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Malaria Journal
Published in: Malaria Journal 1/2018

Open Access 01-12-2018 | Research

Pattern of all-causes and cause-specific mortality in an area with progressively declining malaria burden in Korogwe district, north-eastern Tanzania

Authors: Daniel P. Challe, Mathias L. Kamugisha, Bruno P. Mmbando, Filbert Francis, Mercy G. Chiduo, Celine I. Mandara, Samuel Gesase, Omari Abdul, Martha M. Lemnge, Deus S. Ishengoma

Published in: Malaria Journal | Issue 1/2018

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Abstract

Background

Although death records are useful for planning and monitoring health interventions, such information is limited in most developing countries. Verbal autopsy (VA) interviews are alternatively used to determine causes of death in places without or with incomplete hospital records. This study was conducted to determine all causes and cause-specific mortality in Korogwe health and demographic surveillance system (HDSS) undertaken in Korogwe district, northeastern Tanzania.

Methods

The study was conducted from January 2006 to December 2012 in 14 villages under Korogwe HDSS. Vital events such as births, deaths and migrations were routinely updated quarterly. A standard VA questionnaire was administered to parents/close relatives of the deceased to determine cause of death.

Results

Overall, 1325 deaths of individuals with median age of 46 years were recorded in a population with 170,471.4 person years observed (PY). Crude mortality rate was 7.8 per 1000 PY (95% CI 7.2–8.4) and the highest rate was observed in infants (77.9 per 1000 PY; 95% CI 67.4–90.0). The overall mortality increased between 2006 and 2007, followed by a slight decline up to 2011, with the highest decrease observed in 2012. Causes of deaths were established in 942 (71.1%) deaths and malaria (198 deaths, 21.0%) was the leading cause of death in all age groups except adults (15–59 years). HIV/AIDS (17.6%, n = 365) was the leading cause of death in individuals aged 15–59 years followed by malaria (13.9%) and tuberculosis. Non-communicable diseases (NCDs) including stroke, hypertension, cancer, and cardiac failure caused majority of deaths in elderly (60 years and above) accounting for 37.1% (n = 348) of all deaths, although malaria was the single leading cause of death in this group (16.6%).

