Malaria mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites.
BACKGROUND
Malaria continues to be a major cause of infectious disease mortality in tropical regions. However, deaths from malaria are most often not individually documented, and as a result overall understanding of malaria epidemiology is inadequate. INDEPTH Network members maintain population surveillance in Health and Demographic Surveillance System sites across Africa and Asia, in which individual deaths are followed up with verbal autopsies.


OBJECTIVE
To present patterns of malaria mortality determined by verbal autopsy from INDEPTH sites across Africa and Asia, comparing these findings with other relevant information on malaria in the same regions.


METHODS
From a database covering 111,910 deaths over 12,204,043 person-years in 22 sites, in which verbal autopsy data were handled according to the WHO 2012 standard and processed using the InterVA-4 model, over 6,000 deaths were attributed to malaria. The overall period covered was 1992-2012, but two-thirds of the observations related to 2006-2012. These deaths were analysed by site, time period, age group and sex to investigate epidemiological differences in malaria mortality.


RESULTS
Rates of malaria mortality varied by 1:10,000 across the sites, with generally low rates in Asia (one site recording no malaria deaths over 0.5 million person-years) and some of the highest rates in West Africa (Nouna, Burkina Faso: 2.47 per 1,000 person-years). Childhood malaria mortality rates were strongly correlated with Malaria Atlas Project estimates of Plasmodium falciparum parasite rates for the same locations. Adult malaria mortality rates, while lower than corresponding childhood rates, were strongly correlated with childhood rates at the site level.


CONCLUSIONS
The wide variations observed in malaria mortality, which were nevertheless consistent with various other estimates, suggest that population-based registration of deaths using verbal autopsy is a useful approach to understanding the details of malaria epidemiology.
Matlab HDSS, Bangladesh; International Centre for Diarrhoeal Disease Research, Bangladesh; INDEPTH Network, Accra, Ghana.
P Kim
PK
Streatfield
International Centre for Diarrhoeal Disease Research, Bangladesh; INDEPTH Network, Accra, Ghana; Bandarban HDSS, Bangladesh.
Wasif A
WA
Khan
INDEPTH Network, Accra, Ghana; Chakaria HDSS, Bangladesh; Centre for Equity and Health Systems, International Centre for Diarrhoeal Disease Research, Bangladesh.
Abbas
A
Bhuiya
INDEPTH Network, Accra, Ghana; Chakaria HDSS, Bangladesh; Centre for Equity and Health Systems, International Centre for Diarrhoeal Disease Research, Bangladesh.
Syed M A
SM
Hanifi
INDEPTH Network, Accra, Ghana; AMK HDSS, Bangladesh; Centre for Population, Urbanisation and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh.
Nurul
N
Alam
INDEPTH Network, Accra, Ghana; Nouna HDSS, Burkina Faso; Nouna Health Research Centre, Nouna, Burkina Faso.
Eric
E
Diboulo
INDEPTH Network, Accra, Ghana; Nouna HDSS, Burkina Faso; Nouna Health Research Centre, Nouna, Burkina Faso.
Ali
A
Sié
INDEPTH Network, Accra, Ghana; Nouna HDSS, Burkina Faso; Nouna Health Research Centre, Nouna, Burkina Faso.
Maurice
M
Yé
INDEPTH Network, Accra, Ghana; Ouagadougou HDSS, Burkina Faso; Institut Supérieur des Sciences de la Population, Université de Ouagadougou, Burkina Faso.
Yacouba
Y
Compaoré
INDEPTH Network, Accra, Ghana; Ouagadougou HDSS, Burkina Faso; Institut Supérieur des Sciences de la Population, Université de Ouagadougou, Burkina Faso.
Abdramane B
AB
Soura
INDEPTH Network, Accra, Ghana; Taabo HDSS, Côte d'Ivoire; , Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
Bassirou
B
Bonfoh
INDEPTH Network, Accra, Ghana; Taabo HDSS, Côte d'Ivoire; Swiss Tropical and Public Health Institute, Basel, Switzerland.
