Causes of death in Vanuatu

Abstract

BackgroundThe population of the Pacific Melanesian country of Vanuatu was 234,000 at the 2009 census. Apart from subsistence activities, economic activity includes tourism and agriculture. Current completeness of vital registration is considered too low to be usable for national statistics; mortality and life expectancy (LE) are derived from indirect demographic estimates from censuses/surveys. Some cause of death (CoD) data are available to provide information on major causes of premature death.MethodsDeaths 2001–2007 were coded for cause (ICDv10) for ages 0–59 years from: hospital separations (HS) (n = 636), hospital medical certificates (MC) of death (n = 1,169), and monthly reports from community health facilities (CHF) (n = 1,212). Ill-defined causes were 3 % for hospital deaths and 20 % from CHF. Proportional mortality was calculated by cause (excluding ill-defined) and age group (0–4, 5–14 years), and also by sex for 15–59 years. From total deaths by broad age group and sex from 1999 and 2009 census analyses, community deaths were estimated by deduction of hospital deaths MC. National proportional mortality by cause was estimated by a weighted average of MC and CHF deaths.ResultsNational estimates indicate main causes of deaths <5 years were: perinatal disorders (45 %) and malaria, diarrhea, and pneumonia (27 %). For 15–59 years, main causes of male deaths were: circulatory disease 27 %, neoplasms 13 %, injury 13 %, liver disease 10 %, infection 10 %, diabetes 7 %, and chronic respiratory disease 7 %; and for females: neoplasms 29 %, circulatory disease 15 %, diabetes 10 %, infection 9 %, and maternal deaths 8 %. Infection included tuberculosis, malaria, and viral hepatitis. Liver disease (including hepatitis and cancer) accounted for 18 % of deaths in adult males and 9 % in females. Non-communicable disease (NCD), including circulatory disease, diabetes, neoplasm, and chronic respiratory disease, accounted for 52 % of premature deaths in adult males and 60 % in females. Injuries accounted for 13 % in adult males and 6 % in females. Maternal deaths translate into an annual maternal mortality ratio of 130/100,000 for the period.ConclusionVanuatu manifests a double burden of disease with significant proportional mortality from perinatal disorders and infection/pneumonia <5 years and maternal mortality, coupled with significant proportional mortality in adults (15–59 years) from cardiovascular disease (CVD), neoplasms, and diabetes.

Estimating the pattern of causes of death in Papua New Guinea

“…Males account for twice the burden of injuries as females, similar to what has been reported in Vanuatu [40]. Provinces with the highest burden of injuries are believed to have the highest rates of violence and road traffic accidents.…”

“…Non-communicable diseases are becoming more prominent than infectious diseases, maternal and conditions of poverty globally [35], regionally [40, 41], and in some sections of the PNG population [16, 21]. Our findings demonstrate that evidence of more advanced epidemiological transition in PNG, measured both as the % of all deaths from but also in comparison to the level of infectious disease mortality, is related to higher socioeconomic status [23].…”

“…Our findings from this study show Groups 1 & 2, both in children and also adults and are much more important as a cause of death accounting for 41% of deaths in males and 49% of deaths in females. This is almost double what is reported by the GBD [35] (23% for males and 29% for females) and for other Melanesian countries [40, 41]. The GBD Study estimates lower infectious disease mortality for PNG due to the greater reliance on data from neighbouring countries such as Fiji, Tonga and Samoa, all Pacific countries with higher NCD mortality [35].…”

Premature Mortality From Noncommunicable Diseases in the Federated States of Micronesia, 2003-2012

“…In this study, the 4 major NCDs-cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases-accounted for 71.5% of all premature deaths and 85.3% of NCDspecific premature deaths. The high proportion of premature NCD deaths in FSM is similar to other Pacific island countries and territories, including Fiji, 18 Nauru, 19 Vanuatu, 20 and Tonga. 21 Diabetes was the leading cause of premature death in Micronesian males (17.1%) and females (24.1%).…”

Cancer registration challenges in low- and middle-income countries-the case of the Pacific Islands

“…Under‐recording is likely to have contributed to these differences. Despite relatively low (reported) cancer incidence in many PICTs, cancer is one of the leading causes of death in the region (Carter et al., , ; Pacific Regional Central Cancer Registry, ). There are distinguishing features of cancer epidemiology in the PICTs, such as very high thyroid cancer incidence in New Caledonia and French Polynesia (Ferlay et al., ), a high burden of cervical and uterine cancers, especially in Fiji and the Cook Islands (Foliaki et al., ; Law et al., ) and a high burden of oral cavity and pharyngeal cancers linked with betel nut chewing (Moore et al., ; Pacific Regional Central Cancer Registry, ).…”