Conclusion

The study showed a significant decline of deaths in the Korogwe HDSS site and malaria was the main cause of death in all age groups (except adults, aged 15–59 years) while HIV/AIDS and NCDs were the main causes in adults and elderly, respectively. Further surveillance is required to monitor and document changes in cause-specific mortality as malaria transmission continues to decline in this and other parts of Tanzania.
Literature
1.
Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every year? Lancet. 2003;361(9376):2226–34.CrossRefPubMed
2.
Müller O, Traoré C, Becher H, Kouyaté B. Malaria morbidity, treatment-seeking behaviour, and mortality in a cohort of young children in rural Burkina Faso. Trop Med Int Health. 2003;8(4):290–6.CrossRefPubMed
3.
Etard JF, Le Hesran J, Diallo A, Diallo J, Ndiaye J, Delaunay V. Childhood mortality and probable causes of death using verbal autopsy in Niakhar. Int J Epidemiol. 2004;33:1286–92.CrossRefPubMed
4.
Oti SO, Kyobutungi C. Verbal autopsy interpretation: a comparative analysis of the InterVA model versus physician review in determining causes of death in the Nairobi DSS. Popul Health Metr. 2010;8:21.CrossRefPubMedPubMedCentral
5.
6.
WHO. Improving Mortality Statistics through Civil Registration and Vital Statistics Systems. Strategies for country and partner support. Outcome of a technical meeting. Geneva, World Health Organization; 2014.
7.
Yéemail M, Diboulo E, Niamba L, Sié A, Coulibaly B, Bagagnan C, 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.CrossRef
8.
WHO. Verbal autopsy standards: ascertaining and attributing causes of deaths. The WHO verbal autopsy instrument. Geneva: World Health Organization; 2012. p. 2012.
9.
Deressa W, Fantahun M, Ali A. Malaria-related mortality based on verbal autopsy in an area of low endemicity in a predominantly rural population in Ethiopia. Malar J. 2007;6:128.CrossRefPubMedPubMedCentral
10.
Soofi SB, Ariff S, Khan U, Turab A, Khan GN, Habib A, et al. Diagnostic accuracy of WHO verbal autopsy tool for ascertaining causes of neonatal deaths in the urban setting of Pakistan: a hospital-based prospective study. BMC Pediatr. 2015;15:144.CrossRefPubMedPubMedCentral
11.
Misganaw A, Mariam DH, Araya T, Aneneh A. Validity of verbal autopsy method to determine causes of death among adults in the urban setting of Ethiopia. BMC Med Res Methodol. 2012;12:130.CrossRefPubMedPubMedCentral
12.
Adjuik M, Smith T, Clark S, Todd J, Garrib A, Kinfu Y, et al. Cause-specific mortality rates in sub-Saharan Africa and Bangladesh. Bull World Health Organ. 2006;84(3):181–8.CrossRefPubMedPubMedCentral
13.
Kaatano GM, Mashauri FM, Hi SMK, Mwanga JR, Malima RC. Patterns of malaria related mortality based on verbal autopsy in Muleba district, north-western Tanzania. Tanzan J Health Res. 2009;11:210–8.PubMed
14.
Institute for Health Metrics and Evaluation. The global burden of disease: generating evidence, guiding policy. Seattle: IHME; 2013.
15.
Selvaraj K, Chinnakali P, Majumdar A, Krishnan IS. Acute respiratory infections among under-5 children in India: a situational analysis. J Nat Sci Biol Med. 2014;5:15–20.CrossRefPubMedPubMedCentral
16.
Becher H, Kynast-wolf G, Sié A, Ndugwa R, Ramroth H, Kouyaté B, 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;78:106–13.PubMed
17.
van Eijk A, Adazu K, Ofware P, Vulule J, Hamel M, Slutsker L. Causes of deaths using verbal autopsy among adolescents and adults in rural western Kenya. Trop Med Int Health. 2008;13:1314–24.CrossRefPubMed
18.
Ebireri J, Aderemi AV, Omoregbe N, Adeloye D. Interventions addressing risk factors of ischaemic heart disease in sub-Saharan Africa: a systematic review. BMJ Open. 2016;6:e011881.CrossRefPubMedPubMedCentral
19.
Blomstedt Y, Preet R, Hoffman K, Bangha M, Kinsman J. Tanzania country report October 2012. INDEPTH Train Res Centres Excell Tanzania. 2012;2012:1–81.
20.
