Jaffar S, Leach A, Greenwood A, Greenwood B
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Trop Med Int Health. 2000 Sep;5(9):628-32. doi: 10.1046/j.1365-3156.2000.00610.x.
There is evidence that season of birth may predict adult mortality from infectious diseases in rural Gambia. Using data collected over a five-year period from the rural, eastern region of the Gambia, we examined whether the season of birth influences mortality in childhood. 26 894 births and 3776 deaths among children under the age of five years were recorded in this region during the period 1989-1993. The estimated 1-4 year population was 95 355. In children aged 1-4 years, the mortality rate per 1000 per year was 16.1 (95% CI 14.9, 17.2) for those born in the 'harvest' season (January to June), which was not significantly different from the rate of 17.9 (95% CI 16.7, 19.0) recorded for those born in the 'hungry' season (July to December) (age-stratified Mantel-Haenszel mortality ratio 0. 91, 95% CI 0.83, 1.01; p = 0.08). Nearly all deaths of 1-4 year olds were attributed to infectious diseases, with malaria accounting for over 40%. None of the cause-specific child mortality rates differed significantly according to the season of birth. These data suggest that beyond infancy, when it is easier to separate the effect of season on cause of death from that of the season of birth, there is no marked difference in the rate of death between Gambian children born in the harvest season and those born in the hungry season.
有证据表明，在冈比亚农村地区，出生季节可能预示着成年人因传染病导致的死亡率。利用在冈比亚东部农村地区五年期间收集的数据，我们研究了出生季节是否会影响儿童死亡率。1989年至1993年期间，该地区记录了26894例出生和3776例五岁以下儿童死亡。估计1至4岁的人口为95355人。在1至4岁的儿童中，“收获”季节（1月至6月）出生的儿童每年每1000人的死亡率为16.1（95%可信区间14.9, 17.2），与“饥饿”季节（7月至12月）出生的儿童记录的死亡率17.9（95%可信区间16.7, 19.0）没有显著差异（年龄分层的Mantel-Haenszel死亡率比为0.91，95%可信区间0.83, 1.01；p = 0.08）。几乎所有1至4岁儿童的死亡都归因于传染病，其中疟疾占40%以上。按出生季节划分，特定病因的儿童死亡率均无显著差异。这些数据表明，在婴儿期之后，当更容易将季节对死亡原因的影响与出生季节的影响区分开来时，收获季节出生的冈比亚儿童与饥饿季节出生的儿童之间的死亡率没有明显差异。
