Abstract
BackgroundReliable data on causes of death form the basis for building evidence on health policy, planning, monitoring, and evaluation. In Ethiopia, the majority of deaths occur at home and civil registration systems are not yet functional. The main objective of verbal autopsy (VA) is to describe the causes of death at the community or population level where civil registration and death certification systems are weak and where most people die at home without having had contact with the health system.MethodsCauses of death were classified and prepared based on the International Classification of Diseases (ICD-10). The cause of a death was ascertained based on an interview with next of kin or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history, and circumstances preceding death. The cause of death, or the sequence of causes that led to death, is assigned based on the data collected by the questionnaire. The complete VA questionnaires were given to two blinded physicians and reviewed independently. A third physician was assigned to review the case when disagreements in diagnosis arose.ResultsCommunicable diseases (519 deaths [48.0%]), non-communicable diseases (377 deaths [34.8%]), and external causes (113 deaths [10.4%]) were the main causes of death between 2007 and 2013. Of communicable diseases, tuberculosis (207 deaths [19.7%]), HIV/AIDS (96 deaths [8.9%]) and meningitis (76 deaths [7.0%]) were the most common causes of death.ConclusionTuberculosis, HIV/AIDS, and meningitis were the most common causes of deaths among adults. Death due to non-communicable diseases showed an increasing trend. Increasing community awareness of infections and their interrelationships, tuberculosis case finding, effective local TB programs, successful treatment, and interventions for HIV are supremely important.
Highlights
Reliable data on causes of death form the basis for building evidence on health policy, planning, monitoring, and evaluation
About 899 (83%) of the deaths occurred at home and 726 (67.0%) of deaths happened in mid- to lowland rural areas (Table 1)
Tuberculosis, HIV/AIDS, and meningitis were the main causes of death, whereas in urban areas, tuberculosis, HIV/AIDS, cerebrovascular diseases, and meningitis were the major specific causes of death among adults
Summary
Reliable data on causes of death form the basis for building evidence on health policy, planning, monitoring, and evaluation. The main objective of verbal autopsy (VA) is to describe the causes of death at the community or population level where civil registration and death certification systems are weak and where most people die at home without having had contact with the health system. Data on causes of death are important for mapping the geographical burden of disease and for health sector planning, including assessing programmatic needs, monitoring progress of interventions, and reassessing health priorities. It is reported that more than two-thirds of deaths in the world occur in developing countries but causes of death are not well documented, and vital registration systems are nonexistent or at rudimentary stages [3, 4]. While most global efforts to prevent mortality among young people focus on children under 5 years of age, significant health gains can be attained among adults. Targeted efforts for adults are hindered by a lack of data [5, 9]
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