title: Decreasing child mortality, spatial clustering and decreasing disparity in North-Western Burkina Faso.
abstract: Within relatively small areas, there exist high spatial variations of mortality between villages. In rural Burkina Faso, with data from 1993 to 1998, clusters of particularly high child mortality were identified in the population of the Nouna Health and Demographic Surveillance System (HDSS), a member of the INDEPTH Network. In this paper, we report child mortality with respect to temporal trends, spatial clustering and disparity in this HDSS from 1993 to 2012. Poisson regression was used to describe village-specific child mortality rates and time trends in mortality. The spatial scan statistic was used to identify villages or village clusters with higher child mortality. Clustering of mortality in the area is still present, but not as strong as before. The disparity of child mortality between villages has decreased. The decrease occurred in the context of an overall halving of child mortality in the rural area of Nouna HDSS between 1993 and 2012. Extrapolated to the Millennium Development Goals target period 1990-2015, this yields an estimated reduction of 54%, which is not too far off the aim of a two-thirds reduction.
authors.affiliation: Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.|Institute of Public Health, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Heiko
authors.initials: H
authors.lastname: Becher
authors.affiliation: Institute of Public Health, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Olaf
authors.initials: O
authors.lastname: Müller
authors.affiliation: Institute of Public Health, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Dambach
authors.affiliation: Institute of Public Health, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Gabrysch
authors.affiliation: Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso.
authors.forename: Louis
authors.initials: L
authors.lastname: Niamba
authors.affiliation: Institute of Public Health, University Hospital Heidelberg, Heidelberg, Germany.|INDEPTH Network, Accra, Ghana.|School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.|Faculty of Public Health, Hanoi Medical School, Hanoi, Vietnam.
authors.forename: Osman
authors.initials: O
authors.lastname: Sankoh
authors.affiliation: Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso.
authors.forename: Seraphin
authors.initials: S
authors.lastname: Simboro
authors.affiliation: Institute of Public Health, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Schoeps
authors.affiliation: Institute of Public Health, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Stieglbauer
authors.affiliation: ICF International, Rockville, MD, USA.
authors.forename: Yazoume
authors.initials: Y
authors.lastname: Yé
authors.affiliation: Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso.
authors.forename: Ali
authors.initials: A
authors.lastname: Sié
mesh_terms: D002050:Burkina Faso / Q000453:epidemiology; D046688:Child Mortality / Q000639:trends*; D002675:Child, Preschool; D016000:Cluster Analysis; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D066088:Infant Death; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D066087:Perinatal Death; D054238:Perinatal Mortality / Q000639:trends*; D011159:Population Surveillance; D012111:Residence Characteristics; D012424:Rural Population
keywords: Africa; Afrique; child mortality; clustering; conglomerados; epidemiology; epidemiología; mortalidad infantil; mortalité infantile; regroupement; tendance; tendencia; trend; África; épidémiologie