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Mortality Surveillance Methods to Identify and Characterize Deaths in Child Health and Mortality Prevention
Navit T Salzberg1, Kasthuri Sivalogan1, Quique Bassat2,3,4,5,6
1Emory Global Health Institute, Emory University, Atlanta, Georgia, USA.
Insights
Childhood mortality in low-income countries remains high, with many deaths lacking a clear cause. The CHAMPS Network uses comprehensive surveillance and minimally invasive tissue sampling (MITS) to determine causes of death and inform interventions.
Area of Science:
- Global Health
- Epidemiology
- Pediatrics
Background:
- Childhood mortality remains a significant challenge in low- and middle-income countries, particularly in sub-Saharan Africa and South Asia.
- Deaths often occur outside healthcare facilities, leading to a lack of data on causes and substantial uncertainty in national and global estimates.
- Accurate cause-of-death data is crucial for developing effective interventions and achieving Sustainable Development Goals related to child survival.
Purpose of the Study:
- To establish a comprehensive mortality surveillance system to accurately determine the causes of under-5 mortality and stillbirths.
- To improve the quality of cause-of-death data in regions with high mortality rates.
- To provide actionable data to stakeholders for targeted interventions to reduce preventable deaths.
Main Methods:
- The Child Health and Mortality Prevention Surveillance (CHAMPS) Network employs a multi-faceted approach including facility- and community-based notification systems.
- Minimally invasive tissue sampling (MITS) is conducted rapidly after death, complemented by postmortem laboratory and pathology testing, verbal autopsy, and clinical/demographic data collection.
- Expert review panels determine the final cause of death based on all collected data.
Main Results:
- The CHAMPS Network systematically collects data on under-5 deaths and stillbirths within defined catchment areas.
- Timely notification and MITS enable rapid postmortem investigations.
- Expert review provides definitive causes of death, reducing uncertainty in mortality data.
Conclusions:
- The CHAMPS Network provides high-quality, actionable cause-of-death data for under-5 mortality and stillbirths in high-burden regions.
- This data is essential for informing local, national, and global strategies to reduce childhood mortality.
- Accurate data collection is a critical step towards eliminating preventable perinatal and childhood deaths.
Abstract:
Despite reductions over the past 2 decades, childhood mortality remains high in low- and middle-income countries in sub-Saharan Africa and South Asia. In these settings, children often die at home, without contact with the health system, and are neither accounted for, nor attributed with a cause of death. In addition, when cause of death determinations occur, they often use nonspecific methods. Consequently, findings from models currently utilized to build national and global estimates of causes of death are associated with substantial uncertainty. Higher-quality data would enable stakeholders to effectively target interventions for the leading causes of childhood mortality, a critical component to achieving the Sustainable Development Goals by eliminating preventable perinatal and childhood deaths. The Child Health and Mortality Prevention Surveillance (CHAMPS) Network tracks the causes of under-5 mortality and stillbirths at sites in sub-Saharan Africa and South Asia through comprehensive mortality surveillance, utilizing minimally invasive tissue sampling (MITS), postmortem laboratory and pathology testing, verbal autopsy, and clinical and demographic data. CHAMPS sites have established facility- and community-based mortality notification systems, which aim to report potentially eligible deaths, defined as under-5 deaths and stillbirths within a defined catchment area, within 24-36 hours so that MITS can be conducted quickly after death. Where MITS has been conducted, a final cause of death is determined by an expert review panel. Data on cause of death will be provided to local, national, and global stakeholders to inform strategies to reduce perinatal and childhood mortality in sub-Saharan Africa and South Asia.
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