Fifty‐year mortality trends in three rural African villages

Abstract

Summaryobjective To determine differential improvements in mortality rates according to age, and to discuss differences in neonatal and post-neonatal mortality rates, using longitudinal data from the past 50 years in three rural Gambian villages. conclusion Our analysis indicates a dramatic reduction in mortality rates and an attenuation in the seasonality of death. It is likely that the efficient implementation of basic currently available health measures was one of the key elements in achieving such a major reduction in mortality.

Determinants of epidemiologic transition in rural Africa: the role of socioeconomic status and drinking water source

“…1,4,6,7,[33][34][35][36] This could be true for our study population, where public health services have improved during the follow-up period. In 2003, a national health insurance was established in Ghana.…”

“…[2][3][4][5] Many developing countries have started to experience a decline in mortality, but also in fertility. 6,7 Contrary to the classical sequential stages described above, these countries suffer from the coexistence of infectious and degenerative diseases, which is denominated as polarisation.…”

Mid-upper arm circumference at age of routine infant vaccination to identify infants at elevated risk of death: a retrospective cohort study in the Gambia

“…According to one study, children born during June to October in the Gambia are at elevated risk of death, 36 although more recent evidence suggests that this effect is waning. 25 We also controlled for decade of birth because, since the data span four decades, we wanted to account for changes in the health system or other temporal effects. We estimated the sensitivities and specificities of MUAC and WFLz and used receiver operating characteristic (ROC) curves to assess their discriminatory ability to predict death by 12 months of age.…”

“…This very low death rate, which has been previously noted in Keneba, is believed to result from direct and indirect exposure to improved health interventions in this DSS setting, where research has been conducted for many years. 25 Thus, the presence of the DSS might have undermined our ability to detect the association between anthropometric measures and survival. It may be impossible to find another prospective cohort for validating MUAC cut-offs, but historical data from older cohorts is feasible and can also serve the purpose.…”

Domestication Alone Does Not Lead to Inequality

“…In 1975, the Dunn Nutrition Unit (DNU) set up a permanent research station and medical clinic in Keneba, the largest village. The clinic had an immediate effect on child mortality rates, while morbidity was less affected (Rayco-Solon et al 2004). Fertility, however, has only recently started to decline, despite the availability of contraception at the clinic.…”