Publications by authors named "Cynthia G Whitney"

Introduction: Malnutrition contributes to 45% of all childhood deaths globally, but these modelled estimates lack direct measurements in countries with high malnutrition and under-5 mortality rates. We investigated malnutrition's role in infant and child deaths in the Child Health and Mortality Prevention Surveillance (CHAMPS) network.

Methods: We analysed CHAMPS data from seven sites (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone and South Africa) collected between 2016 and 2023.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the role of meningitis in child mortality under five years old, particularly focusing on data from six sub-Saharan African countries and Bangladesh.
  • It employs post-mortem minimally invasive tissue sampling (MITS) to identify the causes of death and pathogens responsible for meningitis in this age group from December 2016 to December 2023.
  • Findings reveal that meningitis contributed to 7% of child deaths, with common pathogens identified being Acinetobacter baumannii and Klebsiella pneumoniae, particularly affecting neonates and infants.
View Article and Find Full Text PDF

Importance: The emergence of acute neurological symptoms in children necessitates immediate intervention. Although low- and middle-income countries (LMICs) bear the highest burden of neurological diseases, there is a scarcity of diagnostic and therapeutic resources. Therefore, current understanding of the etiology of neurological emergencies in LMICs relies mainly on clinical diagnoses and verbal autopsies.

View Article and Find Full Text PDF

Background: In South Africa, 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2009 and 13-valent PCV (PCV13) was introduced in 2011, both in a two plus one schedule. We evaluated the ongoing effects of PCV on the prevention of invasive pneumococcal disease (IPD) over 15 years of sustained surveillance in South Africa before the COVID-19 pandemic.

Methods: We conducted national, active, laboratory-based surveillance for IPD among all ages in South Africa, including isolate serotyping and susceptibility testing.

View Article and Find Full Text PDF

Introduction: Determining aetiology of severe illness can be difficult, especially in settings with limited diagnostic resources, yet critical for providing life-saving care. Our objective was to describe the accuracy of antemortem clinical diagnoses in young children in high-mortality settings, compared with results of specific postmortem diagnoses obtained from Child Health and Mortality Prevention Surveillance (CHAMPS).

Methods: We analysed data collected during 2016-2022 from seven sites in Africa and South Asia.

View Article and Find Full Text PDF
Article Synopsis
  • * A study conducted between September 2018 and October 2022 in Tennessee and Georgia found that 12.1% of hospitalized adults with CAP had Streptococcus pneumoniae detected, with the most common serotypes being 3, 22F, 19A, and others.
  • * Findings suggest that a significant portion of detected serotypes, approximately one-third, are not covered by current vaccines like PCV15 and PCV20, indicating the need for new vaccines with broader serotype coverage to reduce disease occurrence.
View Article and Find Full Text PDF
Article Synopsis
  • Kenya introduced the 10-valent pneumococcal conjugate vaccine, Synflorix™, in 2011, and early surveys indicated a decline in vaccine-type pneumococcal colonization among children but there was limited information on its long-term effectiveness.
  • A 2017 cross-sectional survey in Kibera and Asembo involved 504 children under 5, showing a significant reduction in overall pneumococcal colonization compared to 2013, with over 90% of participants having received three doses of the vaccine.
  • Despite the decrease in overall colonization, the prevalence of PCV10-GSK serotypes remained relatively stable, indicating a plateau effect in vaccine-type carriage six years after the vaccine's
View Article and Find Full Text PDF
Article Synopsis
  • Researchers focused on children under 5 years old in low- and middle-income countries and analyzed the symptoms and healthcare encounters after hospital discharge to see how they correlated with mortality rates.
  • In the study, 4,243 children were monitored over 60 days, revealing that those with more symptoms had a much higher risk of dying, especially those having difficulty breathing.
  • Caregivers taking children home against medical advice or those requiring readmission to the hospital faced significantly higher mortality rates within 60 days post-discharge.
View Article and Find Full Text PDF

Objective: To derive and validate internally a novel risk assessment tool to identify young children at risk for all-cause mortality ≤60 days of discharge from hospitals in sub-Saharan Africa.

Study Design: We performed a prospective observational cohort study of children aged 1-59 months discharged from Muhimbili National Hospital in Dar es Salaam, Tanzania and John F. Kennedy Medical Center in Monrovia, Liberia (2019-2022).

View Article and Find Full Text PDF

Background: Viruses are the leading etiology of acute respiratory infections (ARI) in children. However, there is limited knowledge on drivers of severe acute respiratory infection (SARI) cases involving viruses. We aimed to identify factors associated with severity and prolonged hospitalization of viral SARI among children < 5 years in Burkina Faso.

View Article and Find Full Text PDF

Introduction: The immediate period after hospital discharge carries a large burden of childhood mortality in sub-Saharan Africa. Our objective was to derive and internally validate a risk assessment tool to identify neonates discharged from the neonatal ward at risk for 60-day post-discharge mortality.

Methods: We conducted a prospective observational cohort study of neonates discharged from Muhimbili National Hospital in Dar es Salaam, Tanzania, and John F Kennedy Medical Centre in Monrovia, Liberia.

View Article and Find Full Text PDF

Delays in illness recognition, healthcare seeking, and in the provision of appropriate clinical care are common in resource-limited settings. Our objective was to determine the frequency of delays in the "Three Delays-in-Healthcare", and factors associated with delays, among deceased infants and children in seven countries with high childhood mortality. We conducted a retrospective, descriptive study using data from verbal autopsies and medical records for infants and children aged 1-59 months who died between December 2016 and February 2022 in six sites in sub-Saharan Africa and one in South Asia (Bangladesh) and were enrolled in Child Health and Mortality Prevention Surveillance (CHAMPS).

