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Mortality-discriminating power of some nutritional, sociodemographic, and diarrheal disease indices
R Bairagi1, M A Koenig, K A Mazumder
1International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.
Insights
Childhood mortality in Bangladesh was best predicted by weight-for-age and weight velocity. Diarrheal disease morbidity was also a useful predictor, while maternal education and child sex were not significant factors.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Childhood mortality remains a significant global health challenge, particularly in low-resource settings.
- Identifying reliable predictors of mortality is crucial for targeted interventions and improved child survival rates.
Purpose of the Study:
- To evaluate the predictive efficacy of nutritional, socioeconomic, and diarrheal disease morbidity variables for subsequent 1-year childhood mortality.
- To determine the most effective indicators for identifying children at high risk of mortality in rural Bangladesh.
Main Methods:
- Longitudinal study design utilizing data from a demographic surveillance system in rural Bangladesh (1988-1990).
- Analysis of anthropometric measurements (weight-for-age, weight velocity), diarrheal morbidity, maternal education, and child sex for approximately 1,900 children aged 6-36 months.
- Statistical comparison of the predictive power of selected variables for 1-year mortality.
Main Results:
- Weight-for-age (%) emerged as the strongest predictor of subsequent childhood mortality.
- Weight velocity (monthly weight gain/loss) was the second-best predictor; standardization did not enhance its predictive power.
- Reported diarrheal morbidity also demonstrated significant predictive value for mortality.
Conclusions:
- Anthropometric indicators, specifically weight-for-age and weight velocity, are powerful tools for predicting childhood mortality in this population.
- Diarrheal disease morbidity is a relevant factor in assessing mortality risk.
- Maternal education and child sex were found to have limited predictive power for mortality in this context.
Abstract:
This study compared the predictive power of selected nutritional (anthropometric), socioeconomic, and diarrheal disease morbidity variables for subsequent childhood mortality over a 1-year period. The data consisted of observations of approximately 1,900 children aged 6-36 months obtained from a longitudinal demographic surveillance system located in a rural area of Bangladesh in 1988-1990. The results suggested that weight-for-age (%) was the best predictor of subsequent mortality over a 1-year period, followed by weight velocity (monthly weight gain or loss in grams). Standardization of weight velocity by the US National Center for Health Statistics standard did not improve the mortality-discriminating power of this variable. Reported diarrheal morbidity was also a useful criterion for predicting mortality. Neither maternal education nor sex of the child had significant mortality-discriminating power.