Causes of infant deaths and patterns of associated factors in Eastern Ethiopia: Results of verbal autopsy (InterVA-4) study

• Published in: PloS one 2022-08, Vol.17 (8), p.e0270245-e0270245
• Main Authors: Mebrahtom, Samuel, Worku, Alemayehu, Gage, Daniel J
• Format: Article
• Language: English
• Subjects: Asphyxia; Autopsies; Autopsy; Babies; Biology and Life Sciences; Births; Death; Developing countries; Diarrhea; Empirical analysis; Enumeration; Ethiopia; Evaluation; Fatalities; Frequency analysis; Frequency distribution; Health aspects; Health risks; Infant mortality; Infants; Infections; Information processing; Interviews; LDCs; Malaria; Maternal & child health; Medicine and Health Sciences; Morbidity; Mortality; Neonates; Newborn babies; People and Places; Pneumonia; Population; Probabilistic models; Public health; Rainy season; Registration; Respiratory system; Risk analysis; Risk factors; Sampling techniques; Statistical analysis; Sustainable development; Vector-borne diseases
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0270245

Background In a range of setting, detecting and generate empirical information on the cause of infant death and contributing risk factors at population level is basically utmost essential to take evidence-based measures in reducing infant morbidity and mortality. An electronic verbal autopsy is suitable tool and best alternative solution to determine individuals' cause of death in a setting where the majority of deaths occur at home and civil registration systems do not exist. The present study was undertaken to find out cause of infant death, applying computer-based probabilistic model (InterVA-4) and analyze the patterns of association factors of mother's and the deceased infant's characteristics to the leading cause-specific infant mortality in Eastern Ethiopia. Methods The study employed a community-based prospective longitudinal survey, which was conducted with routinely enumeration of reported infant deaths for a period of two years (from September 2016 to August 2018) in Eastern part of Ethiopia. Using the two-stage cluster sampling technique, the study was undertaken in four randomly selected districts of West Hararghe zone and two districts of zone 3 in Oromia and Afar regional state, respectively. The study included a total of 362 infants who were deceased during the study period. Data was collected by trained enumerators by interviewing the mothers or guardians of the deceased infant using a 2014 standardize World Health Organization (WHO) Verbal Autopsy questionnaire. InterVA-4 model were used for processing and interpreting verbal autopsy data in order to arrive at the most likely causes of infant death. SPSS version 23 was also used for statistical analysis of frequency distribution and logistic regression for the association between covariates and outcomes. Findings Of the overall (362) deceased infants' during the study period, 53.0% of deaths occurred during neonatal time while 47.0% died in the post-neonatal period. Acute respiratory infection including neonatal and post-neonatal pneumonia (38.4%), birth asphyxia (16.4%), diarrheal diseases (16.3%), prematurity (7.4%) and malaria (4.3%) were found to be the leading causes of infant mortality in the study area. The independent factors strongly associated with probable ARI, including pneumonia related mortality as compared to all-causes of death were infants with maternal age lower than 20 years old (p = 0.001, AOR: 4.82, 95% CI: 1.88, 12.3) and infant being died outside of heath facilities