scholarly journals Density Estimation of Neonatal Mortality Rate Using Empirical Bayes Deconvolution with Poisson Distributed Surrogate in Central Java Province Indonesia

Author(s):  
Fevi Novkaniza ◽  
Khairil Anwar Notodiputro ◽  
I Wayan Mangku ◽  
Kusman Sadik

This article is concerned with the density estimation of Neonatal Mortality Rate (NMR) in Central Java Province, Indonesia. Neonatal deaths contribute to 73% of infant deaths in Central Java Province. The number of neonatal deaths for 35 districts/municipalities in Central Java Province is considered as Poisson distributed surrogate with NMR as the rate of Poisson distribution. It is assumed that each number of neonatal deaths by district/municipality in Central Java Province were realizations of unobserved NMR, which come from unknown prior density. We applied the Empirical Bayes Deconvolution (EBD) method for estimating the unknown prior density of NMR based on Poisson distributed surrogate. We used secondary data from the Health Profiles of Central Java Province, Indonesia, in 2018. The density estimation of NMR by the EBD method showed that the resulting prior estimate is relatively close to the Gamma distribution based on Poisson surrogate. This is implying that the suitability of the obtained prior density estimation as a conjugate prior for Poisson distribution.

2020 ◽  
Vol 5 (2) ◽  
pp. 82-87
Author(s):  
Sinta Wati ◽  
Mateus Sakundarno Adi

Background: The Neonatal Mortality Rate of Central Java in 2018 was 7.3 per 1000 live births and the neonatal mortality rate in Semarang City in 2018 was 4.57 per 1000 live births. The purpose of this study was to analyze neoanatal mortality based on maternal characteristics in Semarang City.Methods: This research used descriptive analysis, derived from secondary data in the Semarang City Health Office. The data was taken from Verbal Perinatal Autopsy data sampling from neonatal cases aged 0-28 days who died in Semarang City. In 2019 there were 50 cases out of 101 neonatal death cases.Results: From the analysis showed that neonatal mortality in Semarang City based on the place of delivery were 90% in hospitals with 86% birth attendants assisted by obstetrics and gynecology specialists. Mothers were aged 20-35 years (74%) and 80% have maternal parity less than 3 children, with pregnancy spacing less than 2 years (56%). Beside that, more than 74% mothers have gestational age less than 37 weeks or during the preterm period and 68% of mothers also do Antenatal Care more than 4 times during pregnancy. Most of mothers have hypertension and anemia (20%). Looking at the risk factors, there are 26% of mothers who have a history of abortion, the mother’s age is too old (16%) and childbirth by cesarian section (10%).Conclusion: Neonatal deaths in Semarang City are already numerous in hospitals and delivery assistants by obstetricians. The biggest possibility is that the quality of ANC services is inadequate and not according to ANC-10-T standards.


Author(s):  
Godwin Oligbu ◽  
Leila Ahmed ◽  
Laura Ferraras-Antolin ◽  
Shamez Ladhani

ObjectiveTo estimate the overall and infection-related neonatal mortality rate and the pathogens responsible using electronic death registrations.DesignRetrospective analysis of national electronic death registrations data.SettingEngland and Wales.PatientsNeonates aged <28 days.Main outcome measuresOverall and infection-related mortality rate per 1000 live births in term, preterm (28–36 weeks) and extremely preterm (<28 weeks) neonates; the contribution of infections and specific pathogens; comparison with mortality rates in 2003–2005.ResultsThe neonatal mortality rate during 2013–2015 (2.4/1000 live births; 5095 deaths) was 31% lower than in 2003–2005 (3.5/1000; 6700 deaths). Infection-related neonatal mortality rate in 2013–2015 (0.32/1000; n=669) was 20% lower compared with 2003–2015 (0.40/1000; n=768), respectively. Infections were responsible for 13.1% (669/5095) of neonatal deaths during 2013–2015 and 11.5% (768/6700) during 2003–2005. Of the infection-related deaths, 44.2% (296/669) were in term, 19.9% (133/669) preterm and 35.9% (240/669) extremely preterm neonates. Compared with term infants (0.15/1000 live births), infection-related mortality rate was 5.9-fold (95% CI 4.7 to 7.2) higher in preterm (0.90/1000) and 188-fold (95% CI 157 to 223) higher in extremely preterm infants (28.7/1000) during 2013–2015. A pathogen was recorded in 448 (67%) registrations: 400 (89.3%) were bacterial, 37 (8.3%) viral and 11 (2.4%) fungal. Group B streptococcus (GBS) was reported in 30.4% (49/161) of records that specified a bacterial infection and 7.3% (49/669) of infection-related deaths.ConclusionsOverall and infection-related neonatal mortality rates have declined, but the contribution of infection and of specific pathogens has not changed. Further preventive measures, including antenatal GBS vaccine may be required to prevent the single most common cause of infection-related deaths in neonates.


