Adult mortality in sub-Saharan Africa: cross-sectional study of causes of death in Zambia.

Abstract

To describe the age-sex pattern and socio-economic differentials in causes of death among adults between the ages of 15 and 59years in Zambia. Using data from the 2010-2012 Zambia sample vital registration with verbal autopsy survey, we calculated the percentage share of causes of death, the age-/sex cause-specific death ratio and cause-eliminated life expectancy at age 15. HIV/AIDS was the leading cause of death across all socio-economic subgroups contributing 40.7% of total deaths during the study period. This was followed by deaths due to injury and accidents (11.2%). Cause-specific death ratios due to HIV/AIDS increased by age and peaked in the 35-39 age group and were higher among females than males. The second-leading cause of death was injuries and accidents for males and tuberculosis for females. The third-leading cause of death was cardiovascular diseases for females and tuberculosis for males. Cause of death patterns varied notably by socio-economic characteristics. Deaths attributable to non-communicable diseases were more evident in adults aged 45-59years. Eliminating HIV/AIDS in Zambia as a cause of death could raise life expectancy at age 15 by 5.7years for males and by 6.4years for females. HIV/AIDS-related health programmes and interventions should be further supported and strengthened, as they would significantly contribute to the reduction in adult mortality in Zambia.