The contribution of reduction in malaria as a cause of rapid decline of under-five mortality: Evidence from the Rufiji Health and Demographic Surveillance System (HDSS) in rural Tanzania

Almamy M. Kanté, Rose Nathan, Stéphane Helleringer, Mrema Sigilbert, Francis Levira, Honorati Masanja, Don De Savigny, Salim Abdulla, James F. Phillips

Research output: Contribution to journalArticle

Abstract

Background: Under-five mortality has been declining rapidly in a number of sub-Saharan African settings. Malaria-related mortality is known to be a major component of childhood causes of death and malaria remains a major focus of health interventions. The paper explored the contribution of malaria relative to other specific causes of under-five deaths to these trends. Methods. This paper uses longitudinal demographic surveillance data to examine trends and causes of death of under-five mortality in Rufiji, whose population has been followed for over nine years (1999-2007). Causes of death, determined by the verbal autopsy technique, are analysed with Arriaga's decomposition method to assess the contribution of declining malaria-related mortality relative to other causes of death as explaining a rapid decline in overall childhood mortality. Results: Over the 1999-2007 period, under-five mortality rate in Rufiji declined by 54.3%, from 33.3 to 15.2 per 1,000 person-years. If this trend is sustained, Rufiji will be a locality that achieves MDG4 target. Although hypotrophy at birth remained the leading cause of death for neonates, malaria remains as the leading cause of death for post-neonates followed by pneumonia. However, declines in malaria death rates accounted for 49.9% of the observed under-five mortality decline while all perinatal causes accounted for only 19.9%. Conclusion: To achieve MDG 4 in malaria endemic settings, health programmes should continue efforts to reduce malaria mortality and more efforts are also needed to improve newborn survival.

Original languageEnglish (US)
Article number180
JournalMalaria Journal
Volume13
Issue number1
DOIs
StatePublished - May 10 2014

Keywords

  • Africa
  • Health and demographic surveillance system
  • Malaria
  • Millennium development goal
  • Tanzania
  • Under-five mortality

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases

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