Table 1.
Causes of deaths among neonates (aged 0–28 days), children (1–59 months), and maternal causes (15–49 years) in Sierra Leone, 2018–20
| Study deaths (male/female) | National annual deaths* | Percentage of national totals† | Risk of death, % | Annual mortality rate, per 1000 livebirths‡ | Lifetime death risk, % | Maternal mortality ratio, per 100 000 livebirths‡ | |||
|---|---|---|---|---|---|---|---|---|---|
| Stillbirths | 154 (75/79) | 4104 | 34% | NA | 15·6 (15·1–16·1) | .. | .. | ||
| Neonatal deaths | .. | .. | .. | .. | .. | .. | .. | ||
| Birth asphyxia and birth trauma | 129 (77/52) | 2550 | 32% | 1·0% | 9·9 (9·5–10·3) | .. | .. | ||
| Sepsis and other infections | 118 (65/53) | 2418 | 30% | 0·9% | 9·4 (9·0–9·8) | .. | .. | ||
| Prematurity and low birthweight | 89 (42/47) | 1596 | 20% | 0·6% | 6·2 (5·9–6·5) | .. | .. | ||
| Other non-communicable causes§ | 27 (17/10) | 531 | 7% | 0·2% | 2·1 (1·9–2·2) | .. | .. | ||
| Pneumonia | 16 (7/9) | 267 | 3% | 0·1% | 1·0 (0·9–1·2) | .. | .. | ||
| Ill-defined or cause unknown | 36 (21/15) | 656 | 8% | 0·3% | 2·5 (2·4–2·7) | .. | .. | ||
| All neonatal deaths | 415 (229/186) | 8018 | 100% | 3·1% | 31·1 (30·4–31·8) | .. | .. | ||
| Deaths at 1–59 months | .. | .. | .. | .. | .. | .. | .. | ||
| Malaria | 855 (429/426) | 7417 | 38% | 2·9% | 28·7 (28·1–29·4) | .. | .. | ||
| Other infectious and parasitic causes¶ | 625 (309/316) | 5545 | 28% | 2·1% | 21·5 (20·9–22·1) | .. | .. | ||
| Pneumonia | 209 (101/108) | 1481 | 7% | 0·6% | 5·7 (5·5–6·0) | .. | .. | ||
| Diarrhoea | 182 (93/89) | 1606 | 8% | 0·6% | 6·2 (5·9–6·5) | .. | .. | ||
| Other non-communicable causes | 84 (36/48) | 697 | 4% | 0·3% | 2·7 (2·5–2·9) | .. | .. | ||
| Injuries | 82 (45/37) | 697 | 4% | 0·3% | 2·7 (2·5–2·9) | .. | .. | ||
| Meningitis or encephalitis | 55 (30/25) | 319 | 2% | 0·1% | 1·2 (1·1–1·4) | .. | .. | ||
| Measles | 31 (16/15) | 243 | 1% | 0·1% | 0·9 (0·8–1·1) | .. | .. | ||
| Acute bacterial sepsis and severe infections | 18 (9/9) | 145 | 1% | 0·1% | 0·6 (0·5–0·7) | .. | .. | ||
| HIV or AIDS | 18 (10/8) | 168 | 1% | 0·1% | 0·7 (0·6–0·8) | .. | .. | ||
| Nutritional diseases | 14 (7/7) | 108 | 1% | 0·0% | 0·4 (0·3–0·5) | .. | .. | ||
| Congenital anomalies | 10 (3/7) | 69 | <1% | 0·0% | 0·3 (0·2–0·3) | .. | .. | ||
| Sickle-cell disorders | 9 (7/2) | 82 | <1% | 0·0% | 0·3 (0·3–0·4) | .. | .. | ||
| Fever of unknown origin | 46 (22/24) | 427 | 2% | 0·2% | 1·7 (1·5–1·8) | .. | .. | ||
| Ill-defined or cause unknown | 84 (43/41) | 699 | 3% | 0·3% | 2·7 (2·5–2·9) | .. | .. | ||
| All 1–59 months deaths | 2322 (1160/1162) | 19 704 | 100% | 7·6% | 76·3 (75·3–77·4) | .. | .. | ||
| Maternal deaths | .. | .. | .. | .. | .. | .. | .. | ||
| Direct causes | 112 | 1046 | 78% | .. | .. | 2·7% | 405 (381–430) | ||
| All haemorrhage | 36 | 336 | 25% | .. | .. | 0·9% | 130 (117–145) | ||
| Infection and sepsis | 22 | 205 | 15% | .. | .. | 0·5% | 80 (70–92) | ||
| Hypertensive disorders | 15 | 140 | 9% | .. | .. | 0·4% | 54 (46–64) | ||
| Abortion | 13 | 121 | 7% | .. | .. | 0.3% | 47 (39–56) | ||
| Other specified causes | 10 | 93 | 7% | .. | .. | 0·2% | 36 (29–44) | ||
| Ill-defined | 16 | 149 | 14% | .. | .. | 0·4% | 58 (49–68) | ||
| Indirect causes | 29 | 271 | 22% | .. | .. | 0·7% | 105 (93–118) | ||
| All maternal deaths | 141 | 1317 | 100% | .. | .. | 3·4% | 510 (483–538) | ||
Data are n, %, or rate (95% CI). NA=not applicable.
The national total for stillbirths was calculated as the proportion of stillbirths (from this study) out of total deaths in the perinatal period in 2019 applied to the 2020 population; national total for maternal deaths was estimated using the UN 2020 average for deaths among women aged 15–49 years.
Percentages are weighted for district and for urban or rural residence; for stillbirths the percentage is of the 12 122 combined total of neonatal and stillbirth deaths nationally; for maternal deaths, the percentage is of all maternal deaths of women aged 15–49 years.
Livebirths for 2020 were estimated by use of the 10-year average (2015–25) from the UN World Population Prospects (2019); stillbirth rate per 1000 includes livebirths and stillbirths in the denominator.
Other non-communicable causes include congenital anomalies (28%), neonatal jaundice (20%), and feeding problems (20%).
Other infectious and parasitic causes were mostly other and unspecified infectious diseases (93%).