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  • 1.
    Cutts, F T
    et al.
    London School of Hygiene and Tropical Medicine Keppel St.
    Dos Santos, C
    Ministry of Health Mozambique.
    Novoa, A
    Eduardo Mondlane Faculty of Medicine Mozambique.
    David, P
    London School of Hygiene and Tropical Medicine Keppel St.
    Macassa, Gloria
    Eduardo Mondlane Faculty of Medicine Mozambique.
    Soares, A C
    Eduardo Mondlane Faculty of Medicine Mozambique.
    Child and Maternal Mortality during a Period of Conflict in Beira City, Mozambique1996Inngår i: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 25, nr 2, s. 349-356Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Child mortality rates have been declining in most developing countries. We studied child and maternal mortality and risk factors for child mortality in Beira city in July 1993, after a decade of conflict in Mozambique.       

    Methods A community-based cluster sample survey of 4609 women of childbearing age was conducted. Indirect techniques were used to estimate child mortality (‘children ever born’ method and Preceding Birth Techniques [PBT]), and maternal mortality sisterhood method). Deaths among the most recent born child, born since July 1990, were classified as cases (n = 106), and two controls, matched by age and cluster, were selected per case.                 

    Results Indirect estimates of the probability of dying from birth to age 5 (deaths before age 5 years, 5q0 per 1000) decreased from 246 in 1977/8 to 212 in 1988/9. The PBT estimate for 1990/91 was 154 (95% confidence interval(CI): 124–184), but recent deaths may have been underreported. Lack of beds in the household (odds ratio[OR] = 2.0, 95% CI: 1.1–3.8), absence of the father (OR = 2.4, 95% CI: 1.2–4.8), low paternal educational level (OR = 2.1, 95% CI: 0.8–5.4), young maternal age (OR = 2.0, 95% CI: 1.0–3.7), self-reported maternal illness (OR = 2.4, 95% CI: 1.2–4.9), and home delivery of the child (OR = 2.3, 95% CI: 1.2–4.5) were associated with increased mortality, but the sensitivity of risk factors was low. Estimated maternal mortality was 410/100 000 live births with a reference date of 1982.                 

    Conclusions Child mortality decreased slowly over the 1980s in Beira despite poor living conditions caused by the indirect effects of the war. Coverage of health services increased over this period. The appropriateness of a risk approach to maternal-child-health care needs further evaluation.

  • 2. Hassler, Sven
    et al.
    Johansson, Robert
    Sjölander, Per
    Högskolan i Gävle, Belastningsskadecentrum.
    Grönberg, Henrik
    Damber, Lena
    Causes of death in the Sami population of Sweden, 1961-2000.2005Inngår i: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 34, nr 3, s. 623-629Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Indigenous people often have a pattern of mortality that is disadvantageous in comparison with the general population. The knowledge on causes of death among the Sami, the natives of northern Scandinavia, is limited. The aim of the present study was to compare gender and cause specific mortality patterns for reindeer herding Sami, non-herding Sami, and non-Sami between 1961 and 2000. METHODS: A Sami cohort was constructed departing from a group of index-Sami identified as either reindeer herding Sami or Sami eligible to vote for the Sami parliament. Relatives of index-Sami were identified in the National Kinship Register and added to the cohort. The cohort contained a total of 41 721 people (7482 reindeer herding Sami and 34 239 non-herding Sami). A demographically matched non-Sami reference population four times as large, was compiled in the same way. Relative mortality risks were analysed by calculating standardized mortality ratios (SMRs). RESULTS: The differences in overall mortality and life expectancy of the Sami, both reindeer herding and non-herding, compared with the reference population were relatively small. However, Sami men showed significantly lower SMR for cancers but higher for external causes of injury. For Sami women, significantly higher SMR was found for diseases of the circulatory system and diseases of the respiratory system. An increased risk of dying from subarachnoid haemorrhage was observed among both Sami men and women. CONCLUSIONS: The similarities in mortality patterns are probably a result of centuries of close interaction between the Sami and the non-Sami, while the observed differences might be due to lifestyle, psychosocial and/or genetic factors.

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