Conclusion

CMR and U5MR were slightly

under emergency thresholds

!! Far higher than levels considered normal

for developing countries

• Measles vaccination rate much lower than

the target set by WHO at 95%

• Usage of ITNs much lower than

the target set by Roll Back Malaria of 60%

• Access to treatment one of the major

problems

Aim

• Assess mortality rates in the catchment area of

the MSF Boguila project

• Assessment of needs in project

• Adaptation of programme activities

Introduction

Central African Republic (CAR) is one

of the poorest countries in the world

MSF has worked in the rural region

of Boguila, northwest part of CAR since 2006.

Project:

Hospital programme

Outpatient department

Health posts

• Main reasons for admission:

• Severe malaria

• Lower respiratory tract infections

• Severe acute diarrhoea

• Recent retrospective mortality surveys

in different prefectures

• All exceeded the emergency threshold

• Mortality had not been assessed in the project area

due to the difficult security situation

Method

Two-stage, cross-sectional survey

18 - 23 April 2012

Interviewing 897 households in 30 clusters

Standardised questionnaire

Demographic information

Mortality data

Information on measles vaccination status

Possession of insecticide-treated

mosquito net (ITN)

Recall period for mortality

322 days from June 1, 2011

= start of the annual cotton sowing activities

The Ethics Review Boards of MSF and of the

MOH in Bangui, CAR, approved the study.

Results

.

Mortality too high for a post-emergency situation

in the Central African Republic

Sibylle Gerstl1, Klaus Lehr2, Till Kinkel3, Philipp du Cros1 1Médecins Sans Frontières, London, UK, 2Médecins Sans Frontières, Boguila, Central African Republic, 3Médecins Sans Frontières,

Berlin, Germany

5 teams of

2 interviewers

conducted interviews

at the site of the

household in the local

languages or French

Study place: Catchment

area of the MSF Boguila

project, Ouham

Prefecture, Central

African Republic, Africa

Acknowledgements

• CAR Ministry of Health

• Field teams of MSF

• Team of local interviewers

• Population who participated in the study

Recommendations

Reinforce the MSF outreach program

Improve populations' access to services

Increase the coverage and quality of

curative and preventive interventions

!! Support of decision-makers and stakeholders

inside and outside the country needed

2

3

1

1.77

0.84

Crude Mortality Rate

Under-5 Mortality Rate

Recall period

139 deaths

61 (43.9%) children <5 years

66% died at home

Most commonly reported

causes/symptoms of death

Malaria/fever

Respiratory infections

Diarrhoea

Sample population: 5322 people

•1204 (23%) children <5 years

22% had measles vaccination with a

vaccination card

31% slept under an ITN the night before

the study

Red line : Emergency threshold for under

5 mortality rate

Blue line: Emergency threshold for crude

mortality rate