Andre FE, Booy R, Bock HL, Clemens J, Datta SK, John T, et al. Vaccination greatly reduces disease, disability, death and inequity worldwide. Bull World Health Organ. 2008;86:81–160.CrossRef
21.
Cairncross S, Valdmanis V. Disease control priorities in development countries water supply, sanitation, and hygiene promotion (2nd Ed) (Jamison DT et al. eds), Chapter 41. New York: Oxford Univ Press; 2006.
22.
23.
24.
Mmbando BP, Vestergaard LS, Kitua AY, Lemnge MM, Theander TG, Lusingu JPA. A progressive declining in the burden of malaria in north-eastern Tanzania. Malar J. 2010;9:216.CrossRefPubMedPubMedCentral
25.
Drakeley C, Abdulla S, Agnandji ST, Fernandes JF, Kremsner P, Lell B, et al. Longitudinal estimation of Plasmodium falciparum prevalence in relation to malaria prevention measures in six sub-Saharan African countries. Malar J. 2017;16:433.CrossRefPubMedPubMedCentral
26.
Mmbando BP, Segeja MD, Msangeni HA, Sembuche SH, Ishengoma DS, Seth MD, et al. Epidemiology of malaria in an area prepared for clinical trials in Korogwe, north-eastern Tanzania. Malar J. 2009;8:165.CrossRefPubMedPubMedCentral
27.
Rutta ASM, Francis F, Mmbando BP, Ishengoma DS, Sembuche SH, Malecela EK, et al. Using community-owned resource persons to provide early diagnosis and treatment and estimate malaria burden at community level in north-eastern Tanzania. Malar J. 2012;11:152.CrossRefPubMedPubMedCentral
28.
Drakeley CJ, Corran PH, Coleman PG, Tongren JE, McDonald SLR, Carneiro I, et al. Estimating medium- and long-term trends in malaria transmission by using serological markers of malaria exposure. Proc Natl Acad Sci USA. 2005;102:5108–13.CrossRefPubMedPubMedCentral
29.
Kamugisha ML, Mmbando BP, Francis F, Ishengoma DS, Challe DP, Lemnge MM. Establishing and implementing Demographic Surveillance System as a tool for monitoring health interventions in Korogwe district, north-eastern Tanzania. Tanzan J Health Res. 2011;13:57–67.PubMed
30.
National Bureaul of Statistics. 2012 population and housing census: population distribution by administrative area. 2013. http://​www.​nbs.​go.​tz. Accessed on November 2016.
31.
Liheluka EA, Lusingu JP, Manongi RN. Community perceptions on the secondary health benefits established by malaria vaccine trials (RTS, S phase 2 and phase 3) at the Korogwe site in north eastern Tanzania. Malar J. 2013;12:157.CrossRefPubMedPubMedCentral
32.
Phillips JF, Macleod BB, Pence B. The Household Registration System: computer software for the rapid dissemination of demographic surveillance systems. Demogr Res. 2000;2:6.CrossRef
33.
34.
35.
36.
Centre for Disease Control and Prevention. Cause-specific adult mortality: evidence from community based surveillance selected sites, Tanzania, 1992–1998. MMWR. 2000;49:416–9.
37.
Masanja H, de Savigny D, Smithson P, Schellenberg J, John T, Mbuya C, et al. Child survival gains in Tanzania: analysis of data from demographic and health surveys. Lancet. 2008;371:1276–83.CrossRefPubMed
38.
Lutambi AM, Alexander M, Charles J, Mahutanga C, Nathan R. Under-five mortality: spatial-temporal clusters in Ifakara HDSS in south-eastern Tanzania. Glob Health Action. 2010;3:32–41.
39.
Kynast-Wolf G, Hammer GP, Müller O, Kouyaté B, Becher H. Season of death and birth predict patterns of mortality in Burkina Faso. Int J Epidemiol. 2006;35:427–35.CrossRefPubMed
40.
Kanjala C, Alberts M, Byass P, Burger S. Spatial and temporal clustering of mortality in Digkale HDSS in rural northern South Africa. Glob Health Action. 2010;3:59–63.
41.
Nakamura H, Ikeda N, Stickley A, Mori R, Shibuya K. Achieving MDG 4 in sub-Saharan Africa: what has contributed to the accelerated child mortality decline in Ghana? PLoS One. 2011;6:e177774.
42.
Jasseh M, Howie SRC, Gomez P, Scott S, Roca A, Cham M, et al. Disease-specific mortality burdens in a rural Gambian population using verbal autopsy, 1998 2007. Glob Health Action. 2014;7:25598.CrossRefPubMed
