Main causes of death in Dande, Angola: results from Verbal Autopsies of deaths occurring during 2009-2012.

Edite Vila Nova Rosário,Jorge Varanda,Susana Vaz Nery,Miguel Brito,Ana Ambrósio Rodrigues,Diogo Costa,Luís Timóteo

doi:10.1186/s12889-016-3365-6

Abstract

BackgroundThe Dande Health and Demographic Surveillance System (HDSS) located in Bengo Province, Angola, covers nearly 65,500 residents living in approximately 19,800 households. This study aims to describe the main causes of deaths (CoD) occurred within the HDSS, from 2009 to 2012, and to explore associations between demographic or socioeconomic factors and broad mortality groups (Group I—Communicable diseases, maternal, perinatal and nutritional conditions; Group II—Non-communicable diseases; Group III—Injuries; IND—Indeterminate).MethodsVerbal Autopsies (VA) were performed after death identification during routine HDSS visits.Associations between broad groups of CoD and sex, age, education, socioeconomic position, place of residence and place of death, were explored using chi-square tests and fitting logistic regression models.ResultsFrom a total of 1488 deaths registered, 1009 verbal autopsies were performed and 798 of these were assigned a CoD based on the 10th revision of the International Classification of Diseases (ICD-10).Mortality was led by CD (61.0 %), followed by IND (18.3 %), NCD (11.6 %) and INJ (9.1 %). Intestinal infectious diseases, malnutrition and acute respiratory infections were the main contributors to under-five mortality (44.2 %). Malaria was the most common CoD among children under 15 years old (38.6 %). Tuberculosis, traffic accidents and malaria led the CoD among adults aged 15–49 (13.5 %, 10.5 % and 8.0 % respectively). Among adults aged 50 or more, diseases of the circulatory system (23.2 %) were the major CoD, followed by tuberculosis (8.2 %) and malaria (7.7 %). CD were more frequent CoD among less educated people (adjusted odds ratio, 95 % confidence interval for none vs. 5 or more years of school: 1.68, 1.04–2.72).ConclusionInfectious diseases were the leading CoD in this region. Verbal autopsies proved useful to identify the main CoD, being an important tool in settings where vital statistics are scarce and death registration systems have limitations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3365-6) contains supplementary material, which is available to authorized users.

Highlights

The Dande Health and Demographic Surveillance System (HDSS) located in Bengo Province, Angola, covers nearly 65,500 residents living in approximately 19,800 households
This study aims to describe the main causes of deaths and explore factors associated with broad mortality groups for the period 2009–2012 in the Dande HDSS study area
This study revealed that malaria is the most common cause of death in the Dande HDSS, Angola, for the period August 2009 to December 2012, affecting mostly children and adolescents less than 15 years of age

Summary

Introduction

The Dande Health and Demographic Surveillance System (HDSS) located in Bengo Province, Angola, covers nearly 65,500 residents living in approximately 19,800 households. This study aims to describe the main causes of deaths (CoD) occurred within the HDSS, from 2009 to 2012, and to explore associations between demographic or socioeconomic factors and broad mortality groups (Group I—Communicable diseases, maternal, perinatal and nutritional conditions; Group II—Non-communicable diseases; Group III—Injuries; IND—Indeterminate). In less than a decade, a vibrant economy has transformed the country from a low income centrally-planned system to a middle income market economy [6, 7]. Such development brings changes in the societal and economic. The resources needed to implement an accurate and complete vital statistics system are not yet fulfilled

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