title: Seasonal and temporal trends in all-cause and malaria mortality in rural Burkina Faso, 1998-2007.
abstract: BACKGROUND
  High mortality levels in sub-Saharan Africa are still a major public health problem. Children are the most affected group with malaria as one of the major causes of death in this region. To plan health interventions, reliable empirical information on cause-specific mortality patterns is essential, yet such data are often not available in developing countries. Health and Demographic Surveillance Systems (HDSS) implementing the verbal autopsy (VA) method provide such data on a longitudinal basis. Physician Coded VA is usually used to determine cause of death, but recently a computerized method, Interpreting VA (InterVA) was alternatively introduced. This study investigates the effect of season on all-cause and malaria mortality analysing cause of death data from 1998 to 2007 obtained by the Nouna HDSS in rural Burkina Faso and derived by InterVA.
  
  
  METHODS
  Monthly mortality rates were calculated for different age groups (infants, children, adolescents, adults, elderly). Seasonal and temporal trends were modelled with parametric Poisson regression adjusted for sex, area of residence and year of death.
  
  
  RESULTS
  Overall, 7,378 deaths occurred corresponding to a mortality rate of 11.9/1,000 with highest rates in infants (56.8/1,000) and children (22.0/1,000). Young children were most affected by malaria. Malaria mortality patterns in children showed significantly higher rates during the rainy season and a stagnant long-term trend. The seasonal trend is well described parametrically with a sinusoidal function. InterVA assigned about half as many deaths to malaria than physicians.
  
  
  CONCLUSIONS
  Malaria mortality remains highly seasonal in rural Burkina Faso. The InterVA method appears to determine reasonably well seasonal mortality patterns, which should be considered for the planning of health resources and activities.
authors.affiliation: Institute of Public Health, University of Heidelberg, Heidelberg, Germany. eotteimkampe@yahoo.com.|London School of Hygiene and Tropical Medicine, London, UK. eotteimkampe@yahoo.com.
authors.forename: Eveline
authors.initials: E
authors.lastname: Otte im Kampe
authors.affiliation: Institute of Public Health, University of Heidelberg, Heidelberg, Germany. olaf.mueller@urz.uni-heidelberg.de.
authors.forename: Olaf
authors.initials: O
authors.lastname: Müller
authors.affiliation: Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso. sieali@yahoo.fr.
authors.forename: Ali
authors.initials: A
authors.lastname: Sie
authors.affiliation: Institute of Public Health, University of Heidelberg, Heidelberg, Germany. h.becher@uke.de.|Institute for Medical Biometry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. h.becher@uke.de.
authors.forename: Heiko
authors.initials: H
authors.lastname: Becher
mesh_terms: D000293:Adolescent; D000328:Adult; D002050:Burkina Faso / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008288:Malaria / Q000453:epidemiology* / Q000401:mortality*; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data*; D012621:Seasons; D055815:Young Adult