Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries: the Every Newborn-INDEPTH study.,The Lancet Global Health

当前位置： X-MOL 学术 › Lancet Global Health › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries: the Every Newborn-INDEPTH study.
The Lancet Global Health ( IF 19.9 ) Pub Date : 2020-03-18 , DOI: 10.1016/s2214-109x(20)30044-9
Joseph Akuze ₁ , Hannah Blencowe ₂ , Peter Waiswa ₃ , Angela Baschieri ₂ , Vladimir S Gordeev ₄ , Doris Kwesiga ₅ , Ane B Fisker ₆ , Sanne M Thysen ₇ , Amabelia Rodrigues ₈ , Gashaw A Biks ₉ , Solomon M Abebe ₉ , Kassahun A Gelaye ₉ , Mezgebu Y Mengistu ₉ , Bisrat M Geremew ₉ , Tadesse G Delele ₉ , Adane K Tesega ₉ , Temesgen A Yitayew ₉ , Simon Kasasa ₁₀ , Edward Galiwango ₁₁ , Davis Natukwatsa ₁₁ , Dan Kajungu ₁₁ , Yeetey Ak Enuameh ₁₂ , Obed E Nettey ₁₃ , Francis Dzabeng ₁₃ , Seeba Amenga-Etego ₁₃ , Sam K Newton ₁₂ , Charlotte Tawiah ₁₃ , Kwaku P Asante ₁₃ , Seth Owusu-Agyei ₁₄ , Nurul Alam ₁₅ , Moinuddin M Haider ₁₅ , Ali Imam ₁₅ , Kaiser Mahmud ₁₅ , Simon Cousens ₂ , Joy E Lawn ₂ ,

Affiliation

Maternal, Adolescent, Reproductive, and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK; Center of Excellence for Maternal Newborn and Child Health Research, School of Public Health, Makerere University, Kampala, Uganda.
Maternal, Adolescent, Reproductive, and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK.
Center of Excellence for Maternal Newborn and Child Health Research, School of Public Health, Makerere University, Kampala, Uganda; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Maternal, Adolescent, Reproductive, and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK; The Institute of Population Health Sciences, Queen Mary University of London, London, UK.
Center of Excellence for Maternal Newborn and Child Health Research, School of Public Health, Makerere University, Kampala, Uganda.
Bandim Health Project, Bissau, Guinea-Bissau; Research Center for Vitamins and Vaccines, Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark; Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Bandim Health Project, Bissau, Guinea-Bissau; Research Center for Vitamins and Vaccines, Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark; Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark.
Bandim Health Project, Bissau, Guinea-Bissau.
Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Center of Excellence for Maternal Newborn and Child Health Research, School of Public Health, Makerere University, Kampala, Uganda; IgangaMayuge Health and Demographic Surveillance System, Iganga, Uganda.
IgangaMayuge Health and Demographic Surveillance System, Iganga, Uganda.
Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana; Kintampo Health Research Centre, Kintampo, Ghana.
Kintampo Health Research Centre, Kintampo, Ghana.
Malaria Centre, London School of Hygiene & Tropical Medicine, London, UK; Kintampo Health Research Centre, Kintampo, Ghana; University of Health and Allied Sciences, Kintampo Health Research Centre, Kintampo, Ghana.
Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh.

Background

An estimated 5·1 million stillbirths and neonatal deaths occur annually. Household surveys, most notably the Demographic and Health Survey (DHS), run in more than 90 countries and are the main data source from the highest burden regions, but data-quality concerns remain. We aimed to compare two questionnaires: a full birth history module with additional questions on pregnancy losses (FBH+; the current DHS standard) and a full pregnancy history module (FPH), which collects information on all livebirths, stillbirths, miscarriages, and neonatal deaths.

Methods

Women residing in five Health and Demographic Surveillance System sites within the INDEPTH Network (Bandim in Guinea-Bissau, Dabat in Ethiopia, IgangaMayuge in Uganda, Matlab in Bangladesh, and Kintampo in Ghana) were randomly assigned (individually) to be interviewed using either FBH+ or FPH between July 28, 2017, and Aug 13, 2018. The primary outcomes were stillbirths and neonatal deaths in the 5 years before the survey interview (measured by stillbirth rate [SBR] and neonatal mortality rate [NMR]) and mean time taken to complete the maternity history section of the questionnaire. We also assessed between-site heterogeneity. This study is registered with the Research Registry, 4720.

Findings

69 176 women were allocated to be interviewed by either FBH+ (n=34 805) or FPH (n=34 371). The mean time taken to complete FPH (10·5 min) was longer than for FBH+ (9·1 min; p<0·0001). Using FPH, the estimated SBR was 17·4 per 1000 total births, 21% (95% CI −10 to 62) higher than with FBH+ (15·2 per 1000 total births; p=0·20) in the 5 years preceding the survey interview. There was strong evidence of between-site heterogeneity (I²=80·9%; p<0·0001), with SBR higher for FPH than for FBH+ in four of five sites. The estimated NMR did not differ between modules (FPH 25·1 per 1000 livebirths vs FBH+ 25·4 per 1000 livebirths), with no evidence of between-site heterogeneity (I²=0·7%; p=0·40).

Interpretation

FPH takes an average of 1·4 min longer to complete than does FBH+, but has the potential to increase reporting of stillbirths in high burden contexts. The between-site heterogeneity we found might reflect variations in interviewer training and survey implementation, emphasising the importance of interviewer skills, training, and consistent implementation in data quality.

Funding

Children's Investment Fund Foundation.

中文翻译：

在五个国家中，用于测量死产和新生儿死亡的两个家庭调查模块的随机比较：每个新生儿-独立研究。

背景

估计每年发生5·100万死产和新生儿死亡。住户调查，尤其是人口与健康调查（DHS），在90多个国家/地区进行，是负担最重地区的主要数据来源，但仍然存在数据质量问题。我们旨在比较两份问卷：一个完整的生育史模块，其中包含关于妊娠损失的其他问题（FBH +；当前的DHS标准）和一个完整的妊娠史模块（FPH），该模块收集有关所有活产，死产，流产和新生儿死亡的信息。

方法

居住在INDEPTH网络（几内亚比绍的Bandim，埃塞俄比亚的Dabat，乌干达的IgangaMayuge，孟加拉国的Matlab和加纳的Kintampo）的五个卫生与人口普查系统站点中的妇女被随机分配（分别）使用FBH +进行访谈或FPH（在2017年7月28日至2018年8月13日之间）。主要结局是调查访谈前5年的死产和新生儿死亡（通过死产率[SBR]和新生儿死亡率[NMR]衡量）和平均花费的时间完成问卷的生育史部分。我们还评估了站点间的异质性。该研究已在研究注册处注册，编号为4720。

发现

69 176名妇女被分配接受FBH +（n = 34 805）或FPH（n = 34 371）的采访。完成FPH（10·5分钟）所需的平均时间比FBH +（9·1分钟； p <0·0001）长。使用FPH，估计的SBR为每1000例总出生的17·4，比前5年的FBH +（每1000例总出生的15·2； p = 0·20）高21％（95％CI -10至62）。调查访谈。有很强的证据表明位点之间存在异质性（I ² = 80·9％； p <0·0001），在五个位点中的四个位点，FPH的SBR高于FBH +。各个模块之间的NMR估算值没有差异（FPH 25·1/1000例生与FBH + 25·4/1000例生），没有站点间异质性的证据（I ² = 0·7％； p = 0·40）。