Evidence map›Paper›PMID 37607788›Full record

Observational studyBMJ open2023

Childhood mortality and associated factors in Migori County, Kenya: evidence from a cross-sectional survey.

Joseph R Starnes, Ash Rogers, Jane Wamae, Vincent Okoth, Sandra A Mudhune, Alyn Omondi, Vincent Were, Doreen Baraza Awino, Christina Hope Lefebvre, Samantha Yap and 4 more

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 22% 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

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Pooled it
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  3. Article
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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

14 authors at 5 institutions in 2 countries.

Joseph R StarnesDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA joseph.starnes@vumc.org.ORCID 0000-0001-7954-5385
Ash RogersLwala Community Alliance, Rongo, Kenya.
Jane WamaeLwala Community Alliance, Rongo, Kenya.
Vincent OkothLwala Community Alliance, Rongo, Kenya.
Sandra A MudhuneLwala Community Alliance, Rongo, Kenya.
Alyn OmondiAdaptive Model for Research and Empowerment of Communities in Africa, Kisumu, Kenya.
Vincent WereKenya Medical Research Institute, Nairobi, Kenya.
Doreen Baraza AwinoLwala Community Alliance, Rongo, Kenya.
Christina Hope LefebvreDepartment of Cultures, Societies, and Global Studies, Northeastern University, Boston, Massachusetts, USA.
Samantha YapDepartment of Cultures, Societies, and Global Studies, Northeastern University, Boston, Massachusetts, USA.
Tom Otieno OdhongDepartment of Health Services, Migori County Government, Migori, Kenya.
Beffy VillDepartment of Health Services, Migori County Government, Migori, Kenya.
Lawrence WereDepartment of Global Health, Boston University, Boston, Massachusetts, USA.
Richard WamaiDepartment of Cultures, Societies, and Global Studies, Northeastern University, Boston, Massachusetts, USA.
Community Partners · USNortheastern University · USLake Victoria Fisheries Organization · KEBoston University · USKenya Medical Research Institute · KE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe under-five mortality (U5M) rate in Kenya (41 per 1000 live births) remains significantly above international goals (25 per 1000 live births). This is further exacerbated by regional inequalities in mortality. We aimed to describe U5M in Migori County, Kenya, and identify associated factors that can serve as programming targets.

designCross-sectional observational survey.

settingAreas served by the Lwala Community Alliance and control areas in Migori County, Kenya.

participantsThis study included 15 199 children born to respondents during the 18 years preceding the survey. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was mortality in the first 5 years of life. The survey was powered to detect a 10% change in various health metrics over time with 80% power.

resultsA total of 15 199 children were included in the primary analyses, and 230 (1.5%) were deceased before the fifth birthday. The U5M rate from 2016 to 2021 was 32.2 per 1000 live births. Factors associated with U5M included year of birth (HR 0.926, p<0.001), female sex (HR 0.702, p=0.01), parental marriage (HR 0.642, p=0.036), multiple gestation pregnancy (HR 2.776, p<0.001), birth spacing less than 18 months (HR 1.894, p=0.005), indoor smoke exposure (HR 1.916, p=0.027) and previous familial contribution to the National Hospital Insurance Fund (HR 0.553, p=0.009). The most common cause of death was malaria.

conclusionsWe describe factors associated with childhood mortality in a Kenyan community using survival analyses of complete birth histories. Mortality rates will serve as the baseline for future programme evaluation as a part of a 10-year study design. This provides both the hyperlocal information needed to improve programming and generalisable conclusions for other organisations working in similar environments.

Indexed as

Birth IntervalsChild MortalityCephalosporinsChildCross-Sectional StudiesFemaleHumansKenyaPregnancyCephalosporinsHR 916community child healthepidemiologyhealth policypaediatricspublic health

Identifiers

PMID37607788
PMCPMC10445361
OpenAlexW4386074735

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.