Present or absent: risks and protective factors of sudden infant death syndrome (SIDS) in the Zambian context.
Nearly all Zambian infants sleep on side, stomach, or shared surface - key SIDS risks.
Present or absent: risks and protective factors of sudden infant death syndrome (SIDS) in the Zambian context.
Despite a reduction in sudden unexplained infant death (sudden unexplained infant death) in high-income countries, the incidence of sudden unexplained infant death and the prevalence of its risk and protective factors remain poorly understood in Zambia due to limited research.
We aimed to describe the infant sleep positions and sleep environments in an urban Zambian population to gain a better understanding of modifiable risk factors for sudden unexplained infant death.
We used antenatal, birth, and postnatal data from the Zambian Infant Cohort Study, a prospective birth cohort, to describe infant sleep practices in Chawama, a densely populated peri-urban community in Lusaka, Zambia.
nearly all infants slept in unsafe positions, raising SIDS risk
We collected data from 596 caregivers and 605 infants.
Overall, sudden infant death syndrome accounted for 8.3% (n/N = 3/36) of deceased infants.
Only 6.4% of caregivers attained an education beyond secondary school, and a significant proportion of infants (20.2%) had low birth weights, with 10.7% of infants confirmed by ultrasound as preterm.
Breastfeeding, a protective factor, reduced from 99.2% on day six to 43.1 at the 24-week visit.
Both modifiable (bed-sharing and prone sleep position) and non-modifiable risk factors (low birthweight and prematurity) of sudden unexplained infant death are prevalent in this low socioeconomic setting in Zambia.
Public health strategies to prevent sudden unexplained infant death need to be innovative and culturally congruent in addressing modifiable risks in settings where there is a lack of space.