Fabienne
F
Jaeger
INDEPTH Network, Accra, Ghana; Taabo HDSS, Côte d'Ivoire; Université Félix Houphoët-Boigny, Abidjan, Côte d'Ivoire.
Eliezer K
EK
Ngoran
INDEPTH Network, Accra, Ghana; Taabo HDSS, Côte d'Ivoire; Swiss Tropical and Public Health Institute, Basel, Switzerland.
Juerg
J
Utzinger
INDEPTH Network, Accra, Ghana; Kilite-Awlaelo HDSS, Ethiopia; Department of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Yohannes A
YA
Melaku
INDEPTH Network, Accra, Ghana; Kilite-Awlaelo HDSS, Ethiopia; Department of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Afework
A
Mulugeta
INDEPTH Network, Accra, Ghana; Kilite-Awlaelo HDSS, Ethiopia; Department of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Berhe
B
Weldearegawi
INDEPTH Network, Accra, Ghana; Farafenni HDSS, The Gambia; Medical Research Council, The Gambia Unit, Fajara, The Gambia.
Pierre
P
Gomez
INDEPTH Network, Accra, Ghana; Farafenni HDSS, The Gambia; Medical Research Council, The Gambia Unit, Fajara, The Gambia.
Momodou
M
Jasseh
INDEPTH Network, Accra, Ghana; Navrongo HDSS, Ghana; Navrongo Health Research Centre, Navrongo, Ghana.
Abraham
A
Hodgson
INDEPTH Network, Accra, Ghana; Navrongo HDSS, Ghana; Navrongo Health Research Centre, Navrongo, Ghana.
Abraham
A
Oduro
INDEPTH Network, Accra, Ghana; Navrongo HDSS, Ghana; Navrongo Health Research Centre, Navrongo, Ghana.
Paul
P
Welaga
INDEPTH Network, Accra, Ghana; Navrongo HDSS, Ghana; Navrongo Health Research Centre, Navrongo, Ghana.
John
J
Williams
INDEPTH Network, Accra, Ghana; Dodowa HDSS, Ghana; Dodowa Health Research Centre, Dodowa, Ghana; School of Public Health, University of Ghana, Legon, Ghana.
Elizabeth
E
Awini
INDEPTH Network, Accra, Ghana; Dodowa HDSS, Ghana; School of Public Health, University of Ghana, Legon, Ghana.
Fred N
FN
Binka
INDEPTH Network, Accra, Ghana; Dodowa HDSS, Ghana; School of Public Health, University of Ghana, Legon, Ghana.
Margaret
M
Gyapong
INDEPTH Network, Accra, Ghana; Ballabgarh HDSS, India; All India Institute of Medical Sciences, New Delhi, India.
Shashi
S
Kant
INDEPTH Network, Accra, Ghana; Ballabgarh HDSS, India; All India Institute of Medical Sciences, New Delhi, India.
Puneet
P
Misra
INDEPTH Network, Accra, Ghana; Ballabgarh HDSS, India; All India Institute of Medical Sciences, New Delhi, India.
Rahul
R
Srivastava
INDEPTH Network, Accra, Ghana; Vadu HDSS, India; Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India.
Bharat
B
Chaudhary
INDEPTH Network, Accra, Ghana; Vadu HDSS, India; Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India.
Sanjay
S
Juvekar
INDEPTH Network, Accra, Ghana; Purworejo HDSS, Indonesia; Department of Public Health, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Abdul
A
Wahab
INDEPTH Network, Accra, Ghana; Purworejo HDSS, Indonesia; Department of Public Health, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Siswanto
S
Wilopo
INDEPTH Network, Accra, Ghana; Kilifi HDSS, Kenya; KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
Evasius
E
Bauni
INDEPTH Network, Accra, Ghana; Kilifi HDSS, Kenya; KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
George
G
Mochamah
INDEPTH Network, Accra, Ghana; Kilifi HDSS, Kenya; KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
Carolyne
C
Ndila
INDEPTH Network, Accra, Ghana; Kilifi HDSS, Kenya; KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Medicine, Imperial College, St. Mary's Hospital, London.
