Jaffar S, Leach A, Greenwood A M, Jepson A, Muller O, Ota M O, Bojang K, Obaro S, Greenwood B M
Medical Research Council Laboratories, The Gambia, West Africa.
Trop Med Int Health. 1997 Jan;2(1):28-37. doi: 10.1046/j.1365-3156.1997.d01-131.x.
A surveillance system was used to detect births and deaths in children in a large, rural, West African population from 1989 to 1993. Cause of death was investigated using post-mortem questionnaires. Overall infant (age 0-11 months) and child (age 1-4 years) mortality rates of 80.1 and 18.8 per 1000 per year were recorded. These were reasonably consistent over the period of surveillance. The most frequent cause of death in infants was acute respiratory infection (ARI), whereas in children it was malaria: these two conditions accounted for 41% of the deaths in children under 5 years old. Other leading causes of death were acute gastroenteritis, malnutrition, and septicaemia. Deaths attributed to ARI decreased over the 5-year period, but mortality rates from other causes were either unchanged or increased slightly. Mortality from all causes peaked in the rainy season and was slightly higher in villages which were part of a primary health care programme than in those which were not. There were also no differences between male and female mortality rates beyond one year of age. Despite the introduction of a number of health interventions, there has been no major change in the overall pattern of mortality in children in a rural area of The Gambia. Malaria and ARI remain the main causes of death.
1989年至1993年期间，在西非一个大型农村人口中使用了一个监测系统来检测儿童的出生和死亡情况。通过尸检问卷调查死亡原因。记录的婴儿（0至11个月）和儿童（1至4岁）的年死亡率分别为每1000人80.1人和18.8人。在监测期间，这些数据相当稳定。婴儿最常见的死亡原因是急性呼吸道感染（ARI），而儿童则是疟疾：这两种情况占5岁以下儿童死亡人数的41%。其他主要死亡原因是急性肠胃炎、营养不良和败血症。在这5年期间，归因于ARI的死亡人数有所下降，但其他原因导致的死亡率要么没有变化，要么略有上升。所有原因导致的死亡率在雨季达到峰值，并且在纳入初级卫生保健计划的村庄中略高于未纳入该计划的村庄。一岁以上男女死亡率也没有差异。尽管实施了多项卫生干预措施，但冈比亚农村地区儿童死亡率的总体模式没有发生重大变化。疟疾和ARI仍然是主要死亡原因。
