Evidence map›Paper›PMID 31002201›Full record

ArticleTropical medicine & international health : TM & IH2019

Home deaths of children under 5 years in rural South Africa: a population-based longitudinal study.

Jessica Price, Merlin Willcox, Chodziwadziwa Whiteson Kabudula, Kobus Herbst, Kathleen Kahn, Anthony Harnden

Abstract read
In one paragraph

Article in Tropical medicine & international health : TM & IH, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jessica PriceNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Merlin WillcoxDepartment of Primary Care and Population Sciences, University of Southampton, Southampton, UK.
Chodziwadziwa Whiteson KabudulaMRC-Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa.
Kobus HerbstAfrica Health Research Institute, Berea, South Africa.
Kathleen KahnMRC-Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa.
Anthony HarndenNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.

Funding

Department of Health CL-2016-26-005Wellcome Trust 058893Wellcome Trust 058893/Z/99/AWellcome Trust 069683Wellcome Trust 069683/Z/02/ZWellcome Trust 085477Wellcome Trust 085477/B/08/ZWellcome Trust 085477/Z/08/ZWellcome Trust 201433Wellcome Trust 201433/Z/16/Z
6 · The paper itself

Abstract

objectivesTo determine the proportion of under-5 deaths that occurred at home in rural South Africa, whether care was sought prior to death, and determinants of home deaths amongst those who sought care.

methodsVerbal autopsy data were used for all under-5 deaths, 2000-2015, in two health and demographic surveillance system sites. Trends in place of death and care-seeking were assessed. Associations between sociodemographic factors and home death despite seeking care were assessed by multivariate logistic regressions.

resultsThere were 3760 under-5 deaths; 1954 (53%) at home and 1510 (41%) in health facilities. Eighty-four per cent of children who died at home accessed healthcare during their final illness. Amongst neonates for whom care was sought, those who were 8-27 days old were more likely to die at home than those who were 0-7 days old (OR = 5.56, 95%CI 2.69-11.55, P < 0.001). Factors associated with home death of infants and young children despite seeking care included low maternal education (OR = 1.71, 95%CI 1.31-2.24, P < 0.001), larger household size (OR = 1.56, 95%CI 1.17-2.06, P = 0.002), traditional medicine use (OR = 2.33, 95%CI 1.75-3.12, P < 0.001) and Mozambican descent (OR = 1.47, 95%CI 1.06-2.03, P = 0.020). The proportion of HIV-related deaths that occurred at home fell from 60% in 2008-2011 to 39% in 2012-2015 ( χ

conclusionMore than half of under-5 deaths in rural South Africa occurred at home although healthcare was sought for most children, highlighting that home deaths are not simply a function of poor care-seeking. Interventions should target high-risk sociodemographic groups.

Indexed as

Child MortalityInfant MortalityCause of DeathChild, PreschoolFemaleHumansInfantInfant, NewbornLongitudinal StudiesMalePatient Acceptance of Health CareRural PopulationSouth Africaautopsie socialeautopsie verbalecare-seekingchild mortalitydécès à domicilefacteurs de risque sociodémographiqueshome deathsmortalité infantilerecherche de soinsrural South Africasocial autopsysociodemographic risk factorsverbal autopsyzone rurale d'Afrique du Sud

Identifiers

PMID31002201
PMCPMC7612936

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.