Magnitude Of Deaths Research Articles

An Audit of Post-neonatal Infant Morbidity and Mortality from Admissions in an Emergency Unit of a Tertiary Hospital in Sokoto, Northwest Nigeria

Background The first year of life is a critical period of adaptation for a young infant during which the child becomes exposed to a lot of infectious agents and other environmental problems as its immune systems and other organs are developing. Magnitude of deaths within the first year of life is a significant socioeconomic index of any population. Challenges can also be brought to the forefront which can be tackled by appropriate authorities. Objectives To assess the causes of morbidity and mortality amongst infants aged 29 days to 12 months admitted in the emergency Paediatric unit (EPU) of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto over a 5- year period. Materials and Methods The admission records of children aged 29 days to 12 months were retrieved. Information extracted included socio-demographic data, diagnosis and outcome of admission. These were entered into a study proforma and analysed with SPSS version 23. Results Total admissions were 1776 in the five-year review. Majority were males accounting for 1030 (58%) with M:F ratio of 1.38:1. 972 (55.4%) were aged 6 to 12 months. Top causes of admissions were diarrhoea disease 328 (18.5%), pneumonia 280 (15.8%), sepsis 211 (11.9%), malaria 202 (11.4%) and malnutrition 154 (8.7%). Mortalities were 223 (12.6%). Highest fatalities out of 223 were from sepsis 47 (21.1%), pneumonia 40 (17.9%), malaria 27 (12.1%), malnutrition 25 (11.2%) and diarrhoea disease 20 (9.0%). Higher proportion of the mortalities were in females 14.5% vs 11.2% (X2 = 4.3; p=0.038). Sepsis mortality was high throughout likewise pneumonia but mortality pattern of other disease conditions varied throughout infancy. Conclusion Post-neonatal admissions were mainly due to infections, likewise mortality of which the top causes varied throughout infancy. Females were more proportionately affected by mortality. These insights on the morbidity and mortality patterns calls for more concerted efforts on child survival strategies and targeting this group of infants is imperative.

Tracking Missing Deaths: An Exploratory Study on the Mortality Impact of COVID-19 in Kozhikode City, India.

The debate over the extent of the mortality impact of COVID-19 in India is still unsettled. This article contributes to the debate, seeking to explore the true mortality impact of the pandemic, by answering four interrelated questions. First, is there any discrepancy between recorded and actual death count? Second, if so, how large it is? Third, what is the extent of misclassification of COVID-19 mortality, and fourth, what is the magnitude of deaths that could be indirectly linked to COVID-19? To answer the questions, we explored three sources of data-all-cause mortality data from the civil registration system, records maintained at the burial grounds/cemeteries and crematoriums, and a household survey. The data collection period was between August 2021 and November 2021. The instrument used for data collection of verbal autopsies was built on the instrument proposed by the World Health Organization for adult mortality. The results revealed that deaths due to various causes including COVID-19 increased considerably at some points in 2020-2021 compared to the base year 2019 in the study setting. Notably, 5.5% of the noninstitutional deaths were unreported at the time of the survey and many deaths were plausibly misclassified, leading to undercounting of COVID-19 deaths. Overall, about half of our sampled deaths (48%) had either direct or indirect attribution to the pandemic. The extent of undercounting of pandemic-related deaths is likely to be either similar or worse in other states. To get reliable state and national estimates, policymakers should conduct a large-scale study.

Trend of disease burden and risk factors of breast cancer in developing countries and territories, from 1990 to 2019: Results from the Global Burden of Disease Study 2019.

The incidence, mortality, burden of disability-adjusted life years (DALYs), and attributable risk factors of breast cancer vary significantly by country or region, particularly between developing and developed countries. This study aimed to analyze breast cancer development trends in developing countries based on the influence of the different sociodemographic indices (SDIs) and World Bank (WB) income-level disease data from 1990 to 2019. Data on the annual incidence, mortality, DALY, years of life lost (YLL) prematurely, years lived with disability (YLD), and age-standardized rate (ASR) of breast cancer from 1990 to 2019 in different countries and territories were obtained from the 2019 Global Burden of Disease (GBD) Study. A comparative risk assessment (CRA) framework was used to analyze the general risk factors. The global age-standardized incidence rate (ASIR) gradually increased from 21.44 per 100,000 population in 1990 to 24.17 per 100,000 population in 2019. It rose precipitously to 2.91- and 2.49-fold, respectively, for countries with middle SDIs and low-middle SDIs. The ASIR of breast cancer was increasing in the lower-middle-income levels in WB, with an estimated annual percentage change (EAPC) of 0.29 [95% uncertainty interval (UI): 0.20-0.37] and reduced income (EAPC of 0.59 [95% UI: 0.53-0.65]). The Solomon Islands and the United Arab Emirates observed the most significant increase in the magnitude of deaths from breast cancer cases. Compared to the death cases of 1990, percentage changes increased separately by 1,169 and 851%. Compared to developed areas, breast cancer-related deaths increased rapidly in developing regions, especially among the middle-aged and elderly groups. Meanwhile, the long-term burden of breast cancer was ever expanding. Of all the GBD regions, Oceania had the youngest age distribution. The deaths in the young and middle-aged groups accounted for 69% in 1990 and 72% in 2019. Percentage changes in deaths from the seven risk factors in low- to middle-SDI regions increased significantly over time across all age groups. However, a diet with high red meat and high body mass index (BMI) accounted for the most considerable increase in the magnitude. Public health policy regarding breast cancer is fundamental in low- and medium-income countries. The development and adoption of cost-effective screening and therapeutic solutions, the mitigation of risk factors, and the establishment of a cancer infrastructure are essential.

