Abstract
IntroductionCOVID-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.MethodsDeath 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.ResultsPeaks 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.ConclusionWe 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.
Funder
National Center for Immunization and Respiratory Diseases
Centre for Health and Wellbeing, Princeton University
Institut Pasteur de Madagascar
United States Agency for International Development
Subject
Public Health, Environmental and Occupational Health,Health Policy
Reference40 articles.
1. Excess mortality during the COVID-19 outbreak in Italy: a two-stage interrupted time-series analysis
2. Global, regional, and national trends in Under-5 mortality between 1990 and 2019 with scenario-based projections until 2030: a systematic analysis by the UN inter-agency group for child mortality estimation;Sharrow;Lancet Glob Health,2022
3. Madagascar’s health challenges;Barmania;Lancet,2015
4. Lang E , Saint-Firmin P , Olivett M , et al . Analyse Du Système de Financement de la Santé À Madagascar pour Guider de futures Réfotrmes, Notamment La CSU. Washington, DC. 2018.
5. Epidemiological characteristics of an urban plague epidemic in Madagascar, August–November, 2017: an outbreak report
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