Malaria and urbanization in central Africa: the example of Brazzaville. Part V: Pernicious attacks and mortality.

The current incidence of pernicious attacks and of mortality due to malaria were studied in Brazzaville. The results of this study, which concerned all the medical units of the town, were analysed in terms of previous studies on the epidemiology of malaria transmission in the various districts of the town. It was estimated that the annual incidence of pernicious attacks in children in Brazzaville is 1.15 per thousand between 0 and 4 years, 0.25 per thousand between 5 and 9 years and 0.05 per thousand between 10 and 14 years. The annual mortality due to malaria was estimated at 0.43 per thousand between 0 and 4 years and 0.08 per thousand between 5 and 9 years. These values are about 30 times lower than those expected from the results of previous studies of the mortality due to malaria in intertropical Africa. Whereas considerable differences in intensity of malaria transmission exist in the different districts of Brazzaville, the incidence of pernicious attacks and the resulting mortality are remarkably unvarying whatever the level of transmission. In particular, similar results were observed for the sector Mfilou-Ngamaba-Ngangouoni, where malaria is holoendemic with over 100 infective bites per person per year and a parasite rate of 80.95% in schoolchildren, and the central sector of Poto-Poto-Ouenze-Moungali, where malaria is hypoendemic with less than one infective bite per person every three years and a parasite rate of less than 4% in schoolchildren. These results are discussed in terms of previous observations in urban and surrounding rural areas.(ABSTRACT TRUNCATED AT 250 WORDS)

[Missed vaccination opportunities in Brazzaville]. / Les occasions de vaccination manquées à Brazzaville.

In order to assess the magnitude of missed immunisation opportunities, a study was carried out at ten randomly selected health centres in Brazzaville (Congo). A survey based on interviews at discharge was conducted with 306 mothers or caretakers of children aged under 2 years. The overall rate of missed immunization opportunities was 12.8% for children and 50.6% for women. The reasons most frequently given were illness of the child, misinformation and unavailable vaccines.

[Survey of measles vaccine coverage in Brazzaville]. / Enquête de couverture vaccinale sur la rougeole à Brazzaville.

Measles is an infectious disease that continues to be a significant cause of morbidity and mortality among children in Brazzaville. A measles vaccination coverage survey was conducted for children aged 9 to 23 months. A standard EPI cluster sample was applied in two areas: urban and peri-urban. Measles coverage of children after the vaccination campaign according to history ranged from 36.6% in urban to 38.6% in peri-urban areas, compared with 34.5 and 42.8% for routine vaccination in the same areas. The overall rate of measles coverage was 75.4%. The mean age of children was 46 weeks.

[Risk factors of intrauterine growth retardation in Congo]. / Facteurs de risque de retard de croissance intra-utérin au Congo.

A case-control study was performed between April 1st and September 30th to investigate determinants of intrauterine growth retardation (IUGR) in 3 centers in Brazzaville, Congo. Each patient group included 539 neonates. Cases were newborns with birth weight below the 10th percentile of the Leroy and Lefort curve. Risk factors of IUGR identified with univariate analysis were: maternal age<20 years, low educational level, unmarried woman, low social and economic status, primiparity, low birthweight of previous child, low interpregnancy interval, number of prenatal examinations<4, maternal weight gain during pregnancy<5kg and malaria. Multivariate analysis retained 3 risk factors: low educational level, low social and economic status, and maternal weight gain during pregnancy<5kg. This study enabled us to identify certain risk factors of IUGR useful for establishing a prevention strategy.