Decline of infant and child mortality rates in rural Senegal over a 37-year period (1963-1999)
Decline of infant and child mortality rates in rural Senegal over a 37-year period (1963-1999)
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DOI：
10.1093/ije/30.6.1286
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发表时间：
2001-12-01
影响因子：
7.7
通讯作者：
Simondon, F
中科院分区：
文献类型：
--
作者：
Delaunay, V;Etard, JF;Simondon, F
背景：尽管有改善的趋势，撒哈拉以南非洲农村地区的儿童死亡率仍然很高，最近在一些国家还有所上升。由于缺乏数据，与儿童死亡率长期下降有关的因素鲜为人知。方法自1963年起对塞内加尔农村人口进行人口监测。对不同时期的婴儿和5岁以下儿童死亡率进行了计算，以得出儿童死亡率的长期趋势。观察了年龄的演变和死亡的季节模式。在观察期间（1963年至1999年），婴儿和5岁以下儿童死亡率分别从223‰下降到80‰和485‰下降到213‰，自1960年代以来，死亡概率以每年不变的速度下降（分别下降3.7%和3.1%）。5岁以下儿童死亡率的年龄格局发生了巨大变化，6至24个月的死亡率大幅下降（从千分之321下降到千分之321）。降到千分之87)。这种变化发生在20世纪70年代。季节性变化的特点是雨季死亡的比例较大，这种变化在1960年代非常明显，然后在1980年代减少，但在1990年代有再次增加的趋势，特别是在1-4岁的儿童中。结论本研究证实了西非农村儿童死亡率下降的长期趋势。关于卫生保健发展的历史知识表明，免疫接种有助于减少和改变年龄模式。疟疾的再次出现似乎是最近季节性变化反弹的最可能解释。对免疫和疟疾的关注应继续成为优先事项。
Background In spite of an improving trend, childhood mortality in rural sub-Saharan Africa remains high and has recently risen in some countries. The factors associated with the long-term decline in childhood mortality are poorly known, due to a lack of data.Methods A Senegalese rural population has been under demographic surveillance since 1963. Infant and under-5 mortality rates were calculated for different periods to generate a long-term trend in childhood mortality. Evolution of age and seasonal patterns of mortality were observed.Findings During the observation period (1963-1999), infant and under-5 mortality rates decreased from 223parts per thousand to 80parts per thousand and 485parts per thousand to 213parts per thousand, respectively, with a constant annual rate of decline in the probability of dying since the 1960s (-3.7% and-3.1%, respectively). The age pattern of the under-5 mortality changed drastically, with a large decrease in the death rate between 6 and 24 months of age (from 321parts per thousand. to 87parts per thousand). This Change took place during the 1970s. The seasonal variation, characterized by a greater proportion of deaths during the rainy season, was very marked during the 1960s, then decreased during the 1980s but it has tended to increase again in the 1990s, particularly among children 1-4 years old.Conclusion This study confirms the long-term trend of decrease in child mortality in rural West Africa. Historical knowledge on healthcare developments suggests that immunizations have, contributed to the decrease and the change in the age pattern. The re-emergence of malaria seems the most likely explanation for the recent rebound in seasonal variation. Attention to immunization and malaria should continue to be a priority.