Causes of Death among Adults in Northern Ethiopia: Evidence from Verbal Autopsy Data in Health and Demographic Surveillance System

Abstract

BackgroundIn countries where registration of vital events is lacking and the proportion of people who die at home without medical care is high, verbal autopsy is used to determine and estimate causes of death.MethodsWe conducted 723 verbal autopsy interviews of adult (15 years of age and above) deaths from September 2009 to January 2013. Trained physicians interpreted the collected verbal autopsy data, and assigned causes of death according to the international classification of diseases (ICD-10). We did analysis of specific as well as broad causes of death (i.e. non-communicable diseases, communicable diseases and external causes of death) by sex and age using Stata version 11.1. We performed logistic regression to identify socio-demographic predictors using odds ratio with 95% confidence interval and a p-value of 0.05.FindingsTuberculosis, cerebrovascular diseases and accidental falls were leading specific causes of death accounting for 15.9%, 7.3% and 3.9% of all deaths. Two hundred sixty three (36.4% [95% CI: 32.9, 39.9]), 252 (34.9% [95% CI: 31.4, 38.4]) and 89 (12.3% [95% CI: 10.1, 14.9]) deaths were due to non-communicable, communicable diseases, and external causes, respectively. Females had 1.5 times (AOR = 1.53 [95% CI: 1.10, 2.15]) higher odds of dying due to communicable diseases than males. The odds of dying due to external causes were 4 times higher among 15–49 years of age (AOR = 4.02 [95% CI: 2.25, 7.18]) compared to older ages. Males also had 1.7 times (AOR = 1.70 [95% CI: 1.01, 2.85]) higher odds of dying due to external causes than females.ConclusionTuberculosis, cerebrovascular diseases and accidental falls were the top three causes of death among adults. Efforts to prevent tuberculosis and cerebrovascular diseases related deaths should be improved and safety efforts to reduce accidents should also receive attention.

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

“…Deaths from injury and accidents among both males and females are more common among decedents with higher levels of education. This finding is consistent with studies conducted in Ethiopia . This is a cause of great concern as highly educated persons contribute importantly to the country's economy and socio‐economic development.…”

“…The use of verbal autopsy (VA) data is increasing in the most sub-Saharan Africa countries [12,13]. Previous studies have used VA data to analyse cause-specific mortality, behavioural risk factors and the impact of public health interventions [14][15][16][17].…”

The impact of dietary risk factors on the burden of non-communicable diseases in Ethiopia: findings from the Global Burden of Disease study 2013

“…In Mauritius, for instance, the proportion of cardiovascular mortality associated with high consumption of sodium was 27.4% [14]. Morbidity and mortality due to CVD are prevalent in Ethiopia [5, 33]. Although the mean sodium intake is higher (2.27 g/day) [37] than the WHO recommended limit (2 g/day), the associated burden of NCDs has not been investigated in previous studies.…”

“…Particularly, evidence shows that addressing dietary risks through nutrition policies and multi-sectoral collaboration are cost effective in mitigating burden of NCDs in developing countries [41, 42]; however, efforts are very limited [20]. In Ethiopia, emphasis has been given to interventions for infectious diseases and maternal health and child undernutrition [43, 44] although the burden of NCDs is high [5, 45]. However, in recent years the government of Ethiopia has acknowledged the increasing burden of NCDs and hence developed a prevention and control strategic action plan [9].…”

“…The number of NCD deaths in the region has risen by 68.0% between 1990 and 2013 [4]. In Ethiopia, despite the prevailing high burden of communicable diseases, the proportion of deaths due to NCDs has increased by 73.7% in these years [1–3, 5] and in 2013, more than a third (35.1%) of all deaths were caused by NCDs. CVD was the second most common causes of death behind specific infectious diseases (diarrhoea, lower respiratory and other infectious diseases together), accounting for 121,211 deaths (16.2% of all deaths) in the country [3].…”