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[The month of birth: a factor of inequality before death].


 African mortality rates are the highest in the world. However, government collected data on mortality rates are "incomplete" because they only reflect a situation among certain sectors of the population for a specific time frame. For example, between 1974-85, infant and child mortality rates in Bamako, Mali were estimated at 200/1000, similar to that of other countries in West Africa, with mortality rates declining for those age 5 due to public health measures and vaccinations. The literature, based on statistical studies, gave the impression that during these 12 years there was a decline in mortality rates in Mali. However, in 1985 there was a measles epidemic and a 2-year dry season precipitating mortality rates unaccounted for during the 1974-85 survey. Infants beyond 1 month of life to age 5 were at highest risk of death, and were 3 times more at risk of dying during the hot months in April and May due to epidemics of measles, diarrhea and meningitis. The vaccination campaign of 1983-84 resulted in incomplete coverage as shown by the 1280 deaths due to the measles epidemic in 1985. The reader must evaluate statistics more critically to fully understand the total situation rather than be mislead by fragmented statistical results.
