Cause-specific mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites
Author(s)
Type
Journal Article
Abstract
BACKGROUND: Because most deaths in Africa and Asia are not well documented, estimates of mortality are often made using scanty data. The INDEPTH Network works to alleviate this problem by collating detailed individual data from defined Health and Demographic Surveillance sites. By registering all deaths over time and carrying out verbal autopsies to determine cause of death across many such sites, using standardised methods, the Network seeks to generate population-based mortality statistics that are not otherwise available. OBJECTIVE: To build a large standardised mortality database from African and Asian sites, detailing the relevant methods, and use it to describe cause-specific mortality patterns. DESIGN: Individual demographic and verbal autopsy (VA) data from 22 INDEPTH sites were collated into a standardised database. The INDEPTH 2013 population was used for standardisation. The WHO 2012 VA standard and the InterVA-4 model were used for assigning cause of death. RESULTS: A total of 111,910 deaths occurring over 12,204,043 person-years (accumulated between 1992 and 2012) were registered across the 22 sites, and for 98,429 of these deaths (88.0%) verbal autopsies were successfully completed. There was considerable variation in all-cause mortality between sites, with most of the differences being accounted for by variations in infectious causes as a proportion of all deaths. CONCLUSIONS: This dataset documents individual deaths across Africa and Asia in a standardised way, and on an unprecedented scale. While INDEPTH sites are not constructed to constitute a representative sample, and VA may not be the ideal method of determining cause of death, nevertheless these findings represent detailed mortality patterns for parts of the world that are severely under-served in terms of measuring mortality. Further papers explore details of mortality patterns among children and specifically for NCDs, external causes, pregnancy-related mortality, malaria, and HIV/AIDS. Comparisons will also be made where possible with other findings on mortality in the same regions. Findings presented here and in accompanying papers support the need for continued work towards much wider implementation of universal civil registration of deaths by cause on a worldwide basis.
Date Issued
2014-10-29
Date Acceptance
2014-09-02
Citation
Global Health Action, 2014, 7
ISSN
1654-9880
Publisher
Co-Action Publishing
Journal / Book Title
Global Health Action
Volume
7
Copyright Statement
© 2014 INDEPTH Network. This is an Open Access article distributed under the terms of the Creative Commons CC-BY 4.0License (http://creativecommons.org/licenses/by/4.0/), allowing third parties to copy and redistribute the material in any medium or format andto remix,transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/25377324
PII: 25362
Subjects
Africa
Asia
INDEPTH Network
cause of death
mortality
verbal autopsy
Africa
Asia
Autopsy
Cause of Death
Data Collection
Databases, Factual
Demography
Female
Humans
Male
Mortality
Population Surveillance
Publication Status
Published
Coverage Spatial
United States
Article Number
ARTN 25362
Date Publish Online
2014-10-29