scholarly journals Trends and causes of adult mortality from 2007 to 2017 using verbal autopsy method, Addis Ababa, Ethiopia

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e047095
Author(s):  
Esete Habtemariam Fenta ◽  
Binyam Girma Sisay ◽  
Seifu H Gebreyesus ◽  
Bilal Shikur Endris
Keyword(s):  
Cause Of Death ◽  
Verbal Autopsy ◽  
Community Education ◽  
Communicable Disease ◽  
Addis Ababa ◽  
Total Mortality ◽  
Adult Mortality ◽  
Communicable Diseases ◽  
Nutritional Deficiencies ◽  
Physician Review

ObjectivesWe aim to analyse the trends and causes of mortality among adults in Addis Ababa.SettingThis analysis was conducted using verbal autopsy data from the Addis Ababa Mortality Surveillance in Addis Ababa, Ethiopia.ParticipantsAll deceased adults aged 15 years and above between 2007–2012 and 2015–2017 were included in the analysis.Outcome measuresWe collected verbal autopsy and conducted physician review to ascertain cause of death.ResultA total of 7911 data were included in this analysis. Non-communicable disease (NCD) accounted for 62.8% of adult mortality. Mortality from communicable diseases, maternal conditions and nutritional deficiencies followed this by accounting for 30.3% of total mortality. Injury accounted for 6.8% of total mortality. We have observed a significant decline in mortality attributed to group one cause of death (43.25% in 2007 to 12.34% in 2017, p<0.001). However, we observed a significant increase in mortality attributed to group II cause of death (from 49.95% in 2007 to 81.17% in 2017, p<0.001). The top five leading cause of death in 2017 were cerebrovascular disease (12.8%), diabetes mellitus (8.1%), chronic liver disease (6.3%), hypertension (5.7%), ischaemic heart disease (5.7%) and other specified neoplasm (5.2%).ConclusionWe documented an epidemiological shift in cause of mortality from communicable diseases to NCD over 10 years. There is a great progress in reducing mortality due to communicable diseases over the past years. However, the burden of NCDs call for actions for improving access to quality health service, improved case detection and community education to increase awareness. Integrating NCD intervention in to a well-established and successful programme targeting communicable diseases in the country might be beneficial for improving provision of comprehensive healthcare.

scholarly journals A comparative analysis of the InterVA model versus physician review in determining causes of neonatal deaths using verbal autopsy data from Nepal

2021 ◽  
Author(s):  
Dinesh Dharel ◽  
Penny Dawson ◽  
Daniel Adeyinka ◽  
Nazeem Muhajarine ◽  
Dinesh Neupane
Keyword(s):  
Cause Of Death ◽  
Verbal Autopsy ◽  
Neonatal Sepsis ◽  
Neonatal Death ◽  
Birth Asphyxia ◽  
Neonatal Infection ◽  
Proximate Cause ◽  
Neonatal Deaths ◽  
Physician Review ◽  
Autopsy Data

Abstract Background: Verbal autopsy is a common method of ascertaining the cause of neonatal death in low resource settings where majority of causes of deaths remain unregistered. We aimed to compare the causes of neonatal deaths assigned by computer algorithm-based model, InterVA (Interpreting Verbal Autopsy) with the usual standard of Physician Review of Verbal Autopsy (PRVA) using the verbal autopsy data collected by Morang Innovative Neonatal Intervention (MINI) study in Nepal. Methods: MINI was a prospective community intervention study aimed at managing newborn illnesses at household level. Trained field staff conducted a verbal autopsy of all neonatal deaths during the study period. The cause of death was assigned by two pediatricians, and by using InterVA version 5. Cohen's kappa coefficient was calculated to compare the agreement between InterVA and PRVA assigned proximate cause of death, using STATATM software version 16.1. Results: Among 381 verbal autopsies for neonatal deaths, only 311 (81.6%) were assigned one of birth asphyxia, neonatal infection, congenital anomalies or preterm-related complications as the proximate cause of death by both InterVA and PRVA, while the remaining 70 (18.4%) were assigned other or non-specific causes. The overall agreement between InterVA and PRVA-assigned cause of death categories was moderate (66.5% agreement, kappa=0.47). Moderate agreement was observed for neonatal infection (kappa=0.48) and congenital malformations (kappa=0.49), while it was fair for birth asphyxia (kappa=0.39), and preterm-related complications (kappa=0.31); but there was only slight agreement for neonatal sepsis (kappa=0.19) and neonatal pneumonia (kappa=0.16) as specific causes of death within neonatal infections. Conclusions: We observed moderate overall agreement for major categories of causes of neonatal death assigned by InterVA and PRVA. The moderate agreement was sustained for the classification of neonatal infection but poor for neonatal sepsis and neonatal pneumonia as distinct categories of neonatal infection. Further studies should investigate the comparative effectiveness of an updated version of InterVA with the current standard of assigning the cause of neonatal death through longitudinal and experimental designs.

scholarly journals An assessment of non-communicable disease mortality among adults in Eastern Uganda, 2010–2016

