Assessing the role of interventions and climate on malaria mortality among children under five years of age

Insights from two decades of data from the Health Demographic Surveillance System of Nouna, Burkina Faso

Bibliographic Data

ID19550294
AuthorsNafissatou Traoré (0009-0007-2816-1905, Swiss Tropical and Public Health Institute), Pascal Zabre (0000-0002-7257-9192, Centre de Recherche en Santé de Nouna), Ourohiré Millogo (0000-0002-2552-8122, Centre National de la Recherche Scientifique et Technologique), Ali Sié (0000-0002-3959-2520, Centre de Recherche en Santé de Nouna), Penelope Vounatsou (0000-0002-4904-5352, Swiss Tropical and Public Health Institute, Allschwil, Switzerland)
Year2026
Volume16
Pages04080-04080
Publication date2026-04-03
Open AccessYes
TypeARTICLE
VenueJournal of Global Health (JOURNAL)
Journal identifiersISSN: 2047-2978 • E-ISSN: 2047-2986
PublisherInternational Society of Global Health (PUBLISHER • GB)
DOI10.7189/jogh.16.04080
PMID41926164
OpenAlexW7148562224
LanguageEN
References cited52

Background: Malaria is a preventable disease that causes serious illness and death. In 2022, it remained the leading cause of death among children under five years of age in Burkina Faso, despite significant intervention efforts over the past two decades. Research on the effects of interventions and climatic factors on malaria morbidity has expanded, but their effects on malaria mortality remain unclear. We aimed to estimate the effects of interventions and lagged climatic factors on malaria mortality among children under five years of age in northwest Burkina Faso. We further evaluated the role of climatic seasonality in patterns of malaria mortality. Methods: We investigated the seasonal patterns of malaria mortality among children under five years of age and their association with climatic factors, such as rainfall and land surface temperature (LST), using wavelet analysis on mortality data from the Nouna Health Demographic Surveillance System spanning 2002-2021. Furthermore, we assessed the effects of interventions, including coverage of insecticide-treated nets (ITNs) and artemisinin-based combination therapies (ACTs), on malaria mortality alongside climate effects using Bayesian negative binomial temporal models for the period 2013-2021. Results: The lag time in the effects of climatic factors varied over time. Malaria mortality, rainfall, and LST showed a 12-month seasonal cycle throughout the years, while LST also had a six-month cycle in specific years. Rainfall lagged by 1.5 to 2 months and LST by 1 to 1.5 months, depending on the seasonal cycle and year. Rainfall was positively associated with malaria mortality (mortality rate ratio (MRR) = 1.59; 95% Bayesian credible interval (BCI) = 1.18, 1.95), LST showed a decrease in mortality (MRR = 0.68; 95% BCI = 0.52, 0.86), and ITN was associated with a reduction in mortality (MRR = 0.59; 95% BCI = 0.42, 0.79); however, ACT was not statistically important. Conclusions: We found that ITN was more effective in reducing malaria mortality than temperature, but rainfall had a greater opposing impact on increasing malaria mortality. The seasonal mortality pattern was more influenced by rainfall than by temperature. Varying climatic lag times highlight the need for adaptive strategies. Policymakers should focus on climate-informed planning, sustained ITN coverage, and reassessment of ACT strategies to further reduce malaria mortality

Child mortality · Malaria · Mortality rate · Psychological intervention · Public health interventions · Public health surveillance · Climate Change and Health Impacts · Malaria Research and Control · Mosquito-borne diseases and control

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