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BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Main causes of death in Dande, Angola: results from Verbal Autopsies of deaths occurring during 2009–2012

Authors: Edite Vila Nova Rosário, Diogo Costa, Luís Timóteo, Ana Ambrósio Rodrigues, Jorge Varanda, Susana Vaz Nery, Miguel Brito

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

The Dande Health and Demographic Surveillance System (HDSS) located in Bengo Province, Angola, covers nearly 65,500 residents living in approximately 19,800 households. This study aims to describe the main causes of deaths (CoD) occurred within the HDSS, from 2009 to 2012, and to explore associations between demographic or socioeconomic factors and broad mortality groups (Group I—Communicable diseases, maternal, perinatal and nutritional conditions; Group II—Non-communicable diseases; Group III—Injuries; IND—Indeterminate).

Methods

Verbal Autopsies (VA) were performed after death identification during routine HDSS visits.
Associations between broad groups of CoD and sex, age, education, socioeconomic position, place of residence and place of death, were explored using chi-square tests and fitting logistic regression models.

Results

From a total of 1488 deaths registered, 1009 verbal autopsies were performed and 798 of these were assigned a CoD based on the 10th revision of the International Classification of Diseases (ICD-10).
Mortality was led by CD (61.0 %), followed by IND (18.3 %), NCD (11.6 %) and INJ (9.1 %). Intestinal infectious diseases, malnutrition and acute respiratory infections were the main contributors to under-five mortality (44.2 %). Malaria was the most common CoD among children under 15 years old (38.6 %). Tuberculosis, traffic accidents and malaria led the CoD among adults aged 15–49 (13.5 %, 10.5 % and 8.0 % respectively). Among adults aged 50 or more, diseases of the circulatory system (23.2 %) were the major CoD, followed by tuberculosis (8.2 %) and malaria (7.7 %). CD were more frequent CoD among less educated people (adjusted odds ratio, 95 % confidence interval for none vs. 5 or more years of school: 1.68, 1.04–2.72).

