Causes of death among females–investigating beyond maternal causes: a community-based longitudinal study

Abstract

BackgroundIn developing countries, investigating mortality levels and causes of death among all age female population despite the childhood and maternal related deaths is important to design appropriate and tailored interventions and to improve survival of female residents.MethodsUnder Kilite-Awlealo Health and Demographic Surveillance System, we investigated mortality rates and causes of death in a cohort of female population from 1st of January 2010 to 31st of December 2012. At the baseline, 33,688 females were involved for the prospective follow-up study. Households under the study were updated every six months by fulltime surveillance data collectors to identify vital events, including deaths. Verbal Autopsy (VA) data were collected by separate trained data collectors for all identified deaths in the surveillance site. Trained physicians assigned underlining causes of death using the 10th edition of International Classification of Diseases (ICD). We assessed overall, age- and cause-specific mortality rates per 1000 person-years. Causes of death among all deceased females and by age groups were ranked based on cause specific mortality rates. Analysis was performed using Stata Version 11.1.ResultsDuring the follow-up period, 105,793.9 person-years of observation were generated, and 398 female deaths were recorded. This gave an overall mortality rate of 3.76 (95% confidence interval (CI): 3.41, 4.15) per 1,000 person-years. The top three broad causes of death were infectious and parasitic diseases (1.40 deaths per 1000 person-years), non-communicable diseases (0.98 deaths per 1000 person-years) and external causes (0.36 per 1000 person-years). Most deaths among reproductive age female were caused by Human Deficiency Virus/Acquired Immune Deficiency Virus (HIV/AIDS) and tuberculosis (0.14 per 1000 person-years for each cause). Pregnancy and childbirth related causes were responsible for few deaths among women of reproductive age—3 out of 73 deaths (4.1%) or 5.34 deaths per 1,000 person-years.ConclusionsCommunicable diseases are continued to be the leading causes of death among all age females. HIV/AIDS and tuberculosis were major causes of death among women of reproductive age. Together with existing efforts to prevent pregnancy and childbirth related deaths, public health and curative interventions on other causes, particularly on HIV/AIDS and tuberculosis, should be strengthened.

Gaps related to screening and diagnosis of tuberculosis in care cascade in selected health facilities in East Africa countries: A retrospective study

“…Intensifying TB screening into RCH services, diabetic and other clinics would increase TB case detection and patients receiving care is hereby recommended. Literature suggests that the magnitude of TB among women attending RCH clinics is high [12] , [13] , [14] and people with diabetes are at increased risk of infections and reactivation because their immuno-compromised status [15] . Ending TB and diabetes requires a joint response to ensure that all people with TB and those with diabetes have access to much-needed care on both fronts [16] , and the WHO recommends systematic screening for TB in people with diabetes especially in settings with high TB prevalence [17] .…”

Causes of death among women of reproductive age during the war in Tigray, Ethiopia

“…This is consistent with previous studies conducted in peaceful settings, which have consistently found that infectious diseases and pregnancy-related causes are the main killers among women in developing countries [ 24 – 27 ]. In some studies, even infectious disease related deaths alone outnumber NCDs and external causes combined [ 25 , 26 ]. Although infectious diseases were dominant even in non-conflict settings, research shows that the impact of infectious diseases usually increases after armed conflicts, mostly due to health system disruption [ 28 , 29 ].…”

How much do the physician review and InterVA model agree in determining causes of death? a comparative analysis of deaths in rural Ethiopia

“…The KA-HDSS is a member of the INDEPTH Network [ 16 ]. Details of the surveillance system, study population, and operating procedures have been published previously [ 2 , 17 – 19 ]. The surveillance started with a baseline population of 66,453 individuals living in 14,453 households.…”