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  • Title: [Infant mortality and its causes in a sub-district of the Ivory Coast].
    Author: N'Guessan Diplo L, Rey JL, Soro B, Coulibaly A.
    Journal: Med Trop (Mars); 1990; 50(4):429-32. PubMed ID: 1963915.
    Abstract:
    The authors studied the infant mortality, between 0 and 30 months of age, in a sub-district in an eastern part of Ivory Coast with a population of 240,000 inhabitants. They recorded 103 deaths, i.e. an infant mortality rate of 29,4 p.c.. Tetanus is the main factor in 10 cases, 8 of them being neonatal. These deaths are caused by the lack of care at the umbilical cord, but not by the lack of medical infrastructure. Other causes are malaria (21), undernutrition (12), meningitidis (10), diarrhea (9), pneumopathy (7), endogenous and obstetrical causes (24). Mortality of infants aged 0-30 months was studied in a subdistrict of the eastern Ivory Coast with a population of 240,000 inhabitants. A cluster sample of the type recommended by the World Health Organization for evaluating progress of the expanded program of immunizations consisted of 2 samples with 30 clusters of 70 children each, 1 taken in urban Abengourou and the other in rural cantons of the subprefecture of Abengourou. A standardized questionnaire was administered to all the mothers about their births within the last 3 years. Supplementary questionnaires concerning all deaths of children of the sample mothers were interpreted by 3 physicians who agreed on a probably diagnosis in each case. The survey covered 2375 infants under 1 year and 1825 aged 12-30 months. The total mortality was 103 deaths in the total sample and 70 for infants aged 0-11 months, for a rate of 29.4%. The difference between the urban rate (31.7%) and the rural rate (26.8%) was not significant. The rate varied significantly by sex for deaths due to malnutrition (11 boys, 1 girl), and pneumopathies (6 girls, 1 boy). Mortality varied significantly according to treatment received and place of death. 55% received traditional treatment and 45% modern treatment. 53% died at home, 36% at a health center, and 9% at the home of a healer. Among infants aged 0-27 days, the cause of death was tetanus for 8, prematurity for 12, neonatal distress for 5, neonatal jaundice for 5, and infection for 2. Among infants aged 1-11 months the cause of death was malaria for 10, meningitis for 7, tetanus for 2, diarrhea for 9, pneumopathy for 3, measles for 4, whooping cough for 2, and unknown for 1. Among infants aged 12-30 months the cause of death was malaria for 11, malnutrition for 12, meningitis for 3, pneumopathy for 4, measles for 1, and sickle cell anemia for 2. Malaria was the single most important cause of death followed by malnutrition for the overall sample. In urban and rural areas respectively, the proportions of infants correctly vaccinated for their age groups were 78.1% and 76.0% for those under 11 months; 92.3% and 80.6% for those 12-17 months; 78.3% and 76.6% for those 18-23 months; and 66.5% and 71.4% for those 24 months and over. Mortality rates varied very significantly by vaccination status. 70 of the children dying had not been vaccinated. Their mortality rate was 19.6%, compared to .5% for children in process of vaccination, 1.1% for children incompletely vaccinated, and .9% for children correctly vaccinated.
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