Guidance for Systematic Integration of Undernutrition in Attributing Cause of Death in Children

• Type of Material: Article
• Authors: Chrsitina R Paganelli, RTI International; Nicholas Kassebaum, University of Washington; Kathleen Strong, World Health Organization; Parminder Suchdev, Emory University; Wieger Voskuijl, University of Amsterdam; Quique Bassat, Hospital Clínic–Universitat de Barcelona; Dianna M Blau, Ctr Dis Control & Prevent; Donna M Denno, University of Washington
• Language: English
• Date: 2021-12-15
• Publisher: OXFORD UNIV PRESS INC
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1093/cid/ciab851
• Title of Journal or Parent Work: CLINICAL INFECTIOUS DISEASES
• Volume: 73
• Issue: SUPPL 5
• Start Page: S374
• End Page: S381
• Grant/Funding Information: This work was supported by the MITS Surveillance Alliance and in whole or in part, by the Bill & Melinda Gates Foundation [OPP1180554]. Under the grant conditions of the Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the author accepted manuscript version that might arise from this submission.
• Keywords: minimally invasive tissue sampling; child mortality surveillance; LIVER; Undernutrition; severe wasting; cause of death; MORTALITY; MALNUTRITION; FOR-GESTATIONAL-AGE; LOW-INCOME; Infectious Diseases; INFANTS; Life Sciences & Biomedicine; GROWTH; Immunology; DIAGNOSIS; Microbiology; Science & Technology
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Minimally invasive tissue sampling (MITS) is increasingly being used to better understand causes of death in low-resource settings. Undernutrition (eg, wasting, stunting) is prevalent among children globally and yet not consistently coded or uniformly included on death certificates in MITS studies when present. Consistent and accurate attribution of undernutrition is fundamental to understanding its contribution to child deaths. In May 2020, members of the MITS Alliance Cause of Death Technical Working Group convened a panel of experts in public health, child health, nutrition, infectious diseases, and MITS to develop guidance for systematic integration of undernutrition, as assessed by anthropometry, in cause of death coding, including as part of the causal chain or as a contributing condition, in children <5 years of age. The guidance presented here will support MITS and other researchers, public health practitioners, and clinicians with a systematic approach to assigning and interpreting undernutrition in death certification.