Author(s):  
Kareem Abiodun John ◽  
Fasoranti Ifedayo Olabisi ◽  
Alonge Abel Olumuyiwa ◽  
Kareem Adesola Olawumi ◽  
Bewaji Temitayo Olubunmi ◽  
...  

Background: The neonatal mortality rate remains high in developing countries despite the significant reduction in under-five mortality globally. Therefore, periodic evaluations on the causes of mortality are an aspect of health status, which could be performed to improve the neonatal mortality rate. Objectives: The present study aimed to determine the pattern and causes of neonatal mortality in the Federal Medical Center in Owo, Ondo State, Southwest Nigeria. Methods: This retrospective study was conducted using the hospital records of the neonates admitted over a five-year period from 1st of January 2015 to 31st of December 2019. Results: In total, 2,065 neonates were admitted, including 208 cases of neonatal deaths. Mortality occurred in 127 males (61.1%) and 81 females (38.9%), with the male-to-female ratio of 1.6:1. Among the recorded deaths, 114 cases (54.8%) occurred within the first 24 hours of admission, while 94 neonates (45.2%) died after 24 hours of admission. In addition, the mortality rate was higher among outborn neonates (n = 120; 57.7%) compared to inborn neonates (n = 88; 42.3%). The major causes of neonatal deaths included birth asphyxia (46.6%), prematurity (23.1%), and sepsis (17.8%). The overall mortality rate over the five-year period was 10.1%, which is equivalent to 19 deaths per 1,000 live births. Conclusions: According to the results, preventable diseases such as birth asphyxia, prematurity, and sepsis remain the major causes of neonatal mortality, of which neonatal deaths occur mostly within 24 hours of admission.


2016 ◽  
Vol 12 (27) ◽  
pp. 55
Author(s):  
Esraa Abd Al-Muhsen Ali

Background: The neonatal mortality rate is a key outcome indicator for newborn care and directly reflects prenatal, natal, and postnatal care. Early neonatal deaths are more closely associated with pregnancy-related factors and maternal health, whereas late neonatal deaths are associated more with factors in the newborn‘s environment. Objectives: To estimate the neonatal mortality rate in Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital in Missan Province during period (2011-2014). To determine the most common causes of death in the neonatal period. Patients and methods: A hospital-based study was done depending on data collected from records of the Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital in Missan Province to calculate the number of deaths within the neonatal period (0-28 days) that was conducted from 2011 to 2014. The other line of data was collected from Obstetrical Ward by calculating number of live births for the same period. Then Neonatal Mortality Rate is calculated and conducted for each year according to the method recommended by WHO. Results: The neonatal mortality rates were 12.15, 13.51, 16.37 and16.11 in 2011 to 2014 respectively in which there was an increment in mortality rate. The main causes of death were respiratory distress syndrome, birth asphyxia and congenital anomalies. Conclusion: Neonatal mortality rate was high in the Aseptic Neonatal Care Unit of Al-Sadder Teaching Hospital, but it was less than the previous period in Iraq since 1990. These results suggest, that to decrease neonatal mortality, improved health service quality is crucial.


