Under-Five Mortality during the Covid-19 Outbreak: Evidence from Four Demographic Surveillance Systems in Low-Income Countries

Julio E. Romero-Prieto , London School of Hygiene and Tropical Medicine (LSHTM)
Andrea Verhulst , Institut National d'Études Démographiques (INED)
Nurul Alam, ICDDR,B
Valérie Delaunay, Institut de Recherche pour le Développement (IRD)
Momodou Jasseh, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine (LSHTM)
Sammy Khagayi, Kenya Medical Research Institute (KEMRI)/CDC Research and Public Health Collaboration
Gilles Pison , Muséum National D'histoire Naturelle
Michel Guillot, University of Pennsylvania & INED
Georges Reniers, London School of Hygiene and Tropical Medicine (LSHTM)

This paper investigates the effect of the epidemic of COVID-19 on under-five mortality in four Health and Demographic Surveillance Systems (HDDS): Siaya-HDSS in Kenya, Basse-HDSS in the Gambia, Niakhar-HDSS in Senegal, and Matlab-HDSS in Bangladesh. Inasmuch as the number of deaths due to COVID-19 is dependent on testing coverage, variations in case definitions, or the performance of health facility-based surveillance, the effect of COVID-19 on under-five mortality is estimated to be indirect, through a measure of excess mortality. We calculate the excess of mortality as the difference between the probabilities of dying in a calendar month affected by the pandemic and a counterfactual estimate that only depends on the secular trend in mortality of each site before the outbreak of COVID-19. We approach to this aim by forecasting the life tables of under-five mortality and quantifying the effects of the epidemic of COVID-19 on the most relevant indicators of mortality from zero to five years (e.g., the neonatal mortality, the post-neonatal mortality, the infant mortality rate, the child mortality rate, and the under-five mortality rate). Preliminary results did not identify any evidence of excess mortality that can be attributed to the COVID-19 outbreak, and these findings would contradict the predictions of earlier simulation studies.

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 Presented in Session 14. COVID-19 mortality across groups and subpopulations