Mortality attributed to sickle cell disease in children and adolescents in Brazil, 2000-2019.

ABSTRACTOBJECTIVE Estimate rates and describe mortality trends attributed to sickle cell disease in children and adolescents in Brazil from 2000 to 2019.METHODS This is an ecological study of the time-trend of mortality rates that used the autoregressive method, proposed by Prais-Winsten, to evaluate trends in the estimated rates of sickle cell disease deaths in children and adolescents in Brazil. Deaths with code D57 were obtained from the Mortality Information System, considering age groups (0–4, 5–9, 10–14, 15–19 years) and were used to estimate age-specific and standardized rates by gender and age.RESULTS From 2000 to 2019, Brazil had 2,422 deaths from sickle cell disease in people under 20 years of age, with higher frequency in the Northeast (40.46%), followed by the Southeast (39.02%), Midwest (9.58%), North (7.84%), and South (3.10%). The main victims were people of Black skin/race (78.73%). In Brazil, the global standardized average rate was 0.20/100,000 people-year, with an elevation trend (annual percentage change – APC = 5.44%; confidence interval – 95%CI: 2.57–8.39). The pattern was repeated in males (APC = 4.38%; 95%CI: 2.17–6.64) and females (APC = 6.96%; 95%CI: 3.05–11.01). Elaborating age-specific rates showed that the range up to four years experienced the highest rates, without distinction by region. The age group of 15 and 19 years was the second most affected in Brazil and in the Northeast, Southeast, and Midwest regions.CONCLUSION Deaths due to sickle cell disorders showed an elevation trend in children and adolescents. Considering that the magnitude of deaths was more evident in the first years (0–4) and late adolescence (15–19), the study suggests that age-specific approaches may impact the control of fatal outcomes caused by sickle cell disease in Brazil.

Magnitude of death and associated factors among road traffic injury victims admitted to emergency outpatient departments of public and private hospitals at Adama Town, East Shewa Zone, Ethiopia.

Objectives:Road traffic injuries, disabilities, and deaths have been a major public health problem worldwide and in Ethiopia. Globally, around 1.35 million people die every year on the roads and 20–50 million sustain nonfatal injuries as a result of road traffic crashes. This study aimed to assess the magnitude of deaths and associated factors among road traffic injury victims admitted to emergency outpatient departments of public and private hospitals at Adama town, East Shewa Zone, Ethiopia.Methods:Institution-based cross-sectional study was conducted among 381 road traffic injury victims admitted to hospitals in Adama town, East Shewa, Ethiopia, from 14 December 2019 to 29 February 2020. Data were collected using interviewer-administered structured questionnaires. Data were entered into EpiData version 4.6.0.2 and analyzed using SPSS version 21. Bivariable and multivariable logistic regressions were fitted to identify variables significantly associated with road traffic injury–related deaths and the results were presented with adjusted odds ratios and 95% confidence interval. Statistical significance was declared at p-value < 0.05.Results:The magnitude of deaths among road traffic injury victims were 12.9%. Age (25–44 years) (adjusted odds ratio = 4.24, 95% confidence interval = 1.70–10.61), rural resident (adjusted odds ratio = 2.26, 95% confidence interval = 1.11–4.55), pedestrian (adjusted odds ratio = 3.72, 95% confidence interval = 1.67–7.99), night-time injury (adjusted odds ratio = 5.29, 95% confidence interval = 2.52–11.10), injuries on weekends (adjusted odds ratio = 2.32, 95% confidence interval = 1.12–4.80), not getting first aid at injury site (adjusted odds ratio = 2.64, 95% confidence interval = 1.02–6.84), and known comorbidity conditions (adjusted odds ratio = 3.01, 95% confidence interval = 1.23–7.38) were significantly associated with road traffic injuries–related deaths.Conclusion:A significant proportion of road traffic injuries resulted in death. Age, place of residence, pedestrians, night-time injury, and not getting first aid were associated with road traffic injuries–related deaths. Preventive strategies that focus on young adults, rural residents, pedestrians, and people with comorbidities would minimize road traffic injuries–related deaths. Moreover, strict supervision on weekend and night-time drives, and providing accessible lifesaving first aid services would have significant importance.