View Article and Find Full Text PDF

Background: Malaria is a leading cause of childhood mortality worldwide. However, accurate estimates of malaria prevalence and causality among patients who die at the country level are lacking due to the limited specificity of diagnostic tools used to attribute etiologies. Accurate estimates are crucial for prioritizing interventions and resources aimed at reducing malaria-related mortality.

View Article and Find Full Text PDF
Article Synopsis
  • The CHAMPS Network investigates childhood deaths, focusing on pneumonia's role and the pathogens involved in cases from six sub-Saharan African countries and Bangladesh from December 2016 to December 2022.
  • Out of 1,120 deaths analyzed, pneumonia was identified as a contributing factor in 40.6%, with most victims being around 9 months old, and 82.9% of these cases had identifiable pathogens.
  • Among the pneumonia deaths, community-acquired pneumonia was responsible for 67.3%, with leading pathogens including Streptococcus pneumoniae and Klebsiella pneumoniae, while 32.7% were linked to hospital-acquired pneumonia.
View Article and Find Full Text PDF

Background: Klebsiella pneumoniae is an important cause of nosocomial and community-acquired pneumonia and sepsis in children, and antibiotic-resistant K pneumoniae is a growing public health threat. We aimed to characterise child mortality associated with this pathogen in seven high-mortality settings.

Methods: We analysed Child Health and Mortality Prevention Surveillance (CHAMPS) data on the causes of deaths in children younger than 5 years and stillbirths in sites located in seven countries across sub-Saharan Africa (Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa) and south Asia (Bangladesh) from Dec 9, 2016, to Dec 31, 2021.

View Article and Find Full Text PDF

Background: The COVID-19 pandemic was associated with widespread social disruptions, as governments implemented lockdowns to quell disease spread. To advance knowledge of consequences for households in resource-limited countries, we examine food insecurity during the pandemic period.

Methods: We conducted a cross-sectional study and used logistic regression to examine factors associated with food insecurity.

View Article and Find Full Text PDF

Objectives: To assess postmortem vitamin A (VA) concentrations in children under 5 years of age and evaluate the association between VA deficiency (VAD) and infectious causes of death (CoD).

Study Design: In this cross-sectional study from the Child Health and Mortality Prevention Surveillance (CHAMPS) Network, liver biopsies collected within 72 hours of death were analyzed from 405 stillbirths and children under 5 years in Kenya and South Africa. Total liver VA (TLVA) concentrations were quantified using ultra-performance liquid chromatography, and cutoffs of ≤0.

View Article and Find Full Text PDF
Article Synopsis
  • * The survey found that a vast majority of respondents were aware of COVID-19 symptoms, transmission, and prevention methods, with high recognition of handwashing (91.9%) and mask-wearing (91.8%) as key preventive measures.
  • * Factors influencing knowledge included education level, age, employment status, wealth, and religion, with information from media sources like television and WhatsApp playing a significant role in enhancing community awareness about the virus.
View Article and Find Full Text PDF

Background: COVID-19 resulted in enormous disruption to life around the world. To quell disease spread, governments implemented lockdowns that likely created hardships for households. To improve knowledge of consequences, we examine how the pandemic period was associated with household hardships and assess factors associated with these hardships.

View Article and Find Full Text PDF

Background: Most childhood deaths globally are considered preventable through high-quality clinical care, which includes adherence to clinical care recommendations. Our objective was to describe adherence to World Health Organization recommendations for the management of leading causes of death among children.

Methods: We conducted a retrospective, descriptive study examining clinical data for children aged 1-59 months who were hospitalized and died in a Child Health and Mortality Prevention Surveillance (CHAMPS) catchment, December 2016-June 2021.

View Article and Find Full Text PDF
Article Synopsis
  • Invasive Group B Streptococcus (GBS) is a major factor in early-onset neonatal sepsis and stillbirth, which this study evaluated in seven low- and middle-income countries to determine its impact on infant mortality.
  • The research included the analysis of 2,966 deaths from December 2016 to December 2021 using minimally invasive tissue sampling, identifying GBS as a contributing factor in 2.7% of infant deaths, including 2.3% of stillborn cases.
  • Results showed significant variation in GBS-attributed deaths across countries, particularly affecting low-birth-weight infants, highlighting the need for tailored interventions in different regions to address this issue.
View Article and Find Full Text PDF

Data were collected as part of the Child Health and Mortality Prevention Surveillance (CHAMPS) network to learn about the effects of COVID-19 lockdowns on child health and access to care. Data were collected between August and September 2021 through a Health and Demographic Surveillance System (HDSS) operating in Eastern Ethiopia using a survey instrument focused on knowledge about COVID-19 and changes in food availability and healthcare services during the COVID-19 related lockdown. The data are representative of two communities in Eastern Ethiopia, one rural (Kersa) and one urban (Harar), and consist of a random sample of 880 households.

View Article and Find Full Text PDF

Importance: The number of deaths of children younger than 5 years has been steadily decreasing worldwide, from more than 17 million annual deaths in the 1970s to an estimated 5.3 million in 2019 (with 2.8 million deaths occurring in those aged 1-59 months [53% of all deaths in children aged <5 years]).

View Article and Find Full Text PDF

Background: There are no validated clinical decision aids to identify neonates and young children at risk of hospital readmission or postdischarge mortality in sub-Saharan Africa, leaving the decision to discharge a child to a clinician's impression. Our objective was to determine the precision of clinician impression to identify neonates and young children at risk for readmission and postdischarge mortality.

Methods: We conducted a survey study nested in a prospective observational cohort of neonates and children aged 1-59 months followed 60 days after hospital discharge from Muhimbili National Hospital in Dar es Salaam, Tanzania or John F.

View Article and Find Full Text PDF