[Mortality and morbidity at young ages in a stable hyperendemic malaria region, community Nyanza-Lac, Imbo South, Burundi].

Abstract

A malaria control programme based on the extensive use of impregnated bednets is planned in an stable hyperendemic malaria area in Burundi (Nyanza-Lac district) where the average number of infective bites per person per year was 312 during the preintervention period. In order to be able to evaluate in depth this important intervention, vital events such as mortality and morbidity were studied in under five-year-old-children during a full year period between June 1990 and May 1991 before the intervention. Village reporters have visited every three weeks 1,200 randomly selected households and completed specific mortality and morbidity questionnaires (prevalence and incidence with a 7 day recall period) adapted from "MRC" questionnaires in the Gambia. Infant and child mortality rates were respectively 108 and 24/1000/y. The definition of a malaria death was based on the opinion of 2 physicians (by consensus) and on the following symptoms alone or in combination: fever < 8 days, convulsions or unconsciousness in the absence of symptoms suggesting an alternative diagnosis. According to this previous definition, malaria was responsible for more than 30% of mortality in under five-year-old-children (specific mortality rate 0-4 year: 14.4/1000/y; specific rate 0-1 year: 38/1000/y; specific rate 1-4 year: 8/1000/y). Diarrhoea (8.1/1000/y) and respiratory tract infections (6.0/1000/y) were respectively the second and third major causes of death. Malaria was also the first cause of morbidity with a yearly average incidence rate of 1.17/person in children under 5 years. Malaria morbidity incidence was highest in children aged 1-2 years (1.79 malaria episodes/person/y).(ABSTRACT TRUNCATED AT 250 WORDS)