Abstract
This paper contributes evidence documenting the continued decline in all-cause mortality and changes in the cause of death distribution over time in four developing country populations in Africa and Asia. We present levels and trends in age-specific mortality (all-cause and cause-specific) from four demographic surveillance sites: Agincourt (South Africa), Navrongo (Ghana) in Africa; Filabavi (Vietnam), Matlab (Bangladesh) in Asia. We model mortality using discrete time event history analysis. This study illustrates how data from INDEPTH Network centers can provide a comparative, longitudinal examination of mortality patterns and the epidemiological transition. Health care systems need to be reconfigured to deal simultaneously with continuing challenges of communicable disease and increasing incidence of non-communicable diseases that require long-term care. In populations with endemic HIV, long-term care of HIV patients on ART will add to the chronic care needs of the community.
Highlights
The dynamics of health and social transitions in Africa and Asia have created unexpected precedents that give rise to new challenges
Sub-Saharan Africa continues to suffer a burden of infectious disease that exceeds the burden from non-communicable disease and injuries
The HIV/AIDS pandemic has led to increased deaths due to infectious illness [5], while the rollout of anti-retroviral therapy (ART) in some countries has improved life expectancy [6, 7]
Summary
The dynamics of health and social transitions in Africa and Asia have created unexpected precedents that give rise to new challenges. Research has demonstrated the uniqueness and complexity of these changes [1, 2]–highlighting the need for robust, prospective data Such data provide detailed descriptions and more nuanced understandings of transition patterns and variation across settings and time and thereby contribute new perspectives to epidemiological transition theory [3]. While countries are at different stages of the epidemiological transition [8], with evolving sex-age and socioeconomic distributions, the interaction of new therapies and improved coverage parallel behavioral and lifestyle change. Together these patterns result in an older population with increased prevalence of HIV/AIDS, and simultaneously, an increasing risk of chronic, non-communicable diseases [9]
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