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248966
Author(s):  
Davis Natukwatsa ◽  
Adaeze C. Wosu ◽  
Donald Bruce Ndyomugyenyi ◽  
Musa Waibi ◽  
Dan Kajungu
Keyword(s):  
Cardiovascular Diseases ◽  
Cause Of Death ◽  
Communicable Disease ◽  
Direct Method ◽  
Mortality Rates ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
Disease Mortality ◽  
Eastern Uganda ◽  
Non Communicable Disease

Background There is a dearth of studies assessing non-communicable disease (NCD) mortality within population-based settings in Uganda. We assessed mortality due to major NCDs among persons ≥ 30 years in Eastern Uganda from 2010 to 2016. Methods The study was carried out at the Iganga-Mayuge health and demographic surveillance site in the Iganga and Mayuge districts of Eastern Uganda. Information on cause of death was obtained through verbal autopsies using a structured questionnaire to conduct face-face interviews with carers or close relatives of the deceased. Physicians assigned likely cause of death using ICD-10 codes. Age-adjusted mortality rates were calculated using direct method, with the average population across the seven years of the study (2010 to 2016) as the standard. Age categories of 30–40, 41–50, 51–60, 61–70, and ≥ 71 years were used for standardization. Results A total of 1,210 deaths among persons ≥ 30 years old were reported from 2010 to 2016 (50.7% among women). Approximately 53% of all deaths were due to non-communicable diseases, 31.8% due to communicable diseases, 8.2% due to injuries, and 7% due to maternal-related deaths or undetermined causes. Cardiovascular diseases accounted for the largest proportion of NCD deaths in each year, and women had substantially higher cardiovascular disease mortality rates compared to men. Conversely, women had lower diabetes mortality rates than men for five of the seven years examined. Conclusions Non-communicable diseases are major causes of death among adults in Iganga and Mayuge; and cardiovascular diseases and diabetes are leading causes of NCD deaths. Efforts are needed to tackle NCD risk factors and provide NCD care to reduce associated burden and premature mortality.

Evaluation of neonatal verbal autopsy using physician review versus algorithm-based cause-of-death assignment in rural Nepal

2005 ◽  
Vol 19 (4) ◽  
pp. 323-331 ◽  
Author(s):  
James V. Freeman ◽  
Parul Christian ◽  
Subarna K. Khatry ◽  
Ramesh K. Adhikari ◽  
Steven C. LeClerq ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Verbal Autopsy ◽  
Physician Review ◽  
Rural Nepal

scholarly journals Application of verbal autopsy in routine civil registration in Lusaka District of Zambia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
C. Chabila Mapoma ◽  
Brian Munkombwe ◽  
Chomba Mwango ◽  
Bupe Bwalya Bwalya ◽  
Audrey Kalindi ◽  
...  
Keyword(s):  
Middle Ages ◽  
Cause Of Death ◽  
Verbal Autopsy ◽  
Opportunistic Infections ◽  
Civil Registration System ◽  
Registration System ◽  
Civil Registration ◽  
Major Teaching Hospital ◽  
External Causes ◽  
Causes Of Deaths

Abstract Background Ascertaining the causes for deaths occurring outside health facilities is a significant problem in many developing countries where civil registration systems are not well developed or non-functional. Standardized and rigorous verbal autopsy methods is a potential solution to determine the cause of death. We conducted a demonstration project in Lusaka District of Zambia where verbal autopsy (VA) method was implemented in routine civil registration system. Methods About 3400 VA interviews were conducted for bodies “brought-in-dead” at Lusaka’s two major teaching hospital mortuaries using a SmartVA questionnaire between October 2017 and September 2018. Probable underlying causes of deaths using VA and cause-specific mortality fractions were determined.. Demographic characteristics were analyzed for each VA-ascertained cause of death. Results Opportunistic infections (OIs) associated with HIV/AIDS such as pneumonia and tuberculosis, and malaria were among leading causes of deaths among bodies “brought-in-dead”. Over 21.6 and 26.9% of deaths were attributable to external causes and non-communicable diseases (NCDs), respectively. The VA-ascertained causes of death varied by age-group and sex. External causes were more prevalent among males in middle ages (put an age range like 30–54 years old) and NCDs highly prevalent among those aged 55 years and older. Conclusions VA application in civil registration system can provide the much-needed cause of death information for non-facility deaths in countries with under-developed or non-functional civil registration systems.

scholarly journals Exploring the mechanisms of collaboration between the Tuberculosis and Diabetes Programs for the control of TB-DM Comorbidity in Ghana

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Rita Suhuyini Salifu ◽  
Khumbulani W. Hlongwana
Keyword(s):  
Communicable Disease ◽  
Control Program ◽  
Communicable Diseases ◽  
Local Health ◽  
National Tuberculosis Control Program ◽  
National Tuberculosis ◽  
Local Health Facility ◽  
Control And Prevention ◽  
And Control ◽  
Non Communicable Disease

