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Comparison of all-cause and malaria-specific mortality from two West African countries with different malaria transmission patterns.

Ndugwa RP, Ramroth H, Müller O, Jasseh M, Sié A, Kouyaté B, Greenwood B, Becher H - Malar. J. (2008)

Bottom Line: Model-based estimates for under-five all-cause mortality rates show a decline from 1960 to 2000 in both countries (Burkina Faso: from 71.8 to 39.0), but more markedly in The Gambia (from 104.5 to 28.4).The weighted-average malaria-specific mortality rate per 1000 person-years for Burkina Faso (15.4, 95% CI: 13.0-18.3) was higher than that in The Gambia (9.5, 95% CI: 9.1-10.1).Child mortality in both countries declined significantly in the period 1960 to 2004, possibly due to socio-economic development, improved health services and specific intervention projects.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Tropical Hygiene and Public Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany. robert.ndugwa@urz.uni-heidelberg.de

ABSTRACT

Background: Malaria is a leading cause of death in children below five years of age in sub-Saharan Africa. All-cause and malaria-specific mortality rates for children under-five years old in a mesoendemic malaria area (The Gambia) were compared with those from a hyper/holoendemic area (Burkina Faso).

Methods: Information on observed person-years (PY), deaths and cause of death was extracted from online search, using key words: "Africa, The Gambia, Burkina Faso, malaria, Plasmodium falciparum, mortality, child survival, morbidity". Missing person-years were estimated and all-cause and malaria-specific mortality were calculated as rates per 1,000 PY. Studies were classified as longitudinal/clinical studies or surveys/censuses. Linear regression was used to investigate mortality trends.

Results: Overall, 39 and 18 longitudinal/clinical studies plus 10 and 15 surveys and censuses were identified for The Gambia and Burkina Faso respectively (1960-2004). Model-based estimates for under-five all-cause mortality rates show a decline from 1960 to 2000 in both countries (Burkina Faso: from 71.8 to 39.0), but more markedly in The Gambia (from 104.5 to 28.4). The weighted-average malaria-specific mortality rate per 1000 person-years for Burkina Faso (15.4, 95% CI: 13.0-18.3) was higher than that in The Gambia (9.5, 95% CI: 9.1-10.1). Malaria mortality rates did not decline over time in either country.

Conclusion: Child mortality in both countries declined significantly in the period 1960 to 2004, possibly due to socio-economic development, improved health services and specific intervention projects. However, there was little decline in malaria mortality suggesting that there had been no major impact of malaria control programmes during this period. The difference in malaria mortality rates across countries points to significant differences in national disease control policies and/or disease transmission patterns.

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Malaria mortality rates (MMR) per 1,000 in Burkina Faso and in The Gambia for children under five, 1981–2003. The lines represent the average malaria mortality rates weighted for study sample sizes.
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Figure 3: Malaria mortality rates (MMR) per 1,000 in Burkina Faso and in The Gambia for children under five, 1981–2003. The lines represent the average malaria mortality rates weighted for study sample sizes.

Mentions: Malaria mortality rates show no clear change for the period 1981 to the late 1990s (see Table 4 and Figure 3). As each of the studies had different aims and designs, comparisons across studies and by regions and time (years) is difficult. For instance, in the Upper River Division, no consistent pattern can be seen and there are wide variations in rates between years. However, in the period 1988–90 the lowest malaria mortality rate (U5MR per 1,000 PY) was seen in the Upper River Division (6.3) in contrast to 18.2 in the Farafenni area, whereas results were comparable in South Bank Division (15.8) and the Banjul area (14.5).


Comparison of all-cause and malaria-specific mortality from two West African countries with different malaria transmission patterns.

Ndugwa RP, Ramroth H, Müller O, Jasseh M, Sié A, Kouyaté B, Greenwood B, Becher H - Malar. J. (2008)

Malaria mortality rates (MMR) per 1,000 in Burkina Faso and in The Gambia for children under five, 1981–2003. The lines represent the average malaria mortality rates weighted for study sample sizes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2254634&req=5

Figure 3: Malaria mortality rates (MMR) per 1,000 in Burkina Faso and in The Gambia for children under five, 1981–2003. The lines represent the average malaria mortality rates weighted for study sample sizes.
Mentions: Malaria mortality rates show no clear change for the period 1981 to the late 1990s (see Table 4 and Figure 3). As each of the studies had different aims and designs, comparisons across studies and by regions and time (years) is difficult. For instance, in the Upper River Division, no consistent pattern can be seen and there are wide variations in rates between years. However, in the period 1988–90 the lowest malaria mortality rate (U5MR per 1,000 PY) was seen in the Upper River Division (6.3) in contrast to 18.2 in the Farafenni area, whereas results were comparable in South Bank Division (15.8) and the Banjul area (14.5).

Bottom Line: Model-based estimates for under-five all-cause mortality rates show a decline from 1960 to 2000 in both countries (Burkina Faso: from 71.8 to 39.0), but more markedly in The Gambia (from 104.5 to 28.4).The weighted-average malaria-specific mortality rate per 1000 person-years for Burkina Faso (15.4, 95% CI: 13.0-18.3) was higher than that in The Gambia (9.5, 95% CI: 9.1-10.1).Child mortality in both countries declined significantly in the period 1960 to 2004, possibly due to socio-economic development, improved health services and specific intervention projects.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Tropical Hygiene and Public Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany. robert.ndugwa@urz.uni-heidelberg.de

ABSTRACT

Background: Malaria is a leading cause of death in children below five years of age in sub-Saharan Africa. All-cause and malaria-specific mortality rates for children under-five years old in a mesoendemic malaria area (The Gambia) were compared with those from a hyper/holoendemic area (Burkina Faso).

Methods: Information on observed person-years (PY), deaths and cause of death was extracted from online search, using key words: "Africa, The Gambia, Burkina Faso, malaria, Plasmodium falciparum, mortality, child survival, morbidity". Missing person-years were estimated and all-cause and malaria-specific mortality were calculated as rates per 1,000 PY. Studies were classified as longitudinal/clinical studies or surveys/censuses. Linear regression was used to investigate mortality trends.

Results: Overall, 39 and 18 longitudinal/clinical studies plus 10 and 15 surveys and censuses were identified for The Gambia and Burkina Faso respectively (1960-2004). Model-based estimates for under-five all-cause mortality rates show a decline from 1960 to 2000 in both countries (Burkina Faso: from 71.8 to 39.0), but more markedly in The Gambia (from 104.5 to 28.4). The weighted-average malaria-specific mortality rate per 1000 person-years for Burkina Faso (15.4, 95% CI: 13.0-18.3) was higher than that in The Gambia (9.5, 95% CI: 9.1-10.1). Malaria mortality rates did not decline over time in either country.

Conclusion: Child mortality in both countries declined significantly in the period 1960 to 2004, possibly due to socio-economic development, improved health services and specific intervention projects. However, there was little decline in malaria mortality suggesting that there had been no major impact of malaria control programmes during this period. The difference in malaria mortality rates across countries points to significant differences in national disease control policies and/or disease transmission patterns.

Show MeSH
Related in: MedlinePlus