Causes of death among adults in northern Ethiopia: evidence from verbal autopsy data in health and demographic surveillance system.

Yohannes Adama Melaku,Afework Mulugeta Bezabih,Gordon Alexander Zello,Berhe Weldearegawi Sahle,Loko Abreha,Semaw Ferede Abera,Fisaha Haile Tesfay,Alemseged Aregay

doi:10.1371/journal.pone.0106781

Yohannes Adama Melaku, Afework Mulugeta Bezabih + Show 6 more

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https://doi.org/10.1371/journal.pone.0106781

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Journal: PloS one	Publication Date: Sep 4, 2014
Citations: 50	License type: CC BY 4.0

Affiliation: Mekelle University, University of Saskatchewan

Abstract

BackgroundIn countries where registration of vital events is lacking and the proportion of people who die at home without medical care is high, verbal autopsy is used to determine and estimate causes of death.MethodsWe conducted 723 verbal autopsy interviews of adult (15 years of age and above) deaths from September 2009 to January 2013. Trained physicians interpreted the collected verbal autopsy data, and assigned causes of death according to the international classification of diseases (ICD-10). We did analysis of specific as well as broad causes of death (i.e. non-communicable diseases, communicable diseases and external causes of death) by sex and age using Stata version 11.1. We performed logistic regression to identify socio-demographic predictors using odds ratio with 95% confidence interval and a p-value of 0.05.FindingsTuberculosis, cerebrovascular diseases and accidental falls were leading specific causes of death accounting for 15.9%, 7.3% and 3.9% of all deaths. Two hundred sixty three (36.4% [95% CI: 32.9, 39.9]), 252 (34.9% [95% CI: 31.4, 38.4]) and 89 (12.3% [95% CI: 10.1, 14.9]) deaths were due to non-communicable, communicable diseases, and external causes, respectively. Females had 1.5 times (AOR = 1.53 [95% CI: 1.10, 2.15]) higher odds of dying due to communicable diseases than males. The odds of dying due to external causes were 4 times higher among 15–49 years of age (AOR = 4.02 [95% CI: 2.25, 7.18]) compared to older ages. Males also had 1.7 times (AOR = 1.70 [95% CI: 1.01, 2.85]) higher odds of dying due to external causes than females.ConclusionTuberculosis, cerebrovascular diseases and accidental falls were the top three causes of death among adults. Efforts to prevent tuberculosis and cerebrovascular diseases related deaths should be improved and safety efforts to reduce accidents should also receive attention.

Highlights

In countries where registration of vital events is lacking and the proportion of people who die at home without medical care is high, verbal autopsy is used to determine and estimate causes of death
In countries where registration of vital events is incomplete(inaccurate) and the proportion of people who die at home without medical care is high, verbal autopsy (VA) is used to identify causes of death [3,4,5,7,8,9] and measure patterns of causes of death [10]
We explored the characteristics and trends of broad causes of death.We assessed the socio-demographic predictors of Communicable diseases (CDs), Non-communicable diseases (NCDs) and External causes of death (ECs) in an adult population

Summary

Introduction

In countries where registration of vital events is lacking and the proportion of people who die at home without medical care is high, verbal autopsy is used to determine and estimate causes of death. The determination of causes of death in developing countries is difficult, as an overwhelming majority of deaths are neither attended by health professionals nor medically certified [1,2,3,4,5]. Health service utilization is very poor with total outpatient use of government health facilities estimated at 0.25 visits per person per year [6]. Due to poor access to health services and low healthcare seeking behavior, most deaths occur outside of health facilities. Mortality data at both health facilities and in communities are lacking

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