@article{fdi:010090031,
  title = {{E}xcess mortality associated with the {COVID}-19 pandemic during the 2020 and 2021 waves in {A}ntananarivo, {M}adagascar},
  author = {{R}abarison, {J}. {H}. and {R}akotondramanga, {J}. {M}. and {R}atovoson, {R}. and {M}asquelier, {B}. and {R}asoanomenjanahary, {A}. {M}. and {D}reyfus, {A}. and {G}architorena, {A}ndres and {R}asambainarivo, {F}. and {R}azanajatovo, {N}. {H}. and {A}ndriamandimby, {S}. {F}. and {M}etcalf, {C}. {J}. and {L}acoste, {V}. and {H}eraud, {J}. {M}. and {D}ussart, {P}.},
  editor = {},
  language = {{ENG}},
  abstract = {{I}ntroduction {COVID}-19-associated mortality remains difficult to estimate in sub-{S}aharan {A}frica because of the lack of comprehensive systems of death registration. {B}ased on death registers referring to the capital city of {M}adagascar, we sought to estimate the excess mortality during the {COVID}-19 pandemic and calculate the loss of life expectancy. {M}ethods {D}eath records between 2016 and 2021 were used to estimate weekly excess mortality during the pandemic period. {T}o infer its synchrony with circulation of {SARS}-{C}o{V}-2, a cross-wavelet analysis was performed. {L}ife expectancy loss due to the {COVID}-19 pandemic was calculated by projecting mortality rates using the {L}ee and {C}arter model and extrapolating the prepandemic trends (1990-2019). {D}ifferences in life expectancy at birth were disaggregated by cause of death. {R}esults{P}eaks of excess mortality in 2020-21 were associated with waves of {COVID}-19. {E}stimates of all-cause excess mortality were 38.5 and 64.9 per 100 000 inhabitants in 2020 and 2021, respectively, with excess mortality reaching & {GE};50% over 6 weeks. {I}n 2021, we quantified a drop of 0.8 and 1.0 years in the life expectancy for men and women, respectively attributable to increased risks of death beyond the age of 60 years. {C}onclusion{W}e observed high excess mortality during the pandemic period, in particular around the peaks of {SARS}-{C}o{V}-2 circulation in {A}ntananarivo. {O}ur study highlights the need to implement death registration systems in low-income countries to document true toll of a pandemic.},
  keywords = {{COVID}-19 ; epidemiology ; public health ; respiratory infections ; {MADAGASCAR}},
  booktitle = {},
  journal = {{BMJ} {G}lobal {H}ealth},
  volume = {8},
  numero = {7},
  pages = {e011801 [11 ]},
  ISSN = {2059-7908},
  year = {2023},
  DOI = {10.1136/bmjgh-2023-011801},
  URL = {https://www.documentation.ird.fr/hor/fdi:010090031},
}