged 0.86 to 0.88 for neonates and 0.93 for 1-59-month-olds. Adjusted random forest prediction models increased average CSMF accuracy for neonates to, at most, 0.90, based on small increases in all countries.ConclusionsThere were few differences in facility and community causes of neonatal and 1-59-month-old deaths in the four countries, and it was possible to project the population CSMF from facility deaths with accuracy greater than the validity of verbal autopsy diagnoses. Confirmation of these findings in additional settings would warrant research into how medical causes of deaths in a representative sample of health facilities can be utilized to estimate the population causes of child death.

Project description:Objective Preterm birth is a major healthcare problem and has been rising gradually in the past three decades in China. Yet the ethnic differences in the rates and distributions of preterm birth remain largely unknown in China. This study used data from Yunnan, a multiethnic province, to explore the differences in preterm birth across ethnicities. Methods A population-based observational study was conducted based on data from the National Free Preconception Health Examination Project in rural Yunnan from Jan 1, 2014 to Dec 31, 2018. Pregnancies with at least one livebirth were included in this study. We estimated the rates and 95% confidence intervals (CIs) of overall preterm birth (born < 37 weeks’ gestation), moderate to late preterm birth (born between 32 and <37 weeks’ gestation), very preterm birth (born between 28 and 31 weeks’ gestation), and extremely preterm birth (born < 28 weeks’ gestation) across maternal ethnicity and compared them using log-binomial regressions. Multivariable log-binomial regressions were used to assess the association between maternal ethnicity and preterm birth with adjustment for potential confounders, including year of delivery, maternal age at delivery, education, occupation, pre-pregnancy body mass index, history of chronic disease, history of preterm birth, smoking and drinking alcohol during early pregnancy, and parity and multiple pregnancy of current pregnancy. Results Among 195,325 women who delivered at least one live baby, 7.90% (95% CI, 7.78–8.02%) were born preterm. The rates of moderate to late preterm birth, very preterm birth, and extremely preterm birth were 6.20% (95% CI, 6.09–6.30%), 1.18% (95% CI, 1.13–1.23%), and 0.52% (95% CI, 0.49–0.56%), respectively. The rates of overall preterm birth, moderate to late preterm birth, very preterm birth, and extremely preterm birth differed across maternal ethnicity. The preterm birth rates in Dai (10.73%), Miao (13.23%), Lisu (12.64%), Zhuang (11.77%), Wa (10.52%), and Lagu (12.34%) women were significantly higher than that in Han women, and the adjusted relative risks were 1.45 [95% CI, 1.36, 1.54], 1.74 (95% CI, 1.62, 1.86), 1.60 (95% CI, 1.47, 1.75), 1.60 (95% CI, 1.46, 1.75), 1.40 (95% CI, 1.22, 1.60), and 1.67 (95% CI, 1.50, 1.87) respectively. There was no difference in preterm birth rate between Han women and Hani, Bai, or Hui women. Conclusion This study found notable differences in the rates of preterm birth and its sub-categories across maternal ethnicities, which were especially higher in ethnic minority women. The findings suggest that greater efforts to reduce ethnic inequalities in preterm birth. Future studies are warranted to understand the drivers of ethnic inequalities in preterm birth in China.

Project description:Background:There is a global resurgence of measles, consequent upon worldwide stagnating measles vaccination coverage. The study aim was to document trends and characteristics of reported cases of measles, measles-related deaths, and measles vaccination coverage (MCV1-first dose of measles-containing vaccine and MCV2-second dose of measles-containing vaccine) at national and sub-national level in Myanmar over a five year period between 2014 and 2018. Methods:This was a descriptive study using routine data collected and submitted to the Expanded Programme on Immunization. Results:Between 2014 and 2018, there were 2673 measles cases of which 2272 (85%) occurred in 2017 and 2018. Five adjacent regions in lower Myanmar were the most affected: in 2017 and 2018, these regions reported 1647 (73%) of the 2272 measles cases in the country. Overall, 73% of measles cases were laboratory confirmed, 21% were epidemiologically linked, and 6% were clinically compatible (clinical diagnosis only), with more laboratory confirmed cases in recent years. Annual measles-related deaths were either zero or one except in 2016 when there were 21 deaths, all occurring in one remote village. In the recent years, the most commonly affected age groups were 0-8 months, 9 months to 4 years, and ??15 years. Among 1907 measles cases with known vaccination status, only 22% had been vaccinated and 70% of those had only received one dose of vaccine. Annual MCV1 coverage nationally varied from 83 to 93% while annual MCV2 coverage nationally varied from 78 to 87%, with no clear trends over the years. Between 2014 and 2018, a high proportion of the 330 townships had MCV coverage <?95%. Over 80% of measles cases were reported from townships that had MCV coverage <?95%. Conclusion:There have been a large number of measles cases in recent years associated with sub-optimal measles vaccine coverage. Myanmar has already conducted supplemental immunization activities in October and November, 2019. Myanmar also needs to improve routine immunization services and targeted responses to measles outbreaks.

Project description:BackgroundThis study aimed to determine long-term variations in mortality trends and identify the leading causes of death among older adults in China from 2009 to 2019 so as to propose interventions to further stabilise the mortality rate among older adults and facilitate healthy ageing.MethodsWe extracted data from the China Death Surveillance database from 2009 to 2019 for all-cause mortality and cause-specific death among individuals aged ≥ 65 years. A joinpoint regression model was used to estimate mortality trends by calculating the annual percentage change (APC). A trend chi-square test was used to estimate sex differences in mortality, and descriptive analysis was used to estimate the leading causes of death. Semi-structured expert interviews were conducted to examine health interventions for older adults.ResultsWe observed an overall declining trend in age-adjusted mortality rates among older adults aged ≥ 65 years in China from 2009 to 2019 (APC, -2.44; P < 0.05). In this population, the male mortality rate was higher than the female mortality rate during this period (P < 0.05). However, the mortality rate among older adults aged ≥ 85 years increased since 2014, particularly among females. Cardiovascular disease (CVD) was the leading cause of death among older adults aged 65-84 years, whereas ischaemic heart disease was the leading cause of death among individuals aged ≥ 85 years, especially among females. The majority of injuries resulting in death were caused by falls, showing an increasing trend.ConclusionsCVD is a major cause of death among older adults aged ≥ 65 years in China, and relevant health intervention strategies should be implemented from the perspectives of physiology, psychology, and living environment. The change in the mortality trend and the distribution of cause of death among older adults aged ≥ 85 years is noteworthy; a diagnostic and management model centred around females aged ≥ 85 years should be implemented. Additionally, a multidimensional fall prevention strategy involving primary medical institutions and care services needs to be implemented to reduce the risk of falls among older adults.

Dataset Information

Neonatal mortality and leading causes of deaths: a descriptive study in China, 2014-2018.

Objective

Methods

Results

Conclusions

Publications

Neonatal mortality and leading causes of deaths: a descriptive study in China, 2014-2018.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets