Patterns of Malaria: Cause-Specific and All-Cause Mortality in a Malaria-Endemic Area of West Africa

Heiko Becher Department of Tropical Hygiene and Public Health, University of Heidelberg, Heidelberg, Germany; Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso; Centre National de Recherche et de la Formation au Paludisme, Ouagadougou, Burkina Faso

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Gisela Kynast-Wolf Department of Tropical Hygiene and Public Health, University of Heidelberg, Heidelberg, Germany; Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso; Centre National de Recherche et de la Formation au Paludisme, Ouagadougou, Burkina Faso

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Ali Sié Department of Tropical Hygiene and Public Health, University of Heidelberg, Heidelberg, Germany; Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso; Centre National de Recherche et de la Formation au Paludisme, Ouagadougou, Burkina Faso

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Robert Ndugwa Department of Tropical Hygiene and Public Health, University of Heidelberg, Heidelberg, Germany; Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso; Centre National de Recherche et de la Formation au Paludisme, Ouagadougou, Burkina Faso

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Heribert Ramroth Department of Tropical Hygiene and Public Health, University of Heidelberg, Heidelberg, Germany; Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso; Centre National de Recherche et de la Formation au Paludisme, Ouagadougou, Burkina Faso

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Bocar Kouyaté Department of Tropical Hygiene and Public Health, University of Heidelberg, Heidelberg, Germany; Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso; Centre National de Recherche et de la Formation au Paludisme, Ouagadougou, Burkina Faso

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Olaf Müller Department of Tropical Hygiene and Public Health, University of Heidelberg, Heidelberg, Germany; Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso; Centre National de Recherche et de la Formation au Paludisme, Ouagadougou, Burkina Faso

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Information on cause-specific mortality is sparse in sub-Saharan Africa. We present seasonal patterns of malaria and all-cause mortality from a longitudinal study with 60,000 individuals in rural northwestern Burkina Faso. The study is based on a demographic surveillance system and covers the period 1999–2003. Overall, 3,492 deaths were observed. Cause of death was ascertained by verbal autopsy. Age-specific death rates by cause and month of death were calculated. Seasonal and temporal trends were modeled with parametric Poisson regression. Infant and children less than 5 years of age mortality was 60.6 (95% CI, 56.2–65.3) and 31.9 (95% CI, 30.4–33.5) per 1,000 for all causes and 23.4 (95% CI, 20.7–26.4) and 13.3 (95% CI, 12.3–14.3) for malaria, respectively. Mortality was significantly higher in the rainy season. It is well described parametrically with a sinusoidal function. In adults, the highest all-cause mortality rates were observed in the dry season. Here, HIV/AIDS has become a leading cause of mortality.

Author Notes

Reprint requests: Heiko Becher, Department of Tropical Hygiene and Public Health, University of Heidelberg, Im Neuenheimer Feld 324, D-69120 Heidelberg, Germany, Telephone: 49-6221-565031, Fax: 49-6221-565948, E-mail: heiko.becher@urz.uni-heidelberg.de.
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