title: Season of birth is not associated with delayed childhood mortality in Upper River Division, The Gambia.
abstract: There is evidence that season of birth may predict adult mortality from infectious diseases in rural Gambia. Using data collected over a five-year period from the rural, eastern region of the Gambia, we examined whether the season of birth influences mortality in childhood. 26 894 births and 3776 deaths among children under the age of five years were recorded in this region during the period 1989-1993. The estimated 1-4 year population was 95 355. In children aged 1-4 years, the mortality rate per 1000 per year was 16.1 (95% CI 14.9, 17.2) for those born in the 'harvest' season (January to June), which was not significantly different from the rate of 17.9 (95% CI 16.7, 19.0) recorded for those born in the 'hungry' season (July to December) (age-stratified Mantel-Haenszel mortality ratio 0. 91, 95% CI 0.83, 1.01; p = 0.08). Nearly all deaths of 1-4 year olds were attributed to infectious diseases, with malaria accounting for over 40%. None of the cause-specific child mortality rates differed significantly according to the season of birth. These data suggest that beyond infancy, when it is easier to separate the effect of season on cause of death from that of the season of birth, there is no marked difference in the rate of death between Gambian children born in the harvest season and those born in the hungry season.
authors.affiliation: Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. shabbar.jaffar@lshtm.ac.uk
authors.forename: S
authors.initials: S
authors.lastname: Jaffar
authors.forename: A
authors.initials: A
authors.lastname: Leach
authors.forename: A
authors.initials: A
authors.lastname: Greenwood
authors.forename: B
authors.initials: B
authors.lastname: Greenwood
mesh_terms: D001723:Birth Rate; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000401:mortality; D005714:Gambia / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D009026:Mortality; D011159:Population Surveillance; D012423:Rural Health; D012621:Seasons; D011795:Surveys and Questionnaires