TY - JOUR T1 - Risk factors of infant mortality in rural The Gambia: a retrospective cohort study JF - BMJ Paediatrics Open JO - BMJ Paediatrics Open DO - 10.1136/bmjpo-2021-001190 VL - 5 IS - 1 SP - e001190 AU - Alexander Jarde AU - Nuredin Ibrahim Mohammed AU - Pierre Gomez AU - Pa Cheboh Saine AU - Umberto D'Alessandro AU - Anna Roca Y1 - 2021/09/01 UR - http://bmjpaedsopen.bmj.com/content/5/1/e001190.abstract N2 - Objective The main objective was to assess the risk factors for infant mortality among children living in the Health and Demographic Surveillance System (HDSS) in Farafenni, The Gambia. Our secondary objective was to assess these risks separately in the neonatal and postneonatal (>28 days) period.Design Retrospective cohort study.Setting HDSS in an urban centre and surrounding area in The Gambia.Patients 7365 infants (47% female) born between 2014 and 2018, of which 126 (1.71%) died in the first year.Main outcome measures Infant mortality.Results Risk factors for mortality were death of any sibling (HR 2.78, 95% CI 1.54 to 5.00), having a twin (HR 1.96, 95% CI 1.01 to 3.80), being born in the harvest season (HR 1.55, 95% CI 1.07 to 2.24), living in a rural village (HR 4.34, 95% CI 2.03 to 9.29) and longer distance to the nearest village with a public health centre (HR 1.33, 95% CI 1.11 to 1.59). In addition, no breast feeding (HR 10.73, 95% CI 6.83 to 16.86) and no BCG vaccination in the first week of life (HR 3.47, 95% CI 1.07 to 11.24) were associated with infant mortality. Similar risk factors were found in the neonatal and postneonatal periods.Conclusion Most risk factors associated with infant mortality (neonatal and postneonatal) are not easily modifiable at the individual level and would require programmatic approaches to target vulnerable infants and facilitate access to health services.Data may be obtained from a third party and are not publicly available. The clinical data has been collected following provision of informed consent under the prerequisite of strict participant confidentiality. Qualified researchers may request access with the Gambia Government/MRC Joint Ethics Committee. The review process and release of data will be facilitated by MRC Unit The Gambia (http://www.mrc.gm/) through the Head of Governance at MRCG Dr Elizabeth Batchilly (Elizabeth.Batchilly@lshtm.ac.uk). Access will not be unduly restricted. ER -