title: Causes of pediatric mortality and case-fatality rates in eight Médecins Sans Frontières-supported hospitals in Africa.
abstract: METHODS
  Eight pediatric hospital in-patient wards in remote, rural and/or insecure areas in Africa.
  
  
  OBJECTIVE
  To describe, in children aged <5 years, 1) overall and individual mortality rates, 2) the 10 most common causes of mortality, and 3) their case-fatality rates.
  
  
  METHODS
  Retrospective analysis of routinely collected standardized program data for 2010.
  
  
  RESULTS
  During 2010, 21 357 children aged <5 years were admitted and 1520 died, resulting in an overall in-patient mortality rate among under-fives of 7%. This remained the same after considering the three most common causes of mortality per hospital. One hospital with a neonatal unit showed a mortality rate of 14%. Of the 10 most common causes of mortality in the eight hospitals, severe malaria, acute lower respiratory tract infection and neonatal infection counted for about 77% of total deaths. Ranking the 10 most common causes of mortality according to case-fatality rates, septicemia, meningitis, low birth weight with pathology, neonatal infection and neonatal asphyxia were the most common (case-fatality rates 15-40%).
  
  
  CONCLUSIONS
  Despite widely different contexts, mortality rates for pediatric in-patients were consistently under 10%. To further reduce mortality, emphasis should be placed on treating sepsis and introducing implementable and/or adapted care packages for neonatal-related pathologies.
authors.affiliation: Médecins Sans Frontières, Medical Department (Operational Research), Operational Centre Brussels, Luxembourg.
authors.forename: W
authors.initials: W
authors.lastname: van den Boogaard
authors.affiliation: Médecins Sans Frontières, Medical Department (Operational Research), Operational Centre Brussels, Luxembourg.
authors.forename: M
authors.initials: M
authors.lastname: Manzi
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
authors.affiliation: Médecins Sans Frontières, Medical Department (Operational Research), Operational Centre Brussels, Luxembourg.
authors.forename: A J
authors.initials: AJ
authors.lastname: Reid
keywords: Africa; neonatal care; operational research; pediatric case-fatality rate; pediatric in-patient mortality