Abstract
BackgroundAlthough death records are useful for planning and monitoring health interventions, such information is limited in most developing countries. Verbal autopsy (VA) interviews are alternatively used to determine causes of death in places without or with incomplete hospital records. This study was conducted to determine all causes and cause-specific mortality in Korogwe health and demographic surveillance system (HDSS) undertaken in Korogwe district, northeastern Tanzania.MethodsThe study was conducted from January 2006 to December 2012 in 14 villages under Korogwe HDSS. Vital events such as births, deaths and migrations were routinely updated quarterly. A standard VA questionnaire was administered to parents/close relatives of the deceased to determine cause of death.ResultsOverall, 1325 deaths of individuals with median age of 46 years were recorded in a population with 170,471.4 person years observed (PY). Crude mortality rate was 7.8 per 1000 PY (95% CI 7.2–8.4) and the highest rate was observed in infants (77.9 per 1000 PY; 95% CI 67.4–90.0). The overall mortality increased between 2006 and 2007, followed by a slight decline up to 2011, with the highest decrease observed in 2012. Causes of deaths were established in 942 (71.1%) deaths and malaria (198 deaths, 21.0%) was the leading cause of death in all age groups except adults (15–59 years). HIV/AIDS (17.6%, n = 365) was the leading cause of death in individuals aged 15–59 years followed by malaria (13.9%) and tuberculosis. Non-communicable diseases (NCDs) including stroke, hypertension, cancer, and cardiac failure caused majority of deaths in elderly (60 years and above) accounting for 37.1% (n = 348) of all deaths, although malaria was the single leading cause of death in this group (16.6%).ConclusionThe study showed a significant decline of deaths in the Korogwe HDSS site and malaria was the main cause of death in all age groups (except adults, aged 15–59 years) while HIV/AIDS and NCDs were the main causes in adults and elderly, respectively. Further surveillance is required to monitor and document changes in cause-specific mortality as malaria transmission continues to decline in this and other parts of Tanzania.
Highlights
Death records are useful for planning and monitoring health interventions, such information is limited in most developing countries
A total of 41,744 individuals [median age of 19 years inter-quartile range (IQR): 9.1–39.5] were registered with 170,471.4 person years observed (PY), and majority (44.5%, n = 18,588) of these were from lowland urban villages
The median age of the deceased was significantly different among the three strata with lowland rural having the highest median age (p < 0.001)
Summary
Death records are useful for planning and monitoring health interventions, such information is limited in most developing countries. This study was conducted to determine all causes and cause-specific mortality in Korogwe health and demographic surveillance system (HDSS) undertaken in Korogwe district, northeastern Tanzania. In order to generate such data, wellestablished, consistent, systematic, and active vital registration systems are needed [2]. Such systems are limited in most developing countries especially in sub-Saharan Africa (SSA) [3]. Some of these countries adopted and introduced a health and demographic surveillance system (HDSS) which is routinely conducted at specific sites as the platform for generating supportive vital events, including mortality data [6]. Verbal autopsy (VA) method is applied to determine cause-specific mortality within these HDSS sites [7]
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