The Excess Mortality of Twins Compared to Singletons from Birth to Age 5 in Sub-Saharan Africa: Analysis of Health and Demographic Surveillance Systems (Hdss)' Data

Adama Ouedraogo, Université de Versailles – Saint-Quentin-en-Yvelines (UVSQ)
Gilles Pison , Muséum National D'histoire Naturelle
Abdramane Soura, Université de Ouagadougou
Sophie Le Coeur, Institut National d'Études Démographiques (INED)
Valérie Delaunay, Institut de Recherche pour le Développement (IRD)
Ane Fisker, Statens Serum Institut
Kassoum Dianou, Catholic University of Louvain (UCLouvain) and Joseph Ki-Zerbo University (UJKZ)

Twin children have a higher mortality rate than singleton children. This situation is all the more worrying in countries in Sub-Saharan Africa, where mortality is already at higher levels than anywhere else. This makes twin health an additional public health challenge on the continent. In this work, we are making a complementary contribution to all existing ones, but by mobilizing other types of data less commonly used to analyse twin over-mortality: longitudinal data from about 21 HDSSs. It compares survival curves between twins and singletons over the period 2010-2014, presents the evolution over time (from 1995 to 2014) of these curves and it determines the age at which a difference in mortality rates between twins and singletons could be maintained. It also studies the factors associated with the survival differential between under 5 twins and singletons. The results obtained show the existence of significant disparities between HDSSs in terms of the survival differential between twins and singletons. They also show that the survival differential between twins and singletons narrows over time. Our analyses also showed that there would be practically no more twin excess deaths after 5th year age. In addition, the analysis of factors associated with the survival differential between twins and singletons has shown that biomedical factors (especially low birth weight and prematurity) explain most of this differential. Keywords: Twins, Singletons, survival curves, survival differential, Health and Demographic Surveillance Systems (HDSS), Indepth Network, sub-Saharan Africa.

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 Presented in Session 14. Infant and Child Mortality