Thomas N
TN
Williams
Meghna
M
Desai
INDEPTH Network, Accra, Ghana; Kisumu HDSS, Kenya; KEMRI/CDC Research and Public Health Collaboration and KEMRI Center for Global Health Research, Kisumu, Kenya.
Mary J
MJ
Hamel
INDEPTH Network, Accra, Ghana; Kisumu HDSS, Kenya; KEMRI/CDC Research and Public Health Collaboration and KEMRI Center for Global Health Research, Kisumu, Kenya.
Kim A
KA
Lindblade
INDEPTH Network, Accra, Ghana; Kisumu HDSS, Kenya; KEMRI/CDC Research and Public Health Collaboration and KEMRI Center for Global Health Research, Kisumu, Kenya.
Frank O
FO
Odhiambo
INDEPTH Network, Accra, Ghana; Kisumu HDSS, Kenya; KEMRI/CDC Research and Public Health Collaboration and KEMRI Center for Global Health Research, Kisumu, Kenya.
Laurence
L
Slutsker
INDEPTH Network, Accra, Ghana; Nairobi HDSS, Kenya; African Population and Health Research Center, Nairobi, Kenya.
Alex
A
Ezeh
INDEPTH Network, Accra, Ghana; Nairobi HDSS, Kenya; African Population and Health Research Center, Nairobi, Kenya.
Catherine
C
Kyobutungi
INDEPTH Network, Accra, Ghana; Nairobi HDSS, Kenya; African Population and Health Research Center, Nairobi, Kenya.
Marylene
M
Wamukoya
INDEPTH Network, Accra, Ghana; Niakhar HDSS, Senegal; Institut de Recherche pour le Developpement (IRD), Dakar, Sénégal.
Valérie
V
Delaunay
INDEPTH Network, Accra, Ghana; Niakhar HDSS, Senegal; Institut de Recherche pour le Developpement (IRD), Dakar, Sénégal.
Aldiouma
A
Diallo
INDEPTH Network, Accra, Ghana; Niakhar HDSS, Senegal; Institut de Recherche pour le Developpement (IRD), Dakar, Sénégal.
Laetitia
L
Douillot
INDEPTH Network, Accra, Ghana; Niakhar HDSS, Senegal; Institut de Recherche pour le Developpement (IRD), Dakar, Sénégal.
Cheikh
C
Sokhna
INDEPTH Network, Accra, Ghana; Agincourt HDSS, South Africa; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
F Xavier
FX
Gómez-Olivé
INDEPTH Network, Accra, Ghana; Agincourt HDSS, South Africa; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Chodziwadziwa W
CW
Kabudula
INDEPTH Network, Accra, Ghana; Agincourt HDSS, South Africa; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Paul
P
Mee
INDEPTH Network, Accra, Ghana; Africa Centre HDSS, South Africa; Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, KwaZulu-Natal, South Africa.
Kobus
K
Herbst
INDEPTH Network, Accra, Ghana; Africa Centre HDSS, South Africa; Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, KwaZulu-Natal, South Africa; National Health Laboratory, Surveillance & Epidemiology of Infectious Diseases, Dudelange, Luxembourg.
Joël
J
Mossong
INDEPTH Network, Accra, Ghana; FilaBavi HDSS, Vietnam; Health System Research, Hanoi Medical University, Hanoi, Vietnam.
Nguyen T K
NT
Chuc
INDEPTH Network, Accra, Ghana.
Samuelina S
SS
Arthur
INDEPTH Network, Accra, Ghana; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Hanoi Medical University, Hanoi, Vietnam; osman.sankoh@indepth-network.org.
Osman A
OA
Sankoh
WHO Collaborating Centre for Verbal Autopsy, Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden.
Marcel
M
Tanner
MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Peter
P
Byass
D000293:Adolescent; D000328:Adult; D000349:Africa / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia / Q000453:epidemiology; D001344:Autopsy; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003625:Data Collection / Q000592:standards*; D016208:Databases, Factual; D003710:Demography; D005260:Female; D006801:Humans; D007223:Infant; D008288:Malaria / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance
Africa; Asia; INDEPTH Network; InterVA; malaria; mortality; verbal autopsy