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Geospatial characterizing of Under-Five Mortality in Alexandria, Egypt

This study aimed to identify geo-spatial pattern of under-five mortality (U5M) in Alexandria and its key determinants. We analyzed the geospatial distribution of 3064 deaths registered at 24 health offices reported from January 2018 to June 2019. The localities of Alexandria city were clustered into high and low incidence areas. Neonates represented 58.7% of U5M, while post-neonates and children were 31.1%, 10.2% respectively. Male deaths were significantly higher (P=0.036). The main leading causes of U5M were prematurity (28.32%), pneumonia (11.01%), cardiac arrest (10.57%), congenital malformation (9.95%), and childhood cardiovascular diseases (9.20%). Spatial distribution of U5M (including the most common three causes) tend to be clustered in western parts of Alexandria (El Hawaria, Bahig, Hamlis and Ketaa Maryiut). Another 9 clusters are at risk of being hotspots. Illiteracy, divorce, and poor locality characteristics (household size, population density, and access to water supply and sanitation), were statistically significant predictors of U5M.