Conclusion

Infectious diseases were the leading CoD in this region. Verbal autopsies proved useful to identify the main CoD, being an important tool in settings where vital statistics are scarce and death registration systems have limitations.
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Literature
1.
2.
Mudenda SS, et al. Feasibility of using a World Health Organization-standard methodology for Sample Vital Registration with Verbal Autopsy (SAVVY) to report leading causes of death in Zambia: results of a pilot in four provinces, 2010. Popul Health Metr. 2011;9:40.CrossRefPubMedPubMedCentral
3.
Mathers CD, et al. Counting the dead and what they died from: an assessment of the global status of cause of death data. Bull World Health Organ. 2005;83(3):171–7.PubMedPubMedCentral
4.
5.
Melaku YA, et al. Causes of death among adults in northern Ethiopia: evidence from verbal autopsy data in health and demographic surveillance system. PLoS One. 2014;9(9):e106781.CrossRefPubMedPubMedCentral
6.
African Development Bank. Angola 2011-2015. Country strategy paper & 2010 Country Portfolio performance Review. 2011.
7.
Butcher A, Jabara C, Jones L. Emerging African economies as growing markets for U.S. Exports, in USITEC executive briefings on trade. 2012.
8.
Huong DL, et al. Socio-economic status inequality and major causes of death in adults: a 5-year follow-up study in rural Vietnam. Public Health. 2006;120(6):497–504.CrossRefPubMed
9.
Misganaw A, Mariam DH, Araya T. Association of socioeconomic and behavioral factors with adult mortality: analysis of data from verbal autopsy in Addis Ababa, Ethiopia. BMC Public Health. 2013;13:634.CrossRefPubMedPubMedCentral
10.
Braveman P, Tarimo E. Social inequalities in health within countries: not only an issue for affluent nations. Soc Sci Med. 2002;54(11):1621–35.CrossRefPubMed
11.
World Health Organisation. Estimated deaths by cause, sex and WHO member state, 2012. Department of Health Statistics and Information Systems. Genebra: World Health Organisation; 2014.
12.
Ministério da Saúde de Angola. Relatório de Avaliação Nacional do Sistema de Informação Sanitária. In: Gabinete de Estudos PeE, editor. Luanda, Angola: Ministério da Saúde; 2010.
13.
e Pinto BA, Alves JG. The causes of death of hospitalized children in Angola. Trop Doct. 2008;38(1):66–7.CrossRefPubMed
14.
Ministério da Saúde de Angola. Plano Nacional de Desenvolvimento Sanitário 2012-2015. Angola: Ministério da Saúde; 2012.
15.
Costa MJA, et al. Setting up a demographic surveillance system in Northen Angola. Afr Popul Stud. 2012;26(2):133–146.
16.
Ministério do Planeamento – Instituto Nacional de Estatística. Inquérito Integrado sobre bem-estar da população. Relatório de tabelas. 2011.
17.
Ministério da Saúde de Angola. Plano municipal de desenvolvimento sanitário 2013-2017. Dande-Bengo: Ministério da Saúde; 2014.
18.
Anker MB, et al. A standard verbal autopsy method for investigating causes of death in infants and children in (WHO/CDS/CSR/ISR/99.4). Genebra: World Health Organization; 1999.
19.
INDEPTH-Network. Standard verbal autopsy questionnaire. Adapted from WHO/CDS/CSR/ISR/99.4. 2003.
20.
Bang AT, Bang RA. Diagnosis of causes of childhood deaths in developing countries by verbal autopsy: suggested criteria. The SEARCH Team. Bull World Health Organ. 1992;70(4):499–507.PubMedPubMedCentral
21.
Mobley CC, et al. Validation study of a verbal autopsy method for causes of childhood mortality in Namibia. J Trop Pediatr. 1996;42(6):365–9.CrossRefPubMed
22.
Quigley MA, Armstrong Schellenberg JR, Snow RW. Algorithms for verbal autopsies: a validation study in Kenyan children. Bull World Health Organ. 1996;74(2):147–54.PubMedPubMedCentral
23.
World Health Organisation. Mortality: guideline for certification and rules for coding. Geneva: International Statistical Classification of Diseases and Related Health Problems-tenth revision; 1993.
24.
Fikree FF, Azam SI, Berendes HW. Time to focus child survival programmes on the newborn: assessment of levels and causes of infant mortality in rural Pakistan. Bull World Health Organ. 2002;80(4):271–6.PubMedPubMedCentral
25.
Mwanyangala MA, et al. Verbal autopsy completion rate and factors associated with undetermined cause of death in a rural resource-poor setting of Tanzania. Popul Health Metr. 2011;9:41.CrossRefPubMedPubMedCentral
26.
World Health Organisation. International Statistical Classification of Diseases and Related Health Problems, 10th Revision. Geneva: World Health Organisation; 2010.
27.
