CHAMPS SITE
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Causes of Death Among Stillbirths and Children Aged <5 Years in Africa and South Asia — Child Health and Mortality Prevention Surveillance, Seven Countries, 2016–2024
Global NetworkCDC Morbidity and Mortality Weekly Report2026Cite ShareZachary J. Madewell, PhD1; Ziyaad Dangor, PhD2; Portia C. Mutevedzi, PhD3; Siobhan L. Johnstone, PhD2; Sanjay G. Lala, PhD4; Shabir A. Madhi, PhD2,5; Sithembiso Velaphi, PhD4; Nega Assefa, PhD6,7,8; Meron Kebede, MD7; Lola Madrid, PhD6,8; Dadi Marami, MSc6,7; J. Anthony G. Scott, MBBS8; George Aol, MCHD9; Kitiezo Aggrey Igunza9; Hellen Muttai, PhD10; Peter Nyamthimba Onyango, MA9; Peter O. Otieno, MA9; Quique Bassat, MD, PhD11,12,13,14,15,16,17; Marcelino Garrine, DVM, PhD12,18; Milton Kincardett, MD12; Inácio Mandomando, PhD11,12,18,19; Ariel Nhacolo, MSc12; Jane Juma, MCHD20; Adama Mamby Keita, MD20; Karen L. Kotloff, MD21; Samba O. Sow, MD20; Milagritos D. Tapia, MD21; Afsana Afrin, MPH22; Shams El Arifeen, DrPH22; Rajib Biswas, MBBS22; Emily S. Gurley, PhD23; Mohammad Zahid Hossain, PhD22; Soter Ameh, PhD24,25,26; Ima-Abasi Bassey, MBBCh24,27; Erick Kaluma, MPH24; Dickens Kowuor, MSc24; Ikechukwu Udo Ogbuanu, MD, PhD24,28; Julu Bhatnagar, PhD29; Dianna M. Blau, DVM, PhD1; Kevin R. Clarke, MD1; Maureen H. Diaz, PhD30; Michelle Dynes, PhD31; Jennifer Kasten, MD29; Roosecelis B. Martines, MD30; Lesley McGee, PhD30; Diane F. Morof, MD32; Elizabeth O’Mara Sage, PhD1; Pratima L. Raghunathan, PhD1; Jana Ritter, DVM29; Wun-Ju Shieh, MD, PhD29; Allan W. Taylor, MD1; Srinivasan Velusamy, PhD30; Jennifer R. Verani, MD30; Ashutosh Wadhwa, PhD33; Jessica L. Waller, MS30; Jonas Winchell, PhD30; Jacob S. Witherbee, MPH30; Mary-Claire Worrell, MPH34; Victor Akelo, MD35; Jeffrey P. Koplan, MD3; Robert F. Breiman, MD3,28; Cynthia G. Whitney, MD36
Problem/Condition: Sub-Saharan Africa and South Asia have the highest rates of stillbirths and rates of death among children aged <5 years, with many countries in those regions unlikely to meet the 2030 goal of ending preventable deaths among newborns and children aged <5 years. Conventional mortality surveillance (determining cause of death…
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Adherence to Perinatal Asphyxia or Sepsis Management Guidelines in Low- and Middle-Income Countries
Sierra leon, South Africa, Bangladesh,JAMA Network Open2025Cite ShareRahman A, Ray M, Madewell ZJ, et al. Adherence to Perinatal Asphyxia or Sepsis Management Guidelines in Low- and Middle-Income Countries. JAMA Netw Open. 2025;8(5):e2510790. doi:10.1001/jamanetworkopen.2025.10790
Importance: Most of the 2.3 million annual neonatal deaths occur in sub-Saharan Africa and South Asia, with perinatal asphyxia and neonatal sepsis being the leading causes of neonatal mortality. Most neonatal deaths are considered preventable through high-quality clinical care, which includes adherence to clinical care guidelines. Objective: To assess adherence…
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Use of minimally invasive tissue sampling to determine the contribution of diarrheal diseases to under-five mortality and associated co-morbidities and co-infections in children with fatal diarrheal diseases in Africa and Bangladesh
BangladeshPLOS Global Public Health2025Cite ShareMutevedzi PC, Madewell ZJ, Kotloff KL, Bassat Q, Chirinda PJ, et al. (2025) Use of minimally invasive tissue sampling to determine the contribution of diarrheal diseases to under-five mortality and associated co-morbidities and co-infections in children with fatal diarrheal diseases in Africa and Bangladesh. PLOS Global Public Health 5(6): e0004772. https://doi.org/10.1371/journal.pgph.0004772
Achieving the Sustainable Development Goal of reducing child mortality to <25 deaths per 1000 live births by 2030 requires strategies to prevent diarrheal disease-related morbidity and mortality. Accurate etiological diagnosis is essential. This study used postmortem diagnostics to investigate the contribution of diarrhea to under-5 mortality and examine co-morbidities and…
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Post-mortem study of endemic human coronaviruses (HCoV-NL63, OC43, 229E and HKU-1) in deaths of children under five in low- and middle-income countries: Findings from the Child Health and Mortality Prevention Surveillance (CHAMPS) study
Bangladesh, Ethiopia, Kenya, Mozambique, Nigeria, Pakistan, Sierra Leone, and South AfricaJournal of Clinical Virology2025Cite ShareBaillie, V., Dangor, Z., Blau, D. M., Mahtab, S., Du Toit, J., Assefa, N., Oundo, J., Kidanemariam, Z. T., Scott, J. A. G., Ameh, S., Ogbuanu, I. U., Ojulong, J., Bunn, J., Kotloff, K. L., Sow, S. O., Tapia, M. D., Keita, A. M., Garrine, M., Mandomando, I., . . . Madhi, S. A. (2025). Post-mortem study of endemic human coronaviruses (HCoV-NL63, OC43, 229E and HKU-1) in deaths of children under five in low- and middle-income countries: Findings from the Child Health and Mortality Prevention Surveillance (CHAMPS) study. Journal of Clinical Virology, 178, 105804. https://doi.org/10.1016/j.jcv.2025.105804
Background:Endemic human coronaviruses (HCoV-229E, HKU1, NL63, and OC43) are common causes of mild or asymptomatic respiratory infections in children but are considered rare causes of death.Methods:We evaluated pediatric deaths from January 2017 through December 2022. A panel of experts determined the cause of death (CoD) by reviewing available data, including…
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Adherence to Perinatal Asphyxia or Sepsis Management Guidelines in Low- and Middle-Income Countries
Multiple sitesJAMA Network Open2025Cite ShareRahman, A., Ray, M., Madewell, Z. J., Igunza, K. A., Akelo, V., Onyango, D., Murila, F., Mwebia, W., Ogbuanu, I. U., Ojulong, J., Kowuor, D., Kaluma, E., Samura, S., El Arifeen, S., Gurley, E. S., Hossain, M. Z., Islam, K. M., Biswas, R., Assefa, N., . . . Rees, C. A. (2025). Adherence to perinatal asphyxia or sepsis management guidelines in low- and middle-income countries. JAMA Network Open, 8(5), e2510790. https://doi.org/10.1001/jamanetworkopen.2025.10790
Key Points Question Do neonates who die of perinatal asphyxia or sepsis in low- and middle-income countries receive guideline-adherent clinical care? Findings In this cross-sectional study of 1194 neonates who died, less than 5% of those who died with perinatal asphyxia received all recommended clinical care, and 61% of those who died…