Excess mortality associated with the COVID-19 pandemic during the 2020 and 2021 waves in Antananarivo, Madagascar.

Autor:	Rabarison JH; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Rakotondramanga JM; Institut Pasteur de Madagascar, Antananarivo, Madagascar.; UMMISCO, Bondy, France., Ratovoson R; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Masquelier B; Universite Catholique de Louvain Centre de recherche en demographie et societes, Louvain la neuve, Belgium., Rasoanomenjanahary AM; Bureau Municipal d'Hygiène, Commune Urbaine d'Antananarivo, Antananarivo, Madagascar., Dreyfus A; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Garchitorena A; Institut Pasteur de Madagascar, Antananarivo, Madagascar.; UMR 224 MIVEGEC, IRD, Montpellier, France., Rasambainarivo F; Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, USA.; Mahaliana Labs SARL, Antananarivo, Madagascar., Razanajatovo NH; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Andriamandimby SF; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Metcalf CJ; Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, USA., Lacoste V; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Heraud JM; Institut Pasteur de Madagascar, Antananarivo, Madagascar jean-michel.heraud@pasteur.fr.; Institut Pasteur de Dakar, Dakar, Senegal., Dussart P; Institut Pasteur de Madagascar, Antananarivo, Madagascar.
Jazyk:	angličtina
Zdroj:	BMJ global health [BMJ Glob Health] 2023 Jul; Vol. 8 (7).
DOI:	10.1136/bmjgh-2023-011801
Abstrakt:	Introduction: COVID-19-associated mortality remains difficult to estimate in sub-Saharan Africa because of the lack of comprehensive systems of death registration. Based on death registers referring to the capital city of Madagascar, we sought to estimate the excess mortality during the COVID-19 pandemic and calculate the loss of life expectancy. Methods: Death records between 2016 and 2021 were used to estimate weekly excess mortality during the pandemic period. To infer its synchrony with circulation of SARS-CoV-2, a cross-wavelet analysis was performed. Life expectancy loss due to the COVID-19 pandemic was calculated by projecting mortality rates using the Lee and Carter model and extrapolating the prepandemic trends (1990-2019). Differences in life expectancy at birth were disaggregated by cause of death. Results: Peaks of excess mortality in 2020-21 were associated with waves of COVID-19. Estimates of all-cause excess mortality were 38.5 and 64.9 per 100 000 inhabitants in 2020 and 2021, respectively, with excess mortality reaching ≥50% over 6 weeks. In 2021, we quantified a drop of 0.8 and 1.0 years in the life expectancy for men and women, respectively attributable to increased risks of death beyond the age of 60 years. Conclusion: We observed high excess mortality during the pandemic period, in particular around the peaks of SARS-CoV-2 circulation in Antananarivo. Our study highlights the need to implement death registration systems in low-income countries to document true toll of a pandemic. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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