ArticleBMJ global health2023
Excess mortality associated with the COVID-19 pandemic during the 2020 and 2021 waves in Antananarivo, Madagascar.
Article in BMJ global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Excess mortality during the COVID-19 pandemic in low-and lower-middle-income countries: a systematic review and meta-analysis.BMC public health · 2024Pooled it
- Pandemic-associated disruption of seasonal mortality patterns in Lusaka, Zambia.BMJ global health · 2026Observational
- The impact of El Niño-Southern Oscillation on the incidence of infectious diarrhea in China: insights from a 15-year national surveillance analysis.Frontiers in public health · 2026Article
- Rethinking the evidence on COVID-19 in Africa.The Lancet. Infectious diseases · 2025Review
- Identifying climatic drivers of respiratory syncytial virus (RSV) seasonality in Antananarivo, Madagascar, 2011-2021: a sentinel surveillance study.BMJ public health · 2024Article
- The Re-Emergence of Rift Valley Fever in Mananjary District, Madagascar in 2021: A Call for Action.Pathogens (Basel, Switzerland) · 2024Article
- High SARS-CoV-2 seroincidence but low excess COVID mortality in Sierra Leone in 2020-2022.PLOS global public health · 2024Article
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14 authors.
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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.
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