Abstract
BackgroundSeasonal variability in mortality has been studied in various regions globally. Proper evaluation of seasonally fluctuating mortality is important to establish effective public health measures. We investigated the overall, age-specific, and cause-specific seasonality of deaths in Chitral District in Pakistan.MethodData on 2577 deaths were provided by the Agha Khan Health Support Program. Seasonal mortality patterns concerning age and causes were examined using the X-12 ARIMA pseudo-additive decomposition method.ResultsOf the total deceased, 59.6% were males. The proportion of deceased males was significantly higher than the female (40.4%, p< 0.001). The average age at death was 57.7 years (SD = 28.7). On average, approximately 43 deaths occurred each month. More than 10% of the deaths occurred in children less than 5-years-of-age. Among all the causes of death, the most frequent was cardiovascular disease (n = 666, 25.8%) followed by respiratory disease (n = 482, 18.7%). Significant seasonality in the overall deaths was evident, with a peak in winter. Deaths in people ≥ 55-years-of-age were significantly seasonal and peaked in winter. Deaths due to cardiovascular, respiratory, and kidney related diseases were also significantly seasonal with winter peaks. Further, deaths due to external causes were significantly seasonal with summer peak.ConclusionIn the winter season, all-cause, except external, and age-specific mortality peaks in Chitral District, Pakistan. Deaths due to external causes and cardiovascular, respiratory, and kidney related diseases were significant seasonal effects.
Highlights
Proper evaluation of seasonally fluctuating factors, including atmospheric conditions, is important to establish effective public health measures
Human activity, seasonal variability in human immune system function, seasonal variations in vitamin D levels, seasonality of melatonin, and pathogen infectivity have explained the seasonality of directly transmitted infectious diseases [1]
A study from Japan reported that Japanese individuals are more prone to die in the winter months with respiratory disease, accidents, parasitic and infectious diseases, digestive diseases, and cerebrovascular diseases as the major causes of death [11]
Summary
Proper evaluation of seasonally fluctuating factors, including atmospheric conditions, is important to establish effective public health measures. Another study [7] reported that a Scottish population experienced 30% more deaths in winter than in summer with respiratory, coronary artery, and cerebrovascular diseases as the leading causes of deaths. In the Netherlands, deaths peaked in winter with cardiovascular and respiratory diseases as the lead causes [9]. A study from Japan reported that Japanese individuals are more prone to die in the winter months with respiratory disease, accidents, parasitic and infectious diseases, digestive diseases, and cerebrovascular diseases as the major causes of death [11]. Proper evaluation of seasonally fluctuating mortality is important to establish effective public health measures. Age-specific, and cause-specific seasonality of deaths in Chitral District in Pakistan
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