CHAMPS report reveals infections drive most under-five deaths in Africa but majority are preventable
By Waihiga K. Muturi
A Landmark study by the Child Health and Mortality Prevention Surveillance (CHAMPS) Network has found that the majority of deaths among children under five in Africa and South Asia are caused by preventable infections.
The report, supported by the Bill and Melinda Gates Foundation and implemented in Kenya by the Kenya Medical Research Institute (KEMRI), offers sobering evidence and a critical roadmap for intervention.
Using Minimally Invasive Tissue Sampling (MITS) a technique that allows for postmortem diagnosis without full autopsies researchers examined 632 deaths of children aged 1 to 59 months across seven high-burden sites. An astonishing 86.9 percent of these deaths were linked to infectious diseases, and over 82 percent were deemed preventable by expert panels.
Dr. Victor Akelo, Senior Director of Science and Implementation at CHAMPS and a lead researcher at KEMRI, explains that prior to this study, global health actors were struggling to reconcile high under-five mortality rates with growing investments in child health.
“The missing link was understanding the actual causes of death,” he says. “That’s where MITS came in providing clarity without the invasiveness of full autopsies.”
MITS, he explains, involves collecting small samples using specialized needles, which are then subjected to rigorous laboratory analysis. This has helped illuminate the most common contributors to child mortality: malnutrition, HIV, malaria, birth defects, lower respiratory tract infections, and diarrheal diseases.
Of particular concern are infections from pathogens such as Klebsiella pneumoniae, Plasmodium falciparum, and Streptococcus pneumoniae. Many of these, including Klebsiella and Acinetobacter baumannii, were found to be nosocomial acquired within healthcare settings highlighting urgent gaps in hospital infection control.
“Some of these pathogens cause sepsis, pneumonia, and meningitis and they’re picked up right in our hospitals,” Dr. Akelo says. “Simple steps like routine sanitation, sterilizing equipment, and training on infection control can make a significant difference.”
The findings are a wake-up call, not only to public health officials but also to political leaders, says Akelo. “We’ve mapped the problem. Now we need the will and resources to act.”
The research builds on decades of work. Kenya, for instance, has made strides in reducing malaria-related deaths through widespread use of insecticide-treated bed nets and preventive treatment for pregnant women. With malaria vaccines now being rolled out, experts hope for even greater progress.
Still, challenges persist. “In Siaya County, where CHAMPS operates, malaria remains a top killer of young children,” Akelo warns.
Pathogens like Plasmodium falciparum can cause life-threatening conditions like cerebral malaria and severe anemia, while Streptococcus pneumoniae is linked to pneumonia and meningitis. Klebsiella, a hospital-acquired infection, poses a grave risk for already vulnerable patients.
Dr. Isaac Kihurani, a paediatric specialist at Aga Khan University Hospital in Nairobi, says dealing with preventable child deaths takes an emotional toll on healthcare workers. “Even as professionals, we feel the weight of losing a patient. Everyone involved doctors, nurses, caregivers has emotionally invested in that child’s survival.”
His colleague, Dr. Aura Nzinga, echoes the sentiment. “We reflect deeply on every case. We hold debriefs to understand what we could have done better, and recommend postmortems to provide answers and closure for grieving families.”
The human side of this crisis is heartbreakingly captured in the story of Mama Baraka, a Kenyan mother whose viral TikTok videos document the tragic loss of her 4-year-old son, Brylejones Baraka. Born with liver complications, the child’s short life was a series of hospital visits, a transplant, and ultimately a fatal infection. A postmortem revealed widespread organ damage and malignant tumors.
“I donated my liver and hoped for the best,” she shared in one of her most-watched videos. “We tried everything. But in the end, God had other plans.”
Her story, viewed over half a million times, has turned her social media page into a digital memorial and a call to action.
Both Dr. Kihurani and Dr. Nzinga stress the need for early intervention, particularly in HIV prevention. “We have protocols to prevent mother-to-child transmission from managing the mother’s viral load to considering alternatives to vaginal birth and breastfeeding,” says Kihurani.
Nzinga adds that treatment must go hand in hand with mental and psychosocial support for both the child and their caregivers. “We work with psychologists to help families cope and ensure children get the best quality of life.”
The urgency of translating CHAMPS’ findings into policy cannot be overstated. With the causes identified and tools available, experts insist it’s now a matter of coordinated effort and scalable implementation.
“The data is there,” says Dr. Akelo. “What we need is action.”
The implications stretch beyond one study or one country. They challenge African governments, health institutions, and international donors to step up to make infection control standard in all healthcare facilities, to expand access to preventive interventions, and to ensure no child dies from a cause that could have been prevented.
Because in the end, as the CHAMPS study shows, the child mortality crisis is not unsolvable. It is a test of commitment.
This report is part of our continuing coverage on child health and innovation in Africa. Future installments will track policy responses and highlight best practices that can turn research into real-life impact.
About the Author
Waihiga K. Muturi is a science communications specialist and freelance digital journalist, he has managed multimillion-dollar programmes aimed at strengthening organisational outreach and partnership development. Waihiga excels at translating complex research findings into actionable policy recommendations and has extensive experience in stakeholder engagement across private, public, and non-profit sectors. He is a Rotarian and an advocate for evidence-based solutions to Africa’s most urgent livelihood challenges. He believes “Africa MUST change the way it tackles Poverty!”
