This survey was carried out on a cohort of children born between 1st January 1981 and 30th June 1987 in the maternity department of the hospital in Linzolo, a village situated 25 km south-west of Brazzaville, the capital of the Congo. The mothers of the children resided in the suburbs of Brazzaville at the time of delivery. In this region, the rate of transmission of Plasmodium falciparum malaria is high without marked seasonable variations. The mothers and children were traced in the second quarter of 1989 in order to assess the rates and, where possible, the causes of mortality. Information on 75% of the recorded births (2424 children) was obtained directly by interviewing the mothers in the home. Between 1981 and 1988, the infant mortality rate varied overall between 33 and 52 per thousand, and in the 1-2 year age group, between 7 and 25 per thousand (1981 to 1987). The number of deaths attributable to malaria was relatively low although resistance to amino-4-quinolone is well established since 1985. During this period, no particular trend was observed in the mortality at 0-2 years, or at 0-5 years.
PIP: The aim of this research was to document the incidence of malaria and infant and child mortality among children residing in suburban areas of Brazzaville, the Congo, which are known for a high transmission of malaria. The study population included all children born between January 1, 1981, and June 30, 1987, in the maternity department of Linzolo Hospital and whose mothers resided in Brazzaville at the time of delivery. Interviews were conducted with 2424 mothers who were traced to the present homes during the second quarter of 1989. Information on 75% of the recorded births in the region was obtained directly from mothers. On the average, 21-29% of families had migrated or had an incorrect address each year. The results yielded rates of infant mortality of 33-52/1000 for children born during 1981-87. There were similar rates of mortality for children aged 1-2 years and 0-5 years. Not only was there low mortality, but there was low malaria mortality. These rates were less than the estimated rates for an urban area of Brazzaville of 69/1000 in 1980 and 57/1000 in 1984. Rural rates around Brazzaville were 62/1000 in 1984. Low malaria mortality rates were found in 1983; i.e., .43/1000 among 0-4 year olds and .08/1000 in the 5-9 year old age group. Rates did not appear to vary by district. Malaria rates are considered low for sub-Saharan Africa. This is attributed to access to drugs such as amino-4-quinoline. a more recent study of malaria mortality in Brazzaville, with lower transmission levels, showed a slight increase, which may be due to lower drug sensitivity to amino-4-quinoline for combating the local strains of P. falciparum. This pattern of drug resistance was observed in Kinshasa, Zaire. There would appear to be a high level of malaria immunity and early treatment of malaria fever in suburban areas of Brazzaville.