Evidence map›Paper›PMID 35385556›Full record

ArticlePloS one2022

Time to under-five mortality and its predictors in rural Ethiopia: Cox-gamma shared frailty model.

Melaku Yalew, Mastewal Arefaynie, Gedamnesh Bitew, Erkihun Tadesse Amsalu, Bereket Kefale, Amare Muche, Zinabu Fentaw, Muluken Genetu Chanie, Mequannent Sharew Melaku, Bezawit Adane and 5 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
4.6field-weighted citation impact, top 6% of its field
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

10 citing papers in PubMed, 12 citations in OpenAlex.

  1. Avoidable mortality in childhood in Colombia: A type of violenceBiomedica : revista del Instituto Nacional de Salud · 2026
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  9. Determinant factors of under-five mortality in rural Ethiopia.Annals of medicine and surgery (2012) · 2022
    Article
  10. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 2 institutions in 1 country.

Melaku YalewDepartment of Reproductive and Family Health, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.ORCID 0000-0002-7314-2523
Mastewal ArefaynieDepartment of Reproductive and Family Health, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Gedamnesh BitewDepartment of Epidemiology and Biostatistics, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Erkihun Tadesse AmsaluDepartment of Epidemiology and Biostatistics, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Bereket KefaleDepartment of Reproductive and Family Health, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Amare MucheDepartment of Epidemiology and Biostatistics, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.ORCID 0000-0002-8533-3570
Zinabu FentawDepartment of Epidemiology and Biostatistics, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.ORCID 0000-0002-4577-868X
Muluken Genetu ChanieDepartment of Health Systems and Policy, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.ORCID 0000-0001-7059-1449
Mequannent Sharew MelakuDepartment of Health Informatics, Institute of Public health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Bezawit AdaneDepartment of Epidemiology and Biostatistics, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Yitayish DamtieDepartment of Reproductive and Family Health, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Metadel AdaneDepartment of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.ORCID 0000-0002-7039-4768
Wolde Melese AyeleDepartment of Epidemiology and Biostatistics, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.ORCID 0000-0003-4830-3599
Assefa AndargieDepartment of Epidemiology and Biostatistics, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Reta DewauDepartment of Epidemiology and Biostatistics, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.ORCID 0000-0001-6531-2468
Wollo University · ETUniversity of Gondar · ET

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUnder-five mortality (U5M) is one of the most important and sensitive indicators of the health status of the community. Despite there having been a substantial reduction in U5M since 1990, its rate is still high in Sub-Saharan African countries. Thus, this study aimed to assess time to under-five mortality and its predictors in rural Ethiopia.

methodsThis study utilized a secondary analysis of the 2016 Ethiopia Demographic and Health Survey (EDHS). A total of 9,807 weighted under-five children selected at different stages were included in the analysis. The Kaplan-Meier and Cox's-gamma shared frailty models were used to estimate survival time and to identify predictors of under-five mortality, respectively. An adjusted Hazard Ratio (AHR) along with a 95% Confidence Interval (CI) was used to measure the effect size and direction of the association.

resultsThe study indicated that 6.69% (95% CI: 6.13, 7.30) of children died before celebrating their fifth birthday in rural Ethiopia. Of all the deaths, the median time to death was 27 months. After controlling the effect of cluster and other confounding factors, female sex (AHR = 0.62, 95% CI: 0.52, 0.75), ever born greater than five children (AHR = 1.40, 95% CI: 1.07, 1.83), very large size at birth (AHR = 1.33, 95% CI: 1.03 1.71), very small size at birth (AHR = 1.41, 95% CI: 1.10, 1.82), twin pregnancy (AHR = 3.5, 95% CI: 2.47, 4.88), not ever breastfeeding (AHR = 11.29, 95% CI: 9.03, 14.12), unimproved latrine (AHR = 3.44, 95% CI: 1.91, 6.17), covered by health insurance (AHR = 0.29, 95% CI: 0.12, 0.70) were predictors of under-five mortality.

conclusionsStill under-five mortality was high in rural Ethiopia as compared to the global under-five mortality rate. In the final model, sex of a child, the total number of children ever born, children's size at birth, type of pregnancy, breastfeeding, type of toilet, and being covered by health insurance were significant predictors of under-five mortality. Further emphasis should be given to twin and not breastfeeding children, as well as households' better encouraging membership of community health insurance and utilization of improved latrines.

Indexed as

FrailtyBirth WeightChildEthiopiaFemaleHumansInfant MortalityInfant, NewbornPregnancyRural Population

Identifiers

PMID35385556
PMCPMC8985961
OpenAlexW4226303985

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.