Kliniken & Institute ... Institute Heidelberger Institut... Groups & Projects Working Groups Epidemiology and... Research Maternal and child... Risk factor analysis ...

Risk factors of infant and child mortality in Burkina Faso

Project team:  Heiko Becher, Gael Hammer; Gisela Kynast-Wolf, Robert Ndugwa, Heribert Ramroth,Gabriele Stieglbauer,

Collaborators within the department:  Albrecht Jahn, Olaf Müller

External collaborators:  Bocar Kouyaté, Adjima Gbangou, Mamadou Sanon, Ali Sie, Nouna, Burkina Faso

Funding:  DFG (SFB 544)

The aim of this study was to quantify the effect of risk factors for childhood mortality in a typical rural setting in sub-Saharan Africa. We performed a survival analysis of births within the DSS population in Nouna. All children born alive in the period 1 January 1993 to 31 December 1999 in the study area (n = 10 122) followed-up until 31 December 1999 were included. All-cause childhood mortality was used as outcome variable.

Within the observation time, 1340 deaths were recorded. In a Cox regression model a simultaneous estimation of hazard rate ratios showed death of the mother and being a twin as the strongest risk factors for mortality. For both, the risk was most pronounced in infancy. Further factors associated with mortality include age of the mother, birth spacing, season of birth, village, ethnic group, and distance to the nearest health centre. Finally, there was an overall decrease in childhood mortality over the years 1993-99.

The study supports the multi-causation of childhood deaths in rural West Africa during the 1990s and supports the overall trend, as observed in other studies, of decreasing childhood mortality in these populations. The observed correlation between the factors highlights the need for multivariate analysis to disentangle the separate effects. These findings illustrate the need for more comprehensive improvement of prenatal and postnatal care in rural sub-Saharan Africa.

Publication: [2]