Evidence map›Paper›PMID 33556118›Full record

ArticlePloS one2021

Linking the timing of a mother's and child's death: Comparative evidence from two rural South African population-based surveillance studies, 2000-2015.

Brian Houle, Chodziwadziwa W Kabudula, Alan Stein, Dickman Gareta, Kobus Herbst, Samuel J Clark

Abstract read
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Brian HouleSchool of Demography, The Australian National University, Canberra, Australia.ORCID 0000-0003-2157-3118
Chodziwadziwa W KabudulaFaculty of Health Sciences, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.ORCID 0000-0002-5867-0336
Alan SteinFaculty of Health Sciences, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Dickman GaretaAfrica Health Research Institute, KwaZulu-Natal, South Africa.
Kobus HerbstAfrica Health Research Institute, KwaZulu-Natal, South Africa.ORCID 0000-0002-5436-9386
Samuel J ClarkFaculty of Health Sciences, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.

Funding

Howard Hughes Medical InstituteWellcome TrustWellcome Trust 058893/Z/99/AWellcome Trust 069683/Z/02/ZWellcome Trust 085477/B/08/ZWellcome Trust 085477/Z/08/ZWellcome Trust 201433/Z/16/Z
6 · The paper itself

Abstract

backgroundThe effect of the period before a mother's death on child survival has been assessed in only a few studies. We conducted a comparative investigation of the effect of the timing of a mother's death on child survival up to age five years in rural South Africa.

methodsWe used discrete time survival analysis on data from two HIV-endemic population surveillance sites (2000-2015) to estimate a child's risk of dying before and after their mother's death. We tested if this relationship varied between sites and by availability of antiretroviral therapy (ART). We assessed if related adults in the household altered the effect of a mother's death on child survival.

findings3,618 children died from 2000-2015. The probability of a child dying began to increase in the 7-11 months prior to the mother's death and increased markedly in the 3 months before (2000-2003 relative risk = 22.2, 95% CI = 14.2-34.6) and 3 months following her death (2000-2003 RR = 20.1; CI = 10.3-39.4). This increased risk pattern was evident at both sites. The pattern attenuated with ART availability but remained even with availability at both sites. The father and maternal grandmother in the household lowered children's mortality risk independent of the association between timing of mother and child mortality.

conclusionsThe persistence of elevated mortality risk both before and after the mother's death for children of different ages suggests that absence of maternal care and abrupt breastfeeding cessation might be crucial risk factors. Formative research is needed to understand the circumstances for children when a mother is very ill or dies, and behavioral and other risk factors that increase both the mother and child's risk of dying. Identifying families when a mother is very ill and implementing training and support strategies for other members of the household are urgently needed to reduce preventable child mortality.

Indexed as

AdultAntiretroviral Therapy, Highly ActiveBlack PeopleChild MortalityChild, PreschoolEpidemiological MonitoringFemaleHIV InfectionsHumansInfantInfant MortalityInfant, NewbornMaleMaternal DeathMothersPopulation Surveillance

Identifiers

PMID33556118
PMCPMC7869981

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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.