43.
Kamugisha ML, Gesase S, Mlwilo TD, Mmbando BP, Segeja MD, Minja DT, et al. Malaria specific mortality in lowlands and highlands of Muheza district, north-eastern Tanzania. Tanzan Health Res Bull. 2007;9:32–7.PubMed
44.
45.
Biggs HM, Lester R, Nadjm B, Mtove G, Todd JE, Kinabo GD, et al. Invasive Salmonella infections in areas of high and low malaria transmission intensity in Tanzania. Clin Infect Dis. 2014;58:638–47.CrossRefPubMed
46.
Gjonҫa A, Tomassini C, Vaupel JW. Male-female differences in mortality in the developed world. MPIDR working paper WP 1999-009, July 1999. http://​www.​demogr.​mpg.​de. Accessed June 05, 2017.
47.
48.
Kahabuka C, Kvåle G, Hinderaker SG. Factors associated with severe disease from malaria, pneumonia and diarrhea among children in rural Tanzania—a hospital-based cross-sectional study. BMC Infect Dis. 2012;12:219.CrossRefPubMedPubMedCentral
49.
Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379:2151–61.CrossRefPubMed
50.
Ndugwa RP, Ramroth H, Müller O, Jasseh M, Sié A, Kouyaté B, et al. Comparison of all-cause and malaria-specific mortality from two West African countries with different malaria transmission patterns. Malar J. 2008;7(1):15.CrossRefPubMedPubMedCentral
51.
Jahn A, Floyd S, Mvula H, Mwinuka V, Mwaiyeghele E, Mcgrath N, et al. Declining child mortality in northern Malawi despite high rates of infection with HIV. Bull World Health Organ. 2010;88:746–53.CrossRefPubMedPubMedCentral
52.
Chandramohan D, Rodrigues LC, Maude GH, Hayes RJ. The validity of verbal autopsies for assessing the causes of institutional maternal death. Stud Fam Plann. 1998;29:414–22.CrossRefPubMed
53.
De Weta N, Oluwaseyia S, Odimegwua C. Youth mortality due to HIV/AIDS in South Africa, 2001–2009: an analysis of the levels of mortality using life table techniques. Afr J AIDS Res. 2014;13:13–20.CrossRef
54.
Walker RW, Jusabani A, Aris E, Gray WK, Unwin N, Swai M, et al. Stroke risk factors in an incident population in urban and rural Tanzania: a prospective, community-based, case–control study. Lancet Glob Health. 2013;1:282–8.CrossRef
55.
Bodker R, Msangeni H, Kisinza W, Lindsay S. Relationship between the intensity of exposure to malaria parasites and infection in the Usambara Mountains, Tanzania. Am J Trop Med Hyg. 2006;74:716–23.PubMed
56.
Drakeley C, Carneiro I, Reyburn H, Malima R, Lusingu J, Cox J, et al. Altitude dependent and -independent variations in Plasmodium falciparum prevalence in northeastern Tanzania. J Infect Dis. 2005;191:1589–98.CrossRefPubMed
57.
Lusingu J, Vestergaard L, Mmbando B, Drakeley C, Jones C, Akida J, et al. Malaria morbidity and immunity among residents of villages with different Plasmodium falciparum transmission intensity in north-eastern Tanzania. Malar J. 2004;2:26.CrossRef
58.
Meyrowitsch DW, Pedersen EM, Alifrangis M, Scheike TH, Malecela MN, Magesa SM, et al. Is the current decline in malaria burden in sub-Saharan Africa due to a decrease in vector population? Malar J. 2011;10:188.CrossRefPubMedPubMedCentral
59.
Mboera LEG, Mazigo HD, Rumisha SF, Kramer RA. Towards malaria elimination and its implication for vector control, disease management and livelihoods in Tanzania. Malar World J. 2013;4:18–20.
60.
O’Meara WP, Mangeni JN, Steketee R, Greenwood B. Changes in the burden of malaria in sub-Saharan Africa. Lancet. 2010;10:545–55.CrossRefPubMed
Metadata
Title
Pattern of all-causes and cause-specific mortality in an area with progressively declining malaria burden in Korogwe district, north-eastern Tanzania
Authors
Daniel P. Challe
Mathias L. Kamugisha
Bruno P. Mmbando
Filbert Francis
Mercy G. Chiduo
Celine I. Mandara
Samuel Gesase
Omari Abdul
Martha M. Lemnge
Deus S. Ishengoma
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2018
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-018-2240-6

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