Infant mortality in Brazil attributable to inborn errors of metabolism associated with sudden death: a time-series study (2002-2014)

The risk factors of infant mortality in Somalia: evidence from the 2018/2019 Somali health & demographic survey

BACKGROUND

Globally, infant mortality is one of the major public health threats, especially in low-income countries. The infant mortality rate of Somalia stands at 73 deaths per 1000 live births, which is one of the highest infant death rates in the region as well as in the world. Therefore, the aim of this study was to ascertain the risk factors of infant mortality in Somalia using national representative data.

METHOD

In this study, data from the Somali Health and Demographic Survey (SHDS), conducted for the first time in Somalia in 2018/2019 and released in 2020, were utilized. The analysis of the data involved employing the Chi-square test as a bivariate analysis. Furthermore, a multivariate Cox proportional hazard model was applied to accommodate potential confounders that act as risk factors for infant death.

RESULTS

The study found that infant mortality was highest among male babies, multiple births, and those babies who live in rural areas, respectively, as compared to their counterparts. Those mothers who delivered babies with small birth size and belonged to a poor wealth index experienced higher infant mortality than those mothers who delivered babies with average size and belonged to a middle or rich wealth index. Survival analysis indicated that mothers who did use ANC services (HR = 0.740; 95% CI = 0.618-0.832), sex of the baby (HR = 0.661; 95% CI = 0.484-0.965), duration of pregnancy (HR = 0.770; 95% CI = 0.469-0.944), multiple births (HR = 1.369; 1.142-1.910) and place of residence (HR = 1.650; 95% CI = 1.451-2.150) were found to be statistically significantly related to infant death.

CONCLUSION

The study investigated the risk factors associated with infant mortality by analyzing data from the first Somali Health and Demographic Survey (SHDS), which included a representative sample of the country's population. Place of residence, gestational duration, infant's gender, antenatal care visits, and multiple births were identified as determinants of infant mortality. Given that infant mortality poses a significant public health concern, particularly in crisis-affected countries like Somalia, intervention programs should prioritize the provision of antenatal care services, particularly for first-time mothers. Moreover, these programs should place greater emphasis on educating women about the importance of receiving antenatal care and family planning services, in order to enhance their awareness of these vital health services and their positive impact on infant survival rates.

An assessment of random forest technique using simulation study: illustration with infant mortality in Bangladesh

We aimed to assess different machine learning techniques for predicting infant mortality (<1 year) in Bangladesh. The decision tree (DT), random forest (RF), support vector machine (SVM) and logistic regression (LR) approaches were evaluated through accuracy, sensitivity, specificity, precision, F1-score, receiver operating characteristics curve and k-fold cross-validation via simulations. The Boruta algorithm and chi-square ( χ 2 ) test were used for features selection of infant mortality. Overall, the RF technique (Boruta: accuracy = 0.8890, sensitivity = 0.0480, specificity = 0.9789, precision = 0.1960, F1-score = 0.0771, AUC = 0.6590; χ 2 : accuracy = 0.8856, sensitivity = 0.0536, specificity = 0.9745, precision = 0.1837, F1-score = 0.0828, AUC = 0.6480) showed higher predictive performance for infant mortality compared to other approaches. Age at first marriage and birth, body mass index (BMI), birth interval, place of residence, religion, administrative division, parents education, occupation of mother, media-exposure, wealth index, gender of child, birth order, children ever born, toilet facility and cooking fuel were potential determinants of infant mortality in Bangladesh. Study findings may help women, stakeholders and policy-makers to take necessary steps for reducing infant mortality by creating awareness, expanding educational programs at community levels and public health interventions.

Expanded newborn bloodspot screening: developed country examples and what can be done in Turkey

Bloodspot screening in newborns is an exemplary public health intervention as it is essential secondary prevention with proven efficacy and benefit for the early diagnosis and prompt treatment of rare diseases. In this mini review, newborn bloodspot screening (NBS) programs of 12 countries were examined in terms of the extent of diseases/disorders screened to form recommendations for Turkey's expanded newborn screening program. Essentially, Turkey and 11 selected countries' official policies/ national programs or strategies in terms of newborn screening and the number of diseases/conditions screened were examined. The current status of spinal muscular atrophy (SMA) screening was also checked through the SMA NBS Alliance. In addition, WHO and EURORDIS guidelines for newborn screening were also reviewed. On the Pubmed database, following the search strategy "((newborn screening[Title/Abstract]) OR (newborn screening program[Title/Abstract])) OR (newborn blood spot screening[Title/Abstract])" in the PubMed database from 1 January 2008 to 1 December 2021. Diseases that will be recommended to be included in the Turkish national newborn bloodspot screening program will be presented by evaluating the updated criteria of Wilson and Jungner by constructing international comparisons. The number of diseases/disorders screened by the inspected 12 countries is eminently variable and ranges from 5 in Turkey to 51 in New York, United States of America (USA). Acknowledging the programs of other countries, it is evident that Turkey must advance its program by evaluating the epidemiological data in Turkey, the health workforce, and infrastructure while relying on the updated screening criteria. The newborn bloodspot screening program should be expanded based on the cost estimates and implemented starting with pilot applications and the diseases/disorders that are deemed appropriate should be included in the national program.

Factors affecting infant mortality in the general population: evidence from the 2016 Ethiopian demographic and health survey (EDHS); a multilevel analysis

Background

Infant mortality is one of the leading public health problems globally; the problem is even more staggering in low-income countries. In Ethiopia seven in ten child deaths occurred during infancy in 2016. Even though the problem is devastating, updated information about the major determinants of infant mortality which is done on a countrywide representative sample is lacking. Therefore, this study was aimed to identify factors affecting infant mortality among the general population of Ethiopia, 2016.

Methods

A Community-based cross-sectional study was conducted in all regions of Ethiopia from January 18 to June 27, 2016. A total of 10,641 live births were included in the analysis. Data were analyzed and reported with both descriptive and analytic statistics. Bivariable and multivariable multilevel logistic regression models were fitted by accounting correlation of individuals within a cluster. Adjusted odds ratio (AOR) with 95% confidence interval was reported to show the strength of the association and its significance.

Results

A total of 10,641 live-births from the Ethiopian demographic and health survey (EDHS) data were included in the analysis. Being male infant (AOR = 1.51; 1.25, 1.82), Multiple birth (AOR = 5.49; 95% CI, 3.88–7.78), Preterm (AOR = 8.47; 95% CI 5.71, 12.57), rural residents (AOR = 1.76; 95% CI; 1.16, 2.67), from Somali region (AOR = 2.07; 1.29, 3.33), Harari (AOR = 2.14; 1.22, 3.75) and Diredawa (AOR = 1.91; 1.04, 3.51) were found to be statistically significantly associated with infant mortality.

Conclusion

The study has assessed the determinants of infant mortality based on EDHS data. Sex of the child, multiple births, prematurity, and residence were notably associated with infant mortality. The risk of infant mortality has also shown differences across different regions. Since infant mortality is still major public health problem interventions shall be done giving more attention to infants who were delivered multiple and who are preterm.