1. ¹London School of Hygiene and Tropical Medicine, London, UK
2. ²John Snow, Inc., Cairo, Egypt
3. ³School of Medicine, George Washington University, Washington, DC, USA
4. ⁴USAID, Cairo, Egypt
5. ⁵Ministry of Health and Population, Cairo, Egypt
6. ⁶Department of Pediatrics and Neonatalogy, Cairo University, Cairo, Egypt

Correspondence: Reginald Gipson, MD, John Snow, Inc., 21 Misr Helwan Agriculture Road, Maadi, Cairo 11431 Egypt.

Abstract

OBJECTIVES: To estimate stillbirth, perinatal (PMR) and neonatal mortality rates (NMR) in Egypt and to assign main causes of death.

STUDY DESIGN: Data were collected from a representative sample of women who gave birth from 17,521 households which were included in the Egypt Demographic and Health Survey (EDHS) 2000. Comparisons were made between three systems for classifying causes of death.

RESULTS: The NMR was 25 per 1000 live births (17 early and eight late). Half the deaths occurred in the first two days of life. Neonatal causes of death were pre-maturity (39%), asphyxia (18%), infections (7%), congenital malformation (6%) and unclassified (29%). The PMR was 34 per 1000 births, mainly attributed to: asphyxia (44%) and prematurity (21%). The revised Wigglesworth classification agreed well with the physicians except the panel attributed more deaths to infections (20%). The WHO verbal autopsy algorithm left 48% of deaths unclassified.

CONCLUSIONS: Infant mortality in Egypt is showing an epidemiological transition with a significant decrease in mortality, resulting in a disproportionate percentage of deaths in the first week of life. Infant mortality in Egypt declined 64% from 124 per 1000 between 1974 and 1978 to 44 per 1000 between 1995 and 1999, the decline being greatest among older infants; 55% of all infant deaths occurred during the neonatal period. The neonatal mortality rate in this study was estimated to be 25 per 1000 live births.