2018 ◽  
Vol 47 (1) ◽  
pp. 125-133 ◽  
Author(s):  
André Sander ◽  
Roland Wauer

Abstract Background The infant mortality rate (IMR), a key indicator of the quality of a healthcare system, has remained at approximately 3.5‰ for the past 10 years in Germany. Generic quality indicators (QIs), as used in Germany since 2010, greatly help in ensuring such a good value but do not seem to be able to further reduce the IMR. The neonatal mortality rate (NMR) contributes to 65–70% of the IMR. We therefore propose single-case analysis of neonatal deaths as an additional method and show an efficient way to implement this approach. Methods We used the Nordic-Baltic classification (NBC) to detect avoidable neonatal deaths. We applied this classification to a sample of 1968 neonatal death records, which represent over 90% of all neonatal deaths in East Berlin from 1973 to 1989. All cases were analyzed as to their preventability based on the complete perinatal and clinical data by a special commission of different experts. The NBC was automatically applied through natural language processing and an ontology-based terminology server. Results The NBC was used to select the group of cases that had a high potential of avoidance. The selected group represented 6.0% of all cases, and 60.4% of the cases within that group were judged avoidable or conditionally avoidable. The automatic detection of malformations showed an F1 score of 0.94. Conclusion The results show that our method can be applied automatically and is a powerful and highly specific tool for selecting potentially avoidable neonatal deaths and thus for supporting efficient single-case analysis.


2019 ◽  
Vol 24 (S1) ◽  
pp. 5-14 ◽  
Author(s):  
Ashish Kc ◽  
Anjani Kumar Jha ◽  
Mahendra Prasad Shrestha ◽  
Hong Zhou ◽  
Abhishek Gurung ◽  
...  

Abstract Introduction Nepal has made considerable progress on improving child survival during the Millennium Development Goal period, however, further progress will require accelerated reduction in neonatal mortality. Neonatal survival is one of the priorities for Sustainable Development Goals 2030. This paper examines the trends, equity gaps and factors associated with neonatal mortality between 2001 and 2016 to assess the likelihood of Every Newborn Action Plan (ENAP) target being reached in Nepal by 2030. Methods This study used data from the 2001, 2006, 2011 and 2016 Nepal Demographic and Health Surveys. We examined neonatal mortality rate (NMR) across the socioeconomic strata and the annual rate of reduction (ARR) between 2001 and 2016. We assessed association of socio-demographic, maternal, obstetric and neonatal factors associated with neonatal mortality. Based on the ARR among the wealth quintile between 2001 and 2016, we made projection of NMR to achieve the ENAP target. Using the Lorenz curve, we calculated the inequity distribution among the wealth quintiles between 2001 and 2016. Results In NDHS of 2001, 2006, 2011 and 2016, a total of 8400, 8600, 13,485 and 13,089 women were interviewed respectively. There were significant disparities between wealth quintiles that widened over the 15 years. The ARR for NMR declined with an average of 4.0% between 2001 and 2016. Multivariate analysis of the 2016 data showed that women who had not been vaccinated against tetanus had the highest risk of neonatal mortality (adjusted odds ratio [AOR] 3.38; 95% confidence interval [CI] 1.20–9.55), followed by women who had no education (AOR 1.87; 95% CI 1.62–2.16). Further factors significantly associated with neonatal mortality were the mother giving birth before the age of 20 (AOR 1.76; CI 95% 1.17–2.59), household air pollution (AOR 1.37; CI 95% 1.59–1.62), belonging to a poorest quintile (AOR 1.37; CI 95% 1.21–1.54), residing in a rural area (AOR 1.28; CI 95% 1.13–1.44), and having no toilet at home (AOR 1.21; CI 95% 1.06–1.40). If the trend of neonatal mortality rate of 2016 continues, it is projected that the poorest family will reach the ENAP target in 2067. Conclusions Although neonatal mortality is declining in Nepal, if the current trend continues it will take another 50 years for families in the poorest group to attain the 2030 ENAP target. There are different factors associated with neonatal mortality, reducing the disparities for maternal and neonatal care will reduce mortality among the poorest families.


