Trend, disease burden and determinants of mortality among children 5-14 years in south-central Ethiopia: analysis using Butajira Health and Demographic Surveillance System data (1987-2022)
No Thumbnail Available
Date
2024-10
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Background: Nearly, 0.9 million children aged 5-14 died globally in 2020. The death is especially
unacceptable since the majority died of preventable or treatable causes. Although communicable diseases
are still the leading causes, non-communicable diseases, and external causes account for half of all deaths,
posing a triple burden.
Objective: To assess the trend, disease burden, and determinants of mortality among children 5-14 years
in Butajira, south-central Ethiopia from 1987 through 2022.
Methods: The Butajira Health and Demographic Surveillance System open prospective cohort (1987-2022)
and cause of death data acquired via verbal autopsy procedures (2007- 2022) were analyzed. Event history
analysis was used to study mortality trends and the incidence of child death by covariates. The broad and
specific causes of death burden for children aged 5-14 years were measured. The adjusted Incidence rate
ratio (aIRR) with its 95% confidence interval in the Poisson regression model was used to measure strength,
direction, and significance of the association between child mortality and exposure variables.
Results: A declining trend in the incidence child mortality was observed (Kendall’s tau = - 0.83; P-value
< 0.0001). The overall incidence of child mortality was 6.31 (5.99, 6.64) deaths per 1000 person-years.
Communicable diseases (39.2%) were the major causes of death followed by non-communicable diseases
(35.4%) and external causes (23.4%). HIV/AIDS (14.6%), severe malnutrition (13.1%), accidental
drowning & submersion (8.5%) and RTA (8.5%) were the leading specific causes of death. The incidence
of child mortality was higher among males with aIRR/95% CI (1.27 (1.15, 1.41)), older children (2.06
(1.84, 2.29)), ruralists (2.42 (1.88, 3.12)), lowlanders (1.37 (1.17, 1.60)), owned house (3.98 (2.33, 6.79)),
small households (1.18 (1.05, 1.32)), uneducated mother (2.03 (1.80, 2.29)), lived 10 KMs away from
hospital (1.34 (1.11, 1.63)), used unprotected water source (1.35 (1.18, 1.55)), had at least one ox [(1.36
(1.19, 1.54), or 2+ oxen (1.54 (1.32, 1.79))] and with a house without window (1.38 (1.18, 1.62)), latrine
(1.96 (1.60, 2.40)) and media exposure (1.87 (1.60, 2.19)).
Conclusion: During the 36 years of study periods in Butajira HDSS, a significant declining trend in the
incidence of child mortality was found. Older children and young adolescents are suffering from triple
burden of diseases. A comprehensive targeted interventions needs to be delivered at societal, household
and personal level to avert the mortality burden.
Description
Keywords
Butajira HDSS, Child mortality, Causes of death, Disease burden, Trend