A systematic review of the burden and risk factors of sudden infant death syndrome (SIDS) in Africa

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Abstract

Background

While sudden infant death syndrome (SIDS) has long been recognized as a leading preventable cause of infant mortality in high-income countries, little is known about the burden of SIDS in Africa. To address this knowledge gap, we conducted the first systematic review of SIDS-related publications in Africa. Our objective was to assess the prevalence of SIDS and its risk factors in Africa.

Methods

We systematically searched PubMed, Embase, Web of Science, Cochrane, and Google Scholar to identify studies published until December 26, 2020. Review authors screened titles and abstracts, and selected articles independently for full-text review. Risk of bias was assessed using the Newcastle Ottawa Scale (NOS) or a modification. Data on the proportion of infants who died of SIDS and reported prevalence of any risk factors were extracted using customized data extraction forms in Covidence.

Results

Our analysis rested on 32 peer-reviewed articles. Nine studies presented prevalence estimates on bedsharing and prone sleeping, suggesting near-universal bedsharing of infants with parents (range, 60 to 91.8%) and frequent use of the prone sleeping position (range, 26.7 to 63.8%). Eleven studies reported on the prevalence of SIDS, suggesting high rates of SIDS in Africa. The prevalence of SIDS ranged from 3.7 per 1000 live births in South Africa, 2.5 per 1000 live births in Niger, and 0.2 per 1000 live births in Zimbabwe. SIDS and other sudden infant deaths accounted for between 2.5 to 21% of infant deaths in South Africa and 11.3% in Zambia.

Conclusions

Africa may have the highest global rate of SIDS with a high burden of associated risk factors. However, majority of the studies were from South Africa which limits generalizability of our findings to the entire continent. There is an urgent need for higher quality studies outside of South Africa to fill this knowledge gap.

Protocol registration

Prospero Registration Number: CRD42021257261

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Most cited references 61

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The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

Matthew J L Page, Joanne E McKenzie, Patrick Bossuyt … (2028)

The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.

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Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? a systematic review

Raúl Herzog, Mª José Álvarez-Pasquin, Camino Díaz … (2013)

Background The Summit of Independent European Vaccination Experts (SIEVE) recommended in 2007 that efforts be made to improve healthcare workers’ knowledge and beliefs about vaccines, and their attitudes towards them, to increase vaccination coverage. The aim of the study was to compile and analyze the areas of disagreement in the existing evidence about the relationship between healthcare workers’ knowledge, beliefs and attitudes about vaccines and their intentions to vaccinate the populations they serve. Methods We conducted a systematic search in four electronic databases for studies published in any of seven different languages between February 1998 and June 2009. We included studies conducted in developed countries that used statistical methods to relate or associate the variables included in our research question. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies and extracted their relevant characteristics. The data were descriptively analyzed. Results Of the 2354 references identified in the initial search, 15 studies met the inclusion criteria. The diversity in the study designs and in the methods used to measure the variables made it impossible to integrate the results, and each study had to be assessed individually. All the studies found an association in the direction postulated by the SIEVE experts: among healthcare workers, higher awareness, beliefs that are more aligned with scientific evidence and more favorable attitudes toward vaccination were associated with greater intentions to vaccinate. All the studies included were cross-sectional; thus, no causal relationship between the variables was established. Conclusion The results suggest that interventions aimed at improving healthcare workers’ knowledge, beliefs and attitudes about vaccines should be encouraged, and their impact on vaccination coverage should be assessed.

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SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment.

Rachel Moon (2016)

Approximately 3500 infants die annually in the United States from sleep-related infant deaths, including sudden infant death syndrome (SIDS), ill-defined deaths, and accidental suffocation and strangulation in bed. After an initial decrease in the 1990s, the overall sleep-related infant death rate has not declined in more recent years. Many of the modifiable and nonmodifiable risk factors for SIDS and other sleep-related infant deaths are strikingly similar. The American Academy of Pediatrics recommends a safe sleep environment that can reduce the risk of all sleep-related infant deaths. Recommendations for a safe sleep environment include supine positioning, use of a firm sleep surface, room-sharing without bed-sharing, and avoidance of soft bedding and overheating. Additional recommendations for SIDS risk reduction include avoidance of exposure to smoke, alcohol, and illicit drugs; breastfeeding; routine immunization; and use of a pacifier. New evidence and rationale for recommendations are presented for skin-to-skin care for newborn infants, bedside and in-bed sleepers, sleeping on couches/armchairs and in sitting devices, and use of soft bedding after 4 months of age. In addition, expanded recommendations for infant sleep location are included. The recommendations and strength of evidence for each recommendation are published in the accompanying policy statement, "SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment," which is included in this issue.

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Author and article information

Journal

Journal ID (nlm-ta): J Glob Health

Journal ID (iso-abbrev): J Glob Health

Journal ID (publisher-id): JGH

Title: Journal of Global Health

Publisher: International Society of Global Health

ISSN (Print): 2047-2978

ISSN (Electronic): 2047-2986

Publication date (Electronic, pub): 25 December 2021

Publication date (Electronic, collection): 2021

Volume: 11

Electronic Location Identifier: 04075

Affiliations

[1 ]Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA

[2 ]Right to Care – Zambia, Lusaka, Zambia

[3 ]Boston University School of Medicine, Department of Pediatrics, Boston, Massachusetts, USA

[4 ]Boston Medical Center, Division of Pediatric Infectious Diseases, Department of Pediatrics, Boston, Massachusetts, USA

[5 ]Boston University School of Public Health, Department of Community Health, Boston, Massachusetts, USA

[6 ]University of Zambia, School of Medicine, Department of Pediatrics, Lusaka, Zambia

Author notes

Correspondence to: Godwin K. Osei-Poku, MD, MPH Department of Global Health Boston University School of Public Health 801 Massachusetts Avenue Boston, MA 02118 USA  opkg2013@ 123456bu.edu

Article

Publisher ID: jogh-11-04075

DOI: 10.7189/jogh.11.04075

PMC ID: 8719309

PubMed ID: 35003713

SO-VID: 4d3bf532-4976-4a12-a8a4-d7b2c2157288

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This work is licensed under a Creative Commons Attribution 4.0 International License.

A systematic review of the burden and risk factors of sudden infant death syndrome (SIDS) in Africa

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Abstract

Background

Methods

Results

Conclusions

Protocol registration

Related collections

Global Health Next Generation Network

Most cited references 61

The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? a systematic review

SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment.

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