Adult mortality in sub‐Saharan Africa: cross‐sectional study of causes of death in Zambia

Chisumpa, Vesper Hichilombwe; Odimegwu, Clifford; Saikia, Nandita

doi:10.1111/tmi.13302

Cited by 11 publications

(9 citation statements)

References 37 publications

(51 reference statements)

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“…In LMICs, Group II diseases contributed more than half of the mortality overall (58.1%) and in both sexes. The proportion of adult deaths due to injuries in Kisumu was higher among men than women, similar to trends in other SSA countries [ 15 , 30 ]. Across all geographical areas, there was a high burden of Group I causes of death in ages 0–44 with a switch to Group II CODs in older age groups.…”

Section: Discussionsupporting

confidence: 76%

All-cause and cause-specific mortality rates for Kisumu County: a comparison with Kenya, low-and middle-income countries

Waruiru

Oramisi

Sila³

et al. 2022

BMC Public Health

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Background Understanding the magnitude and causes of mortality at national and sub-national levels for countries is critical in facilitating evidence-based prioritization of public health response. We provide comparable cause of death data from Kisumu County, a high HIV and malaria-endemic county in Kenya, and compared them with Kenya and low-and-middle income countries (LMICs). Methods We analyzed data from a mortuary-based study at two of the largest hospital mortuaries in Kisumu. Mortality data through 2019 for Kenya and all LMICs were downloaded from the Global Health Data Exchange. We provided age-standardized rates for comparisons of all-cause and cause-specific mortality rates, and distribution of deaths by demographics and Global Burden of Disease (GBD) classifications. Results The all-cause age-standardized mortality rate (SMR) was significantly higher in Kisumu compared to Kenya and LMICs (1118 vs. 659 vs. 547 per 100,000 population, respectively). Among women, the all-cause SMR in Kisumu was almost twice that of Kenya and double the LMICs rate (1150 vs. 606 vs. 518 per 100,000 population respectively). Among men, the all-cause SMR in Kisumu was approximately one and a half times higher than in Kenya and nearly double that of LMICs (1089 vs. 713 vs. 574 per 100,000 population). In Kisumu and LMICs non-communicable diseases accounted for most (48.0 and 58.1% respectively) deaths, while in Kenya infectious diseases accounted for the majority (49.9%) of deaths. From age 10, mortality rates increased with age across all geographies. The age-specific mortality rate among those under 1 in Kisumu was nearly twice that of Kenya and LMICs (6058 vs. 3157 and 3485 per 100,000 population, respectively). Mortality from injuries among men was at least one and half times that of women in all geographies. Conclusion There is a notable difference in the patterns of mortality rates across the three geographical areas. The double burden of mortality from GBD Group I and Group II diseases with high infant mortality in Kisumu can guide prioritization of public health interventions in the county. This study demonstrates the importance of establishing reliable vital registry systems at sub-national levels as the mortality dynamics and trends are not homogeneous.

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Section: Discussionsupporting

confidence: 76%

All-cause and cause-specific mortality rates for Kisumu County: a comparison with Kenya, low-and middle-income countries

Waruiru

Oramisi

Sila³

et al. 2022

BMC Public Health

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“…This suggests that, in sub-Saharan Africa, violence is less predictive of lifetime uncertainty. Other factors contributing to high young- and middle-adult mortality rates in the region, such as communicable diseases including HIV, are likely more important drivers of lifetime uncertainty ( 30 , 31 ). As indicated by the interaction term (GPI × year) in Table 2 , the association between GPI and lifetime uncertainty remains similar across years, with the exception of the MENA.…”

Section: Resultsmentioning

confidence: 99%

“…This suggests that for this region violence is less predictive of lifetime uncertainty. Other factors contributing to high young and middle adult mortality in the region, such as the role of communicable diseases including HIV, are more important drivers of lifetime uncertainty 34,35 .…”

Section: Figure 1 Global Lifetime Uncertainty (Standard Deviation) An...mentioning

confidence: 99%

A global assessment of the impact of violence on lifetime uncertainty

et al. 2023

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Uncertainty around age at death, or lifetime uncertainty, is a key public health indicator and a marker of inequality in survival. How does the extent of violence affect lifetime uncertainty? We address this question by quantifying the impact of violence on dispersion in the ages at death, the metric most used to measure lifetime uncertainty. Using mortality data from the Global Burden of Disease Study and the Internal Peace Index between 2008 and 2017, we find that the most violent countries are also those with the highest lifetime uncertainty. In the Middle East, conflict-related deaths are the largest contributor to lifetime uncertainty. In Latin America, a similar pattern is attributable to homicides. The effects are larger in magnitude for men, but the consequences remain considerable for women. Our study points to a double burden of violence on longevity: Not only does violence shorten individual lives, but it also makes the length of life less predictable.

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“…In Zambia, HIV remains the leading cause of death [ 19 ]. Government entities like the National HIV/AIDS/STI/TB Council (NAC) value the importance of strengthening the public health workforce in order to analyse routine HIV surveillance data from government health information systems [ 20 ].…”

Section: Project Evaluationmentioning

confidence: 99%

Zambia field epidemiology training program: strengthening health security through workforce development

Kateule¹,

Sinyange²,

Malambo³

et al. 2020

Pan Afr Med J

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The Zambia Field Epidemiology Training Program (ZFETP) was established by the Ministry of Health (MoH) during 2014, in order to increase the number of trained field epidemiologists who can investigate outbreaks, strengthen disease surveillance, and support data-driven decision making. We describe the ZFETP´s approach to public health workforce development and health security strengthening, key milestones five years after program launch, and recommendations to ensure program sustainability. Program description: ZFETP was established as a tripartite arrangement between the Zambia MoH, the University of Zambia School of Public Health, and the U.S. Centers for Disease Control and Prevention. The program runs two tiers: Advanced and Frontline. To date, ZFETP has enrolled three FETP-Advanced cohorts (training 24 residents) and four Frontline cohorts (training 71 trainees). In 2016, ZFETP moved organizationally to the newly established Zambia National Public Health Institute (ZNPHI). This re-positioning raised the program´s profile by providing residents with increased opportunities to lead high-profile outbreak investigations and analyze national surveillance data-achievements that were recognized on a national stage. These successes attracted investment from the Government of Republic of Zambia (GRZ) and donors, thus accelerating field epidemiology workforce capacity development in Zambia. In its first five years, ZFETP achieved early success due in part to commitment from GRZ, and organizational positioning within the newly formed ZNPHI, which have catalyzed ZFETP´s institutionalization. During the next five years, ZFETP seeks to sustain this momentum by expanding training of both tiers, in order to accelerate the professional development of field epidemiologists at all levels of the public health system.

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Adult mortality in sub‐Saharan Africa: cross‐sectional study of causes of death in Zambia

Cited by 11 publications

References 37 publications

All-cause and cause-specific mortality rates for Kisumu County: a comparison with Kenya, low-and middle-income countries

All-cause and cause-specific mortality rates for Kisumu County: a comparison with Kenya, low-and middle-income countries

A global assessment of the impact of violence on lifetime uncertainty

Zambia field epidemiology training program: strengthening health security through workforce development

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