Abstract Objectives To explore the mechanisms of collaboration between the stakeholders, including National Tuberculosis Control Program (NTP) and the Non-Communicable Disease Control and Prevention Program (NCDCP) at the national, regional, and local (health facility) levels of the health care system in Ghana. This is one of the objectives in a study on the “Barriers and Facilitators to the Implementation of the Collaborative Framework for the Care and Control of Tuberculosis and Diabetes in Ghana” Results The data analysis revealed 4 key themes. These were (1) Increased support for communicable diseases (CDs) compared to stagnant support for non-communicable diseases (NCDs), (2) Donor support, (3) Poor collaboration between NTP and NCDCP, and (4) Low Tuberculosis-Diabetes Mellitus (TB-DM) case detection.

scholarly journals Early detection and management of major non-communicable diseases in urban primary healthcare facilities in Ethiopia: a study protocol for a type-3 hybrid implementation-effectiveness design

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040564
Author(s):  
Helen Yifter ◽  
Afrah Omer ◽  
Seid Gugsa ◽  
Abebaw Fekadu ◽  
Abraham Kebede ◽  
...  
Keyword(s):  
Early Detection ◽  
Primary Healthcare ◽  
Addis Ababa ◽  
Communicable Diseases ◽  
Barriers And Facilitators ◽  
Non Communicable Diseases ◽  
Implementation Effectiveness ◽  
Evaluation Phase ◽  
Intervention Protocol ◽  
Type 3

IntroductionIntegrating early detection and management of non-communicable diseases in primary healthcare has an unprecedented role in making healthcare more accessible particularly in low- and middle-income countries such as Ethiopia. This study aims to design, implement and evaluate an evidence-based intervention guided by the HEARTS technical package and implementation guide to address barriers and facilitators of integrating early detection and management of hypertension, diabetes mellitus and cardiovascular diseases in primary healthcare settings of Addis Ababa.MethodologyWe will employ a type-3 hybrid implementation-effectiveness study from November 2020 to May 2022. This study will target patients ≥40 years of age. Ten health centres will be randomly selected from each subcity of Addis Ababa. The study will have four phases: (1) Baseline situational analysis (PEN facility-capacity assessment, 150 observations of patient healthcare provider interactions and 697 patient medical record reviews), (2) Consolidated Framework for Implementation Research (CFIR) inspired qualitative assessment of barriers and facilitators (20 in-depth interviews of key stakeholders), (3) Design of intervention protocol. The intervention will have capacity enhancement components including training of non-communicabledisease (NCDservice providers, provision of essential equipment/supporting materials and monthly monitoring and feedback and (4) Implementation monitoring and evaluation phase using the RE-AIM (reach, efficacy, adoption, implementation and maintenance) framework. Outcomes on early detection and management of NCDs will be assessed to examine the effectiveness of the study.Ethics and dissemination planEthical clearance was obtained from the Addis Ababa University, College of Health Sciences Institutional Review Board and Addis Ababa Health Bureau. We plan to present the findings from this research in conferences and publish them in peer-reviewed journals.

scholarly journals Monitoring progress with national and subnational health goals by integrating verbal autopsy and medically certified cause of death data

2021 ◽  
Vol 6 (5) ◽  
pp. e005387
Author(s):  
Tim Adair ◽  
Sonja Firth ◽  
Tint Pa Pa Phyo ◽  
Khin Sandar Bo ◽  
Alan D Lopez
Keyword(s):  
Cause Of Death ◽  
Verbal Autopsy ◽  
Integration Method ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Death Registration ◽  
Chronic Respiratory Diseases ◽  
Health Goals ◽  
Specific Mortality ◽  
Four Causes

IntroductionThe measurement of progress towards many Sustainable Development Goals (SDG) and other health goals requires accurate and timely all-cause and cause of death (COD) data. However, existing guidance to countries to calculate these indicators is inadequate for populations with incomplete death registration and poor-quality COD data. We introduce a replicable method to estimate national and subnational cause-specific mortality rates (and hence many such indicators) where death registration is incomplete by integrating data from Medical Certificates of Cause of Death (MCCOD) for hospital deaths with routine verbal autopsy (VA) for community deaths.MethodsThe integration method calculates population-level cause-specific mortality fractions (CSMFs) from the CSMFs of MCCODs and VAs weighted by estimated deaths in hospitals and the community. Estimated deaths are calculated by applying the empirical completeness method to incomplete death registration/reporting. The resultant cause-specific mortality rates are used to estimate SDG Indicator 23: mortality between ages 30 and 70 years from cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. We demonstrate the method using nationally representative data in Myanmar, comprising over 42 000 VAs and 7600 MCCODs.ResultsIn Myanmar in 2019, 89% of deaths were estimated to occur in the community. VAs comprised an estimated 70% of community deaths. Both the proportion of deaths in the community and CSMFs for the four causes increased with older age. We estimated that the probability of dying from any of the four causes between 30 and 70 years was 0.265 for men and 0.216 for women. This indicator is 50% higher if based on CSMFs from the integration of data sources than on MCCOD data from hospitals.ConclusionThis integration method facilitates country authorities to use their data to monitor progress with national and subnational health goals, rather than rely on estimates made by external organisations. The method is particularly relevant given the increasing application of routine VA in country Civil Registration and Vital Statistics systems.

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