New malaria-control policies and child mortality in Senegal : reaching millennium development goal 4

2012

Article référencé dans le Web of Science WOS:000299795000021

Trape Jean-François, Sauvage C., Ndiaye O., Douillot Laetitia, Marra Adama, Diallo Aldiouma, Cisse B., Greenwood B., Milligan P., Sokhna Cheikh, Molez Jean-François

Journal of Infectious Diseases, 2012, 205 (4), p. 672-679 ISSN 0022-1899

Background. The Demographic Surveillance System established in 1962 in Niakhar, Senegal, is the oldest in Africa. Here, we analyze trends in overall child mortality, malaria, and other causes of death in Niakhar from the beginning of data collection to 2010. Methods. After an initial census, demographic data were updated yearly from 1963 through 2010. From 1984, causes of death were determined by the verbal autopsy technique. Results. During 1963-2010, infant and under-5 mortality rates decreased from 223 parts per thousand to 18 parts per thousand and from 485 parts per thousand to 41 parts per thousand, respectively. The decrease was progressive during the entire observation period, except during 1990-2000, when a plateau and then an increase was observed. Malaria-attributable mortality in under-5 children decreased from 13.5 parts per thousand deaths per 1000 children per year during 1992-1999 to 2.2 parts per thousand deaths per 1000 children per year in 2010. During this period, all-cause mortality among children aged < 5 years decreased by 80%. Conclusions. Inadequate treatment for chloroquine-resistant malaria and an epidemic of meningitis during the 1990s were the 2 factors that interrupted a continuous decrease in child mortality. Direct and indirect effects of new malaria-control policies, introduced in 2003 and completed during 2006-2008, are likely to have been the key cause of the recent dramatic decrease in child mortality.

Entomologie médicale / Parasitologie / Virologie [052]

Fonds IRD [F B010055395]

fdi:010055395