Trends in mortality from external causes in the Republic of Seychelles between 1989 and 2018

Anne Abio,Till Bärnighausen,Pascal Bovet,Masood Ali Shaikh,Michael Lowery Wilson,Joachim Didon,Jussi P Posti

doi:10.1038/s41598-020-79228-8

Abstract

Data on injury-related mortality are scarce in the African region. Mortality from external causes in the Seychelles was assessed, where all deaths are medically certified and the population is regularly enumerated. The four fields for underlying causes of death recorded were reviewed in the national vital statistics register. The age-standardised mortality rates were estimated (per 100,000 person-years) from external causes in 1989–1998, 1999–2008, and 2009–2018. Mortality rates per 100,000 person-years from external causes were 4–5 times higher among males than females, and decreased among males over the three 10-year periods (127.5, 101.4, 97.1) but not among females (26.9, 23.1, 26.9). The contribution of external causes to total mortality did not change markedly over time (males 11.6%, females 4.3% in 1989–2018). Apart from external deaths from undetermined causes (males 14.6, females 2.4) and “other unintentional injuries” (males 14.1, females 8.0), the leading external causes of death in 2009–2018 were drowning (25.9), road traffic injuries (18.0) and suicide (10.4) among males; and road traffic injuries (4.6), drowning (3.4) and poisoning (2.6) among females. Mortality from broad categories of external causes did not change consistently over time but rates of road traffic injuries increased among males. External causes contributed approximately 1 in 10 deaths among males and 1 in 20 among females, with no marked change in cause-specific rates over time, except for road traffic injuries. These findings emphasise the need for programs and policies in various sectors to address this large, but mostly avoidable health burden.

Highlights

Data on injury-related mortality are scarce in the African region
According to the World Health Organisation (WHO), and based on previously reported data from the same database used in this study, the age-standardised mortality rates from external causes in the Seychelles in 2008 were 81 and 17 per 100,000 inhabitants among males and females, respectively[4], with road traffic related mortality being 8.6 per 100,000 inhabitants in 2 0132,3
Broad categories of external causes of death can be defined based on the nature of the causes of injuries, and include road traffic injuries, drowning, suicide, poisoning, homicide, falls, other unintentional injuries, other intentional injuries and those with undetermined intent[5]

Summary

Introduction

Data on injury-related mortality are scarce in the African region. Mortality from external causes in the Seychelles was assessed, where all deaths are medically certified and the population is regularly enumerated. External causes contributed approximately 1 in 10 deaths among males and 1 in 20 among females, with no marked change in cause-specific rates over time, except for road traffic injuries. Mortality rates per year and per 100,000 inhabitants varied by region and were, for example, 99 in South East Asia, 62 in the Americas and 49 in Europe in 20121 By contrast, it was estimated, despite the lack of country-wide data on both cause-specific mortality and population distribution in most countries in the region, that the age-standardised mortality from external causes was as high as 116 per 100,000 inhabitants in 2012 in A frica[1], with road traffic injuries often contributing the largest burden[2,3].

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Conclusion