Varo R
Cole K
Madewell ZJ
Iglesias JF
Igunza KA
Akelo V
Mugah C
Onyango D
Were JA
Madhi SA
Dangor Z
Johnstone S
Lala SG
Ruder T
Mandomando I
Kincardett M
Xerinda EG
Scott JAG
Assefa N
Madrid L
Hassen FA
Edris Y
Ogbuanu I
Bassey IA
Samura S
Sillah AS
Kaluma E
Arifeen SE
Biswas R
Gurley ES
Rahman A
Hossain MZ
Omer SB
Kazi AM
Belgaumi SM
Allana R
Keita AM
Bassat Q
Mutevedzi PC
Whitney CG
Rees CA
Child Health
Mortality Prevention Surveillance Network
BMJ Open. 2026;16e106095
OBJECTIVES: To describe (1) the proportion of deaths that were in recently hospitalised children and (2) causes of mortality among deceased children aged 0-59 months with preceding hospitalisations who enrolled in a mortality surveillance programme. DESIGN: Descriptive study using prospectively collected data. SETTING: Eight Child Health and Mortality Prevention Surveillance (CHAMPS) community and healthcare sites in sub-Saharan Africa and South Asia. PARTICIPANTS: Deaths among children aged 0-59 months enrolled in CHAMPS 2016-2023. INTERVENTIONS: None. PRIMARY AND SECONDARY OUTCOME MEASURES: Deaths with antecedent hospitalisations within 180 days of death. Causes of death determined by expert panels who reviewed clinical data and histopathologic and microbiologic results from postmortem minimally invasive tissue sampling. RESULTS: CHAMPS enrolled 8548 deaths; we excluded 3688 neonates who died before discharge or /=-3 (37.5%, 95% CI 32.0% to 43.5%). CONCLUSIONS: We observed a high proportion of deaths with antecedent hospitalisations within 180 days among young children across eight sites in sub-Saharan Africa and Asia. Among those deaths, children aged 1-11 months and undernourished infants were over-represented, suggesting early follow-up as a potential point to focus targeted support and future research.
