Conference Abstract | Volume 8, Abstract 16 | Published: 16 Jul 2025
Ruth Muwema1,2,3,&, Martin Mwansa1,2,3, Danny Kabwe1,2,3, Cheepa Haabeenzu4, Lwito Mutale5, James Zulu1,2, Cephas Sialubanji2,3, Dabwitso Banda1,2, Nyambe Sinyange2
1Zambia Field Epidemiology Training Program, Lusaka, Zambia, 2Zambia National Public Health Institute, Lusaka, Levy Mwanawasa Medical University, Lusaka, 3Ministry of Health, University Teaching Hospital – Adult Infectious Disease Hospital, 4Copperbelt Provincial Health Office, Ndola
&Corresponding author: Ruth Muwema, Zambia Field Epidemiology Training Program, Lusaka, Zambia, Email: muwemar@gmail.com
Received: 03 Jun 2024, Accepted: 11 Aug 2024, Published: 16 Jul 2025
This is part of the Proceedings of the Zambia Field Epidemiology Training Program Alumni Conference, September 11 – 13, 2024
Keywords: Under-five, mortality, diarrhoea, Health data management, Public health interventions
©Ruth Muwema et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Ruth Muwema et al. Investigating mortalities among children under five in Livingstone District, Zambia: June to July 2023. Journal of Interventional Epidemiology and Public Health. 2025;8 (Conf Proc 4):16. https://doi.org/10.37432/JIEPH-CONFPRO4-00016
Ninety percent of deaths among children under five in low- and lower-middle-income nations are related to diarrhea, a global public health concern. An estimated 15,000 children under-five years in Zambia die from diarrhea each year, making it the third leading cause of death. A rise in under-five fatalities was reported in the Livingstone district during June through July, 2023; the study investigated the reported increased mortality among children under-five years and proposed recommendations.
A retrospective observational study design was employed. We gathered information from the line list, laboratory test results, patient files, and the electronic Integrated Disease Surveillance and Response(eIDSR) system. We included all under-five children who had a history of diarrhoea and were admitted to a health facility from June to July 2023. Descriptive statistical analyses, including frequencies, and median, were conducted to characterize the demographic and clinical profiles of the under-five fatalities. Temporal trends in diarrheal disease rates and Rotavirus vaccination coverage were assessed using graphical methods. Mortality trends could not be assessed due to incomplete data.
A total of 98 under-five children were included in the study, seven of which were mortalities, giving a case fatality rate (CFR) of 7.1%. The median age was 11 (IQR 7-14) months. The under-one children were 55(56%) and 33 (60%) were males. Rotavirus vaccination coverage for years 2021, 2022 and 2023 were 56%, 53%, and 39%, respectively, against a target of 80%. Rotavirus pathogen prevalence was at 70% among the cases of diarrhoea in the district. There was an upward trend in diarrhoea cases in 2023 from May to July as compared to the same period in 2021 and 2022.
An increase in mortalities could not be confirmed as data on previous trends of diarrhoea related deaths were incomplete. However, there was an increase in diarrhoea cases among the under-five children during the review period. Low vaccination coverage may be associated with a high incidence of rotavirus among cases with diarrhea, we advocate for strong public health education, increased immunization, and outreach services. In addition, data management in health facilities should be a priority.
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