One in five children born with a twin sibling in sub-Saharan Africa risks dying before the age of five—three times faster that singleton, according to research published in The Lancet medical journal.
“Twins account for 10.7 percent of all under-five deaths and 15.1 percent of neonatal (newborn) deaths in the region and these percentages are increasing,” the study said.
The research further revealed that under-5 mortality among twins has slightly declined by 327·7 per 1000 livebirths in 1995–2001. This decline of 35·0% was much less steep than the 50·6% reduction among singletons in the same time frame.
Sub-Saharan Africa has the highest rate of naturally occurring twin births in the world. Whereas natural twinning rates are about six to nine twin births per 1000 maternities in east Asia and Latin America, and eight to 16 in Europe, North America, and the Middle East.
Twin births are as high as 18 per 1000 or more in the central African twinning zone that runs from Guinea, Liberia, and Ivory Coast in the west of Africa to Tanzania, Mozambique, and the Comoros in the east.1 About 3–4% of children born in sub-Saharan Africa are members of a twin pair.
The study suggested that to reduce twin mortality in sub-Saharan Africa, improvements in health-care services are needed in all three phases of the process: during pregnancy, at delivery, and post partum are mandatory.
Expectant mothers are also advised to form a habit of delivering in hospitals equipped with trained staff who can handle twin delivery.
A prior test to detect twins was also recommended by the study as special attention might be required during the pregnancy period like for instance antenatal care.