Benjamin Schluter, Masquelier Bruno
(DEMO/UCLouvain)
Metcalf Jessica, Anjarasoa Rasoanomenjanahary
Changes in the seasonality of death in Antananarivo (Madagascar) and implications for health planning
Seasonal patterns of mortality have been identified in Sub-Saharan Africa but their changes over time are not well documented. Based on death notification data from Antananarivo, the capital city of Madagascar, this study assesses seasonal patterns of all-cause and cause- specific mortality by age groups and evaluates how these patterns changed over the period 1976-2015. Using Generalized Additive Mixed regression models (GAMM) we find that among children, risks of dying were the highest during the hot and rainy season, but seasonality in child mortality has significantly declined since the mid-1970s, driven by declines in the burden of infectious diseases and nutritional deficiencies. In adults aged 60 and above, all-cause mortality rates are the highest in the dry and cold season, due to peaks in cardiovascular diseases, with little change over time. Overall, shifts in disease patterns brought about by the epidemiological transition, rather than changes in seasonal variation in cause-specific mortality, are the main drivers of trends in the seasonality of all-cause mortality.