Robert Black

BackgroundInformation on the causes of deaths from diarrhoea in children younger than 5 years is needed to design improved preventive and therapeutic approaches. We aimed to conduct a systematic analysis of studies to report estimates of the causes of deaths from diarrhoea in children younger than 5 years at global and regional levels during 2000–21.MethodsFor this systematic review and Bayesian multinomial analysis, we included 12 pathogens with the highest attributable incidence in the Global Enteric Multicenter Study. We searched PubMed, Scopus, Embase, Web of Science, Global Health Index Medicus, Global Health OVID, IndMed, Health Information Platform for the Americas (PLISA), Africa-Wide Information, and Cochrane Collaboration for articles published between Jan 1, 2000, and Dec 31, 2020, using the search terms "child", "hospital", "diarrhea", "diarrhoea", "dysentery", "rotavirus", " …

Objective To describe the mortality risks by fine strata of gestational age and birthweight among 230 679 live births in nine low‐ and middle‐income countries (LMICs) from 2000 to 2017. Design Descriptive multi‐country secondary data analysis. Setting Nine LMICs in sub‐Saharan Africa, Southern and Eastern Asia, and Latin America. Population Liveborn infants from 15 population‐based cohorts. Methods Subnational, population‐based studies with high‐quality birth outcome data were invited to join the Vulnerable Newborn Measurement Collaboration. All studies included birthweight, gestational age measured by ultrasound or last menstrual period, infant sex and neonatal survival. We defined adequate birthweight as 2500–3999 g (reference category), macrosomia as ≥4000 g, moderate low as 1500–2499 g and very low birthweight as <1500 g. We analysed fine strata classifications of preterm, term …

Almost 6· 5 million children and adolescents younger than 20 years died globally in 2021, the vast majority from preventable causes. 1 Reliable and timely data on causes of death are needed to better focus the attention of the global community on improving the survival of children and adolescents and to guide effective policy and programmes. But no less importantly, these data must be publicly available and easily accessible. We introduce an open data portal with yearly estimates on causes of death for children and adolescents younger than 20 years for the period 2000–21. The data hosted in this portal are part of a joint effort between the Child and Adolescent Causes of Death Estimation (CA CODE) project and the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). The portal is managed by UNICEF and was first launched in 2008 by UN IGME, reporting global, regional, and national …

The pathway to a thriving newborn begins before conception and continues in utero with a healthy placenta and the right balance of nutrients and growth factors that are timed and sequenced alongside hormonal suppression of labour until a mature infant is ready for birth. Optimal nutrition that includes adequate quantities of quality protein, energy, essential fats, and an extensive range of vitamins and minerals not only supports fetal growth but could also prevent preterm birth by supporting the immune system and alleviating oxidative stress. Infection, illness, undernourishment, and harmful environmental exposures can alter this trajectory leading to an infant who is too small due to either poor growth during pregnancy or preterm birth. Systemic inflammation suppresses fetal growth by interfering with growth hormone and its regulation of insulin-like growth factors. Evidence supports the prevention and treatment of …

Meta‐analyses consistently have found that antenatal multiple micronutrient supplementation (MMS) compared with iron and folic acid (IFA) alone reduce adverse birth outcomes. In 2020, the World Health Organization (WHO) placed a conditional recommendation for MMS and requested additional trials using ultrasounds to establish gestational age, because the evidence on low birthweight (LBW), preterm birth and small for gestational age (SGA) was considered inconsistent. We conducted meta‐analyses to determine if the effects of MMS on LBW, preterm birth and SGA differed by gestational age assessment method. Using data from the 16 trials in the WHO analyses, we calculated the effect estimates of MMS versus IFA on birth outcomes (generic inverse variance method and random effects model) stratified by method of gestational age assessment: ultrasound, prospective collection of the date of last …

Context The timing of introducing complementary feeding (CF) is crucial because premature or delayed CF can be associated with adverse health outcomes in childhood and adulthood. Objective This systematic review aims to evaluate the impact of the timing of CF introduction on health, nutrition, and developmental outcomes among normal-term infants. Data Sources Electronic databases and trial registries were searched, along with the reference lists of the included studies and relevant systematic reviews. Data Extraction Two investigators independently extracted data from the included studies on a standardized data-extraction form. Data Analysis Data were meta-analyzed separately for randomized controlled trials (RCTs) and observational studies on the basis of early introduction of CF (< 3 months, < 4 …

Children with weight‐for‐age z‐score (WAZ) <−3 have a high risk of death, yet this indicator is not widely used in nutrition treatment programming. This pooled secondary data analysis of children aged 6–59 months aimed to examine the prevalence, treatment outcomes, and growth trajectories of children with WAZ <−3 versus children with WAZ ≥−3 receiving outpatient treatment for wasting and/or nutritional oedema, to inform future protocols. Binary treatment outcomes between WAZ <−3 and WAZ ≥−3 admissions were compared using logistic regression. Recovery was defined as attaining mid‐upper‐arm circumference ≥12.5 cm and weight‐for‐height z‐score ≥−2, without oedema, within a period of 17 weeks of admission. Data from 24,829 children from 9 countries drawn from 13 datasets were included. 55% of wasted children had WAZ <−3. Children admitted with WAZ <−3 compared to those with …

Sub-Saharan Africa lacks timely, reliable, and accurate national data on mortality and causes of death (CODs). In 2018 Mozambique launched a sample registration system (Countrywide Mortality Surveillance for Action [COMSA]-Mozambique), which collects continuous birth, death, and COD data from 700 randomly selected clusters, a nationally representative population of 828,663 persons. Verbal and social autopsy interviews are conducted for COD determination. We analyzed data collected in 2019–2020 to report mortality rates and cause-specific fractions. Cause-specific results were generated using computer-coded verbal autopsy (CCVA) algorithms for deaths among those age 5 years and older. For under-five deaths, the accuracy of CCVA results was increased through calibration with data from minimally invasive tissue sampling. Neonatal and under-five mortality rates were, respectively, 23 (95% CI: 18 …