Demographic profiles of victims of fatal road traffic accidents in central Indian population: A cross sectional study

The study was carried out in the department of forensic medicine at Government College and hospital, Nagpur over a period of one and half year on 200 dead bodies of victims of road traffic fatalities brought to mortuary for medico-legal post mortem examination. The purpose of study is to analyse the magnitude of deaths due to road traffic accidents and to study the demographic profiles, so the preventive measure can be undertaken. The peak incidence was seen in age group of 21-30 years; males comprised a majority and constituted 83.50% cases. 61.50% cases were belongs to urban area and in 56% cases four wheeler and above were offending vehicle. Majority of victims of road traffic accidents died within 6 hours and head injury was most common cause of death which accounts total 56% cases of road traffic accident deaths. The study emphasis that there should be multi-disciplinary approach and effective road safety interventions to reduce the incidence of RTA, thereby reduction in injuries and deaths on the roads. Keywords: Road traffic accidents (RTAs), Victims, Demographic profile.

Profile of deaths due to thermal injuries in a coastal township in South India

Morbidity and mortality related to thermal injuries are a serious health concern worldwide. Burns and scalds are known to be responsible for a significant fraction of deaths in South India every year. The aim of this retrospective study is to give an overview of the trends in burn epidemiology in Manipal, during the years 2011 to 2015. The 5years retrospective research was conducted in the mortuary attached to the tertiary care teaching hospital in the study area. All cases of deaths due to thermal injuries between 2011 and 2015 were included in this study. Relevant information was collected from post mortem records and analysed for descriptive statistics using Statistical Package for Social Sciences (SPSS) 21. Deaths due to thermal injuries constituted 14% of the total unnatural deaths that occurred during the study period. 68% of the victims were female. The victims were aged between 1 and 80 years. The percentage of burnt body surface area varied in the range of 22% and 100%. The time interval between the occurrence of the incident and death of the victim ranged between 1 day and 3 months. The highest number of cases occurred in the months of April, May and June. The causes of death included complications such as hypovolemia, septicaemia, pulmonary edema and renal failure. The findings of this study give us an insight into the pattern and magnitude of deaths due to thermal injuries so that preventative measures can be suggested and taken up accordingly

Boston bombings and resilience - what do we mean by this?

Boston bombings and resilience - what do we mean by this?

The pattern of deaths in road traffic crashes in Sindh, Pakistan

The objectives of this study were to examine the pattern and magnitude of deaths in road traffic crashes (RTCs) in Sindh province of Pakistan. This cross-sectional study used data obtained from government documents and content analysis of daily newspapers' reports on incidents of deaths in RTCs. Results showed that the total annual number of RTCs, fatal RTCs and deaths in RTCs were 2272 (±293), 1104 (±89) and 1321 (±136) respectively. On average, there were four deaths per day in RTCs. The victims were 85% male and the majority were between 15 and 49 years of age. Pedestrians, passengers, motorcyclists and drivers were most commonly the victims. Deaths in RTCs were double in rural areas compared to urban areas. The most common causes of fatal RTCs were by being hit by a vehicle, breakdown and collision of motor vehicles and speeding. The frequent involvement of the men of working age in RTCs may have serious social and economic implications; therefore, the prevention of RTCs, as far as possible, is imperative.

SURVIVAL RATIO IN LIFE TABLES

In the usual life table the number of survivals lx at age x, starting from the original number l0, 100, 030 or 10, 000 at birth is tabulated. If we designate the ratio lx+n/lx x 100 (n=1, 2, 3, ) as survival ratio, this indicates the proportion of persons reaching (x+n) years of age among persons who reached x years of age. And the magnitude of this ratio depends on the magnitude of deaths in the age interval between x and (x+n). If persons in the age interval are healthy, the number of deaths would be small, and the ratio lx+n/lxwould consequently be large. Hence the ratio may serve as an adequate indicator of the healthiness of persons in that age interval.From this point of view, all kinds of ratios were computed using six Life Tables of Japanese so far published, x being changed from 0 to 80, and n from 1 to 90.An abstract of the result is shown in Table I and II anddepicted in Fig. I-V. How the ratios change with age and interval may be clearwithout any further explanation.