@article{ref1,
title="The Butajira project in Ethiopia: a nested case-referent study of under-five mortality and its public health determinants",
journal="Bulletin of The World Health Organization",
year="1993",
author="Shamebo, D. and Sandström, A. and Muhe, L. and Freij, L. and Krantz, I. and Lönnberg, G. and Wall, S.",
volume="71",
number="3-4",
pages="389-396",
abstract="In Butajira district, Ethiopia (130 km south of Addis Ababa), 2 trained field workers went to each household of 306 5 children who died between October 1988 and September 1989 and of 612 age, sex, and study area matched referents to interview caretakers as part of a study analyzing determinants of 5 mortality, especially parental and environmental determinants. Leading causes of infant and child deaths were acute respiratory infections (ARI) (33 and 20%, respectively) and diarrheal disease (23 and 32%, respectively). The multivariate analysis showed that Silti ethnicity of the mother (odds ration = 1.74), paternal illiteracy (OR = 1.45), and nonmembership in people's organizations (OR = 1.95) were parental risk factors. All children with all 3 parental factors were at a 4.6 times higher risk of 5 mortality than those with no parental risk factors. Infants with 3 parental risk factors were at a considerably greater mortality risk than were 1-4 year old children with 3 parental risk factors (OR, 10.7 vs. 2.5). Children with 3 parental risk factors living in the highlands faced a higher risk of death than those in the lowlands (15.5 vs. 2.8). 3 parental risk factors carried a higher risk of mortality pursuant to ARI than to diarrhea (14.8 vs. 2.4). The only environmental risk factor was no window in the house (OR = 1.54). Absence of windows was especially risky for infants (OR = 2.7) and for children with ARI (OR = 1.8 vs. 1.3 with diarrhea). Lack of windows was linked to crowding and poor housing. Public health interventions to eliminate parental or environmental factors would result in 55% or 31% fewer deaths, respectively. These findings suggest that parental factors have a greater impact on 5 mortality than environmental factors and that both parental and environmental factors and that both parental and environmental factors have a greater impact on infant than on child mortality.<p /><p>Language: en</p>",
language="en",
issn="0042-9686",
doi="",
url="http://dx.doi.org/"
}