Patterns of Age-Specific Mortality in Children in Endemic Areas of Sub-Saharan Africa

Salim Abdullah Ifakara Health Research and Development Centre, Tanzania; Center for Disease Control and Prevention, Kenya Medical Research Institute, Kenya; Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso; Navrongo Health Research Centre, Ghana; Centro de Investigacao em Saude de Manhica, Mozambique; Kintampo Health Research Centre, Ghana; Swiss Tropical Institute, Basel, Switzerland; INDEPTH Network Secretariat, Ghana

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Kubaje Adazu Ifakara Health Research and Development Centre, Tanzania; Center for Disease Control and Prevention, Kenya Medical Research Institute, Kenya; Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso; Navrongo Health Research Centre, Ghana; Centro de Investigacao em Saude de Manhica, Mozambique; Kintampo Health Research Centre, Ghana; Swiss Tropical Institute, Basel, Switzerland; INDEPTH Network Secretariat, Ghana

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Honorati Masanja Ifakara Health Research and Development Centre, Tanzania; Center for Disease Control and Prevention, Kenya Medical Research Institute, Kenya; Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso; Navrongo Health Research Centre, Ghana; Centro de Investigacao em Saude de Manhica, Mozambique; Kintampo Health Research Centre, Ghana; Swiss Tropical Institute, Basel, Switzerland; INDEPTH Network Secretariat, Ghana

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Diadier Diallo Ifakara Health Research and Development Centre, Tanzania; Center for Disease Control and Prevention, Kenya Medical Research Institute, Kenya; Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso; Navrongo Health Research Centre, Ghana; Centro de Investigacao em Saude de Manhica, Mozambique; Kintampo Health Research Centre, Ghana; Swiss Tropical Institute, Basel, Switzerland; INDEPTH Network Secretariat, Ghana

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Abraham Hodgson Ifakara Health Research and Development Centre, Tanzania; Center for Disease Control and Prevention, Kenya Medical Research Institute, Kenya; Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso; Navrongo Health Research Centre, Ghana; Centro de Investigacao em Saude de Manhica, Mozambique; Kintampo Health Research Centre, Ghana; Swiss Tropical Institute, Basel, Switzerland; INDEPTH Network Secretariat, Ghana

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Edith Ilboudo-Sanogo Ifakara Health Research and Development Centre, Tanzania; Center for Disease Control and Prevention, Kenya Medical Research Institute, Kenya; Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso; Navrongo Health Research Centre, Ghana; Centro de Investigacao em Saude de Manhica, Mozambique; Kintampo Health Research Centre, Ghana; Swiss Tropical Institute, Basel, Switzerland; INDEPTH Network Secretariat, Ghana

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Ariel Nhacolo Ifakara Health Research and Development Centre, Tanzania; Center for Disease Control and Prevention, Kenya Medical Research Institute, Kenya; Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso; Navrongo Health Research Centre, Ghana; Centro de Investigacao em Saude de Manhica, Mozambique; Kintampo Health Research Centre, Ghana; Swiss Tropical Institute, Basel, Switzerland; INDEPTH Network Secretariat, Ghana

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Seth Owusu-Agyei Ifakara Health Research and Development Centre, Tanzania; Center for Disease Control and Prevention, Kenya Medical Research Institute, Kenya; Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso; Navrongo Health Research Centre, Ghana; Centro de Investigacao em Saude de Manhica, Mozambique; Kintampo Health Research Centre, Ghana; Swiss Tropical Institute, Basel, Switzerland; INDEPTH Network Secretariat, Ghana

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Ricardo Thompson Ifakara Health Research and Development Centre, Tanzania; Center for Disease Control and Prevention, Kenya Medical Research Institute, Kenya; Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso; Navrongo Health Research Centre, Ghana; Centro de Investigacao em Saude de Manhica, Mozambique; Kintampo Health Research Centre, Ghana; Swiss Tropical Institute, Basel, Switzerland; INDEPTH Network Secretariat, Ghana

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Thomas Smith Ifakara Health Research and Development Centre, Tanzania; Center for Disease Control and Prevention, Kenya Medical Research Institute, Kenya; Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso; Navrongo Health Research Centre, Ghana; Centro de Investigacao em Saude de Manhica, Mozambique; Kintampo Health Research Centre, Ghana; Swiss Tropical Institute, Basel, Switzerland; INDEPTH Network Secretariat, Ghana

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Fred N. Binka Ifakara Health Research and Development Centre, Tanzania; Center for Disease Control and Prevention, Kenya Medical Research Institute, Kenya; Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso; Navrongo Health Research Centre, Ghana; Centro de Investigacao em Saude de Manhica, Mozambique; Kintampo Health Research Centre, Ghana; Swiss Tropical Institute, Basel, Switzerland; INDEPTH Network Secretariat, Ghana

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Understanding of the age- and season- dependence of malaria mortality is an important prerequisite for epidemiologic models of malaria immunity. However, most studies of malaria mortality have aggregated their results into broad age groups and across seasons, making it hard to predict the likely impact of interventions targeted at specific age groups of children. We present age-specific mortality rates for children aged < 15 years for the period of 2001–2005 in 7 demographic surveillance sites in areas of sub-Saharan Africa with stable endemic Plasmodium falciparum malaria. We use verbal autopsies (VAs) to estimate the proportion of deaths by age group due to malaria, and thus calculate malaria-specific mortality rates for each site, age-group, and month of the year. In all sites a substantial proportion of deaths (ranging from 20.1% in a Mozambican site to 46.2% in a site in Burkina Faso) were attributed to malaria. The overall age patterns of malaria mortality were similar in the different sites. Deaths in the youngest children (< 3 months old) were only rarely attributed to malaria, but in children over 1 year of age the proportion of deaths attributed to malaria was only weakly age-dependent. In most of the sites all-cause mortality rates peaked during the rainy season, but the strong seasonality in malaria transmission in these sites was not reflected in strong seasonality in the proportion of deaths attributed to malaria, except in the two sites in Burkina Faso. Improvement in the specificity of malaria verbal autopsies would make it easier to interpret the age and season patterns in such data.

Author Notes

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