GBD 2013 Mortality and Cause of Death Collaborators, Salomon JA. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117-71.
28.
Ahmad OE, Boschi-Pinto C, Lopez AD, Murray CJL, Lozano R, Inoue M. Age standardization of rates: a new WHO standard GPE. Discussion Paper Series: No. 31. Geneva: World Health Organization; 2000.
29.
van Eijk AM, et al. Causes of deaths using verbal autopsy among adolescents and adults in rural western Kenya. Trop Med Int Health. 2008;13(10):1314–24.CrossRefPubMed
30.
31.
Magalhaes RJ, et al. Finding malaria hot-spots in northern Angola: the role of individual, household and environmental factors within a meso-endemic area. Malar J. 2012;11:385.CrossRefPubMedPubMedCentral
32.
Sousa-Figueiredo JC, et al. Epidemiology of malaria, schistosomiasis, geohelminths, anemia and malnutrition in the context of a demographic surveillance system in northern Angola. PLoS One. 2012;7(4):e33189.CrossRefPubMedPubMedCentral
33.
Narh-Bana SA, et al. Adult deaths and the future: a cause-specific analysis of adult deaths from a longitudinal study in rural Tanzania 2003-2007. Trop Med Int Health. 2012;17(11):1396–404.CrossRefPubMed
34.
Leitao J, et al. Comparison of physician-certified verbal autopsy with computer-coded verbal autopsy for cause of death assignment in hospitalized patients in low- and middle-income countries: systematic review. BMC Med. 2014;12:22.CrossRefPubMedPubMedCentral
35.
Becher H, et al. Patterns of malaria: cause-specific and all-cause mortality in a malaria-endemic area of west Africa. Am J Trop Med Hyg. 2008;78(1):106–13.PubMed
36.
37.
Kaatano GM, et al. Patterns of malaria related mortality based on verbal autopsy in Muleba District, north-western Tanzania. Tanzan J Health Res. 2009;11(4):210–8.PubMed
38.
Raviglione MC, et al. Tuberculosis and HIV: current status in Africa. Aids. 1997;11(Suppl B):S115–23.PubMed
39.
Getahun H, et al. HIV infection-associated tuberculosis: the epidemiology and the response. Clin Infect Dis. 2010;50 Suppl 3:S201–7.CrossRefPubMed
40.
Ministério da Saúde de Angola. Discurso do Ministro da Saúde na Abertura do 24° Conselho Consultivo 16-17.Dez. Angola: Ministério da Saúde; 2014.
41.
Patton GC, et al. Global patterns of mortality in young people: a systematic analysis of population health data. Lancet. 2009;374(9693):881–92.CrossRefPubMed
42.
Sjursen IH. Angola Health Survey: Opportunities to reduce maternal and newborn mortality, I. Hestad, Editor. 2012, CHR MICHELSEN INSTITUTE & Centro de Estudos e Investigação Científica.
43.
Herbst AJ, Mafojane T, Newell ML. Verbal autopsy-based cause-specific mortality trends in rural KwaZulu-Natal, South Africa, 2000-2009. Popul Health Metr. 2011;9:47.CrossRefPubMedPubMedCentral
44.
Pires JE, Sebastiao YV, Langa AJ, Nery SV. Hypertension in Northern Angola: prevalence, associated factors, awareness, treatment and control. BMC Public Health. 2013;13(1):90.CrossRefPubMedPubMedCentral
45.
Marquez PV, Farrington JL. Sub-Saharan Africa: The Challenge of Non-Communicable Diseases and Road Traffic Injuries. Washington, DC: The World Bank; 2013.
46.
47.
Hanifi SMA, Mahmood SS and Bhuiya A. Cause-specific mortality and socioeconomic status in Chakaria, Bangladesh. Glob Health Action. 2014;7(25473).
48.
Kahn K, et al. Socio-economic status and child mortality in a rural sub-district of South Africa. INDEPTH Network. Measuring health equity in small areas: Findings from demographic surveillance sites. Aldershot: Ashgate; 2005. p. 67–86.
49.
Ye M, et al. An improved method for physician-certified verbal autopsy reduces the rate of discrepancy: experiences in the Nouna Health and Demographic Surveillance Site (NHDSS), Burkina Faso. Popul Health Metr. 2011;9:34.CrossRefPubMedPubMedCentral
50.
Fantahun M, et al. Young adult and middle age mortality in Butajira demographic surveillance site, Ethiopia: lifestyle, gender and household economy. BMC Public Health. 2008;8:268.CrossRefPubMedPubMedCentral
51.
52.
53.
Byass P, et al. Comparing verbal autopsy cause of death findings as determined by physician coding and probabilistic modelling: a public health analysis of 54 000 deaths in Africa and Asia. J Glob Health. 2015;5(1):010402.PubMedPubMedCentral
Metadata
Title
Main causes of death in Dande, Angola: results from Verbal Autopsies of deaths occurring during 2009–2012
Authors
Edite Vila Nova Rosário
Diogo Costa
Luís Timóteo
Ana Ambrósio Rodrigues
Jorge Varanda
Susana Vaz Nery
Miguel Brito
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3365-6

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