Non-Communicable Diseases Attributed Mortality and Associated Sociodemographic Factors in Papua New Guinea: Evidence from Comprehensive Health and Epidemiological Surveillance System

Abstract

Background: Papua New Guinea (PNG) is undergoing an epidemiological transition with increased mortality from NCDs. This study examined NCDs-attributed mortality and associated sociodemographic factors in PNG. Method: Using WHO 2016 instrument, 926 verbal autopsy (VA) interviews were conducted in six major provinces from January 2018 to December 2020. InterVA-5 tool was used to assign causes of death (COD). Multivariable logistic regression analysis was performed to identify sociodemographic factors associated with mortalities from emerging and endemic NCDs. Finding: NCDs accounted for 47% of all deaths, including 20% of emerging and 27% of endemic NCDs. Leading CODs from emerging NCDs were identified including cardiac diseases, stroke, and diabetes. The risk of dying from emerging NCDs was significantly lower among populations under age 44y compared with population aged 75+y (OR: 0.14 [0.045-0.433]; p-value: 0.001). People living in urban areas were twice likely to die from emerging NCDs than those in rural areas (OR: 1.92 [1.116-3.31]; p-value: 0.018). People in Madang province were 70% less likely to die from emerging NCDs compared to those from East New Britain province (OR: 0.314 [0.135-0.73]; p-value: 0.007). Leading CODs from endemic NCDs included digestive neoplasms, respiratory neoplasms, and other neoplasms. Only children aged 0-4y had significant lower risk of dying from endemic NCDs compared to the population aged 75+y (OR: 0.114 [95% CI: 0.014-0.896; p-value: 0.039). Interpretation: Public health interventions are urgently needed, prioritizing urban population and those aged over 44y to reduce premature mortality from NCDs. Funding: This study was funded by the PNG Government. Declaration of Interest: None to declare. Ethical Approval: The CHESS was granted ethics approvals from Instructional Review Board of PNG Institute of Medical Research (IRB’s Approval no. 18.05) and the Medical Research Advisory Committee of Papua New Guinea (MRAC’s Approval no. 18.06).