Impact of Malnutrition and Measles Mortality on Underfives All-Cause Mortality in Gweru City, Zimbabwe, in 1960-89

A study was carried out to determine secular changes in all-cause mortality rates for children aged < 5 years in 1960-1989 and their association with measles and malnutrition mortality rates in the same age group in the same period in city of Gweru, Zimbabwe. The study utilized under-fives mortality data from births and deaths registration office and measles and malnutrition surveillance data obtained from Gweru city’s public health department. Data was analysed in SPSS version 20 for windows and linear regression analysis was used to determine whether measles and malnutrition mortality rates were independent predictors of all-cause underfives mortality rates. It was found that in 1960-1989 underfives mortality rates from all causes were 10.2-63.7/1000 live births (median: 28.7, Q1 = 16.2, Q3 = 42.6) and these rates significantly and linearly declined in this period (χ 2 for linear trend=165.74, p < 0.001). Measles mortality rates among underfives significantly and linearly declined (χ 2 for linear trend = 812.49, p<0.001) while malnutrition mortality rates in the same age group also significantly and linearly declined (X 2 for linear trend = 2411.54, p<0.001) in underfives in 1960-1989. Linear regression analysis indicated that malnutrition mortality rates (Regression Coefficient = 0.072, 95% CI = 0.039 0.104, p < 0.001) and measles mortality rates (Regression Coefficient = 0.029, 95% CI = 0.006-0.052, p=0.02) were independent predictors of all-cause underfives mortality rates with an adjusted coefficient of determination of 70.5% (Adjusted R 2 = 0.7048) with malnutrition mortality rates uniquely explaining 21% of the variance in all-cause mortality (semipartial correlation squared = 0.21) while measles mortality rates uniquely explained 7% of the variance in all-cause mortality rates (semipartial correlation squared =0.068). It was concluded that decline in malnutrition and measles mortality rates among underfives significantly contributed to decline in all-cause underfives mortality rates in 1960-89 in Gweru city, Zimbabwe. On account of these findings, it is critical that efforts directed at controlling malnutrition and measles be intensified in areas and populations of similar settings.