Hammer Gaël P, Somé Florent, Müller Olaf, Kynast-Wolf Gisela, Kouyaté Bocar, Becher Heiko
Department of Epidemiology, Institute for Tropical Hygiene and Public Health, University of Heidelberg, Germany.
Malar J. 2006 Jun 8;5:47. doi: 10.1186/1475-2875-5-47.
Reliable mortality data are a prerequisite for planning health interventions, yet such data are often not available in developing countries, particularly in sub-Saharan Africa (SSA). Demographic surveillance systems (DSS) implementing the verbal autopsy (VA) method are the only possibility to observe cause-specific mortality of a population on a longitudinal basis in many countries.
This paper reports all-cause and cause-specific mortality rates in children under the age of five years from 1999 until 2003 in a malaria holoendemic area of north-western Burkina Faso. The DSS of the Nouna Health Research Centre, in which VA data were analysed, covers a rural population of about 30,000 (41 villages) and an urban population of about 25,000 (Nouna town).
A total of 1,544 deaths were analysed, 87 (6%), 225 (14%), 317 (21%) and 915 (59%) of which occurred in the periods < 1 month, 1-5 months, 6-11 months and 1-4 years respectively. All cause mortality rates of children under five years were higher in the rural than the urban area (34 vs 24 per 1,000 person-years) and in the rainy than the dry season (35 vs 29 per 1,000 person-years). Malaria was the most frequent diagnosis (42%) with peak mortality rates in infants aged 6-11 months.
Malaria is the most important cause of death in this remote area of SSA, even considering the low specificity of malaria diagnosis in young children. Strengthening the existing malaria control tools is of prime importance to reduce the high childhood mortality in the endemic areas of SSA.
可靠的死亡率数据是规划卫生干预措施的前提条件，但在发展中国家，尤其是撒哈拉以南非洲地区（SSA），此类数据往往难以获取。在许多国家，实施口头尸检（VA）方法的人口监测系统（DSS）是纵向观察特定人群死因死亡率的唯一途径。
本文报告了1999年至2003年布基纳法索西北部疟疾高度流行地区5岁以下儿童的全因死亡率和特定病因死亡率。分析VA数据的努纳健康研究中心的DSS覆盖了约30,000人的农村人口（41个村庄）和约25,000人的城市人口（努纳镇）。
共分析了1544例死亡病例，其中87例（6%）、225例（14%）、317例（21%）和915例（59%）分别发生在<1个月、1 - 5个月、6 - 11个月和1 - 4岁年龄段。5岁以下儿童的全因死亡率在农村地区高于城市地区（每1000人年分别为34例和24例），在雨季高于旱季（每1000人年分别为35例和29例）。疟疾是最常见的诊断病因（42%），6 - 11个月龄婴儿的死亡率最高。
即使考虑到幼儿疟疾诊断的低特异性，疟疾仍是撒哈拉以南非洲这个偏远地区最重要的死亡原因。加强现有的疟疾控制手段对于降低撒哈拉以南非洲流行地区儿童的高死亡率至关重要。
