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Seasonal variation in child mortality in rural Guinea-Bissau

Bibi Uhre Nielsen1,2, Stine Byberg1,2,3, Peter Aaby1,2

  • 1Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau.

Tropical Medicine & International Health : TM & IH
|May 3, 2017
PubMed

Insights

Child mortality in Guinea-Bissau is 51% higher during the rainy season than the dry season, with risks increasing significantly with age. Malaria is a key driver of this seasonal disparity in child deaths.

Area of Science:

  • Global Health
  • Pediatrics
  • Epidemiology

Background:

  • Child mortality rates in many African nations exhibit seasonal variations, with higher incidences during the rainy season.
  • Understanding these seasonal patterns is crucial for targeted public health interventions in vulnerable populations.

Purpose of the Study:

  • To investigate the impact of season on child mortality in rural Guinea-Bissau.
  • To analyze seasonal mortality trends stratified by age groups, sex, and time periods.

Main Methods:

  • Utilized data from the Bandim Health Project, a health and demographic surveillance system in Guinea-Bissau, covering children under five from 1990 to 2013.
  • Employed Cox proportional hazards models to compare mortality rates between the rainy and dry seasons, calculating rainy vs. dry season mortality rate ratios (r/d-mrr).
  • Examined seasonal effects across different age strata (<1 month, 1-11 months, 12-59 months) and analyzed causes of death using verbal autopsies interpreted with InterVa-4 software.

Main Results:

  • Overall child mortality declined by nearly two-thirds between 1990 and 2013, yet mortality remained 51% higher in the rainy season compared to the dry season.
  • The disparity in mortality between seasons significantly increased with age: neonates (0.94 r/d-mrr), post-neonatal infants (1.57 r/d-mrr), and children aged 12-59 months (1.83 r/d-mrr).
  • Malaria was identified as the primary contributor to the seasonal mortality difference, accounting for 50% of rainy season deaths, though this finding was dependent on the inclusion of season in the analysis.

Conclusions:

  • Despite an overall decline in child mortality, the rainy season consistently posed a higher risk.
  • The age-dependent increase in seasonal mortality highlights the vulnerability of older infants and young children during the rainy season.
  • Malaria prevention and control strategies are critical for mitigating seasonal child mortality in Guinea-Bissau.
Abstract

Keywords:
Guinea-BissauGuinée-Bissauage groupscausa de muertecause de décèscause of deathchild mortalityestacionesgroupes d’âgegrupos de edadmortalidad infantilmortalité infantilesaisonsseasonssexsexesexo

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