Child Development Clinical Trial
Official title:
A Longitudinal Birth Cohort Study in Coast Province, Kenya
In 2010, 7.6 million children under the age of five died worldwide and yet the causes of only 2.7% (0.205 million) of these deaths were medically certified. A thorough understanding of the causes of child mortality is necessary to guide research efforts aimed at tackling this important global health problem. Prospective birth cohort studies present an opportunity to examine the relationships between early-life exposures and multiple health and non-health related outcomes including death, illness, and socioeconomic factors. In this study, the investigators will provide insight into the underlying causes of child mortality by collecting data on early-life exposures and health and non-health related outcomes in the first year of life.
In 2010, 7.6 million children under the age of five died worldwide, mainly from preventable
and treatable conditions (Liu et al., 2012). Notably, the burden of under-five mortality
varies dramatically by country. The majority of child deaths are seen in Africa (3.6
million) and southeast Asia (2.1 million deaths), compared to 0.16 million and 0.28 million
under-five deaths in Europe and the Americas, respectively (Liu et al., 2012). In Kenya,
over 120,000 under-5 deaths were estimated in 2010 and approximately 35% of these deaths
occurred in the neonatal period.
A thorough understanding of the etiology of child mortality is necessary to guide research
efforts aimed at tackling this important global health problem. Importantly, in 2010, the
causes of only 2.7% (0.205 million) of all deaths in children under the age of five were
medically certified (Liu et al., 2012), highlighting the need to gather data on the causes
of mortality.
Prospective longitudinal birth cohort studies present an opportunity to examine temporal
relationships between early-life exposures (i.e. prenatal, pregnancy, and early postnatal
exposures) and multiple health and non-health related outcomes including mortality,
morbidity, and socioeconomic circumstances. It is well documented that exposures that occur
early in life, including genetic, environmental, socioeconomic, and lifestyle factors, may
have long-lasting effects on growth, development, and health outcomes throughout an
individual's entire life course (Lynch & Smith, 2005). Thus, data on exposures during
pregnancy and early childhood are valuable and may provide clues to the etiology of
long-term outcomes.
Additional value can be gained through cross-cohort collaborations and comparisons (Larsen
et al., 2013)(Paternoster et al., 2012)(Brion et al., 2011). Notably, by pooling data from
multiple cohort studies, causal inferences can be made with greater confidence. For example,
if a similar relationship is observed across multiple populations, each with their own
distinct set of confounding variables, it is less likely that the observed association is
being driven by confounders. Similarly, cross-cohort comparisons enable researchers to
investigate patterns associated with health, social, and economic outcomes in distinct
regions of the world. These types of analyses may provide valuable insight into the
underlying causes of global health inequalities.
The objective of this study is to implement a longitudinal prospective birth cohort study in
Kenya to obtain extensive information on early-life exposures and health and non-health
related outcomes in the first year of life.
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Observational Model: Cohort, Time Perspective: Prospective
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