2019 ◽  
Vol 66 (3) ◽  
pp. 315-321
Author(s):  
M Innerdal ◽  
I Simaga ◽  
H Diall ◽  
M Eielsen ◽  
S Niermeyer ◽  
...  

Abstract Background Mali has a high neonatal mortality rate of 38/1000 live births; in addition the fresh stillbirth rate (FSR) is 23/1000 births and of these one-third are caused by intrapartum events. Objectives The aims are to evaluate the effect of helping babies breathe (HBB) on mortality rate at a district hospital in Kati district, Mali. Methods HBB first edition was implemented in April 2016. One year later the birth attendants were trained in HBB second edition and started frequent repetition training. This is a before and after study comparing the perinatal mortality during the period before HBB training with the period after HBB training, the period after HBB first edition and the period after HBB second edition. Perinatal mortality is defined as FSR plus neonatal deaths in the first 24 h of life. Results There was a significant reduction in perinatal mortality rate (PMR) between the period before and after HBB training, from 21.7/1000 births to 6.0/1000 live births; RR 0.27, (95% CI 0.19–0.41; p &lt; 0.0001). Very early neonatal mortality rate (24 h) decreased significantly from 6.3/1000 to 0.8/1000 live births; RR 0.12 (95% CI 0.05–0.33; p = 0.0006). FSR decreased from 15.7/1000 to 5.3/1000, RR 0.33 (95% CI 0.22–0.52; p &lt; 0.0001). No further reduction occurred after introducing the HBB second edition. Conclusion HBB may be effective in a local first-level referral hospital in Mali.


2020 ◽  
Author(s):  
Ruth Guinsburg ◽  
Adriana Sanudo ◽  
Carlos Roberto V Kiffer ◽  
Ana Silvia S Marinonio ◽  
Daniela T Costa-Nobre ◽  
...  

Abstract Background: Populational studies analyzing neonatal deaths in middle-income countries may contribute to design interventions to achieve the Sustainable Development Goals, established by United Nations. This study goal is to analyze the annual trend of neonatal mortality in São Paulo State, Brazil, over a 10-year period and its underlying causes and to identify maternal and neonatal characteristics at birth associated with neonatal mortality.Method: Populational study of births and deaths from 0-27 days between 2004-2013 in São Paulo State, Brazil. The annual trend of neonatal mortality rate according to gestational age was analyzed by Poisson or by Negative Binomial Regression models. Basic causes of neonatal death were classified according to ICD-10. Association of maternal demographic variables (block 1), prenatal and delivery care variables (block 2), and neonatal characteristics at birth (block 3) with neonatal mortality was evaluated by Poisson regression analysis adjusted by year of birth. Results: Among 6,056,883 live births in São Paulo State during the study period, 48,309 died from 0-27 days (neonatal mortality rate: 8.0/1,000 live births). For the whole group and for infants with gestational age 22-27, 28-31, 32-36, 37-41 and ≥42 weeks, reduction of neonatal mortality rate was, respectively, 18%, 15%, 38%, 53%, 31%, and 58%. Median time until 50% of deaths occurred was 3 days. Main basic causes of death were respiratory disorders (25%), malformations (20%), infections (17%), and perinatal asphyxia (7%). Variables independently associated with neonatal deaths were maternal schooling, prenatal care, parity, newborn sex, 1st minute Apgar, and malformations. Cesarean delivery, compared to vaginal, was protective against neonatal mortality for infants at 22-31 weeks, but it was a risk factor for those with 32-41 weeks.Conclusion: Despite the significant decrease in neonatal mortality rate over the 10-year period in São Paulo State, improved access to qualified health care is needed in order to avoid preventable neonatal deaths and increase survival of infants that need more complex levels of assistance.


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