Mortality beyond emergency threshold in a silent crisis– results from a population-based mortality survey in Ouaka prefecture, Central African Republic, 2020

Abstract Background The Central African Republic (CAR) suffers a protracted conflict and has the second lowest human development index in the world. Available mortality estimates vary and differ in methodology. We undertook a retrospective mortality study in the Ouaka prefecture to obtain reliable mortality data. Methods We conducted a population-based two-stage cluster survey from 9 March to 9 April, 2020 in Ouaka prefecture. We aimed to include 64 clusters of 12 households for a required sample size of 3636 persons. We assigned clusters to communes proportional to population size and then used systematic random sampling to identify cluster starting points from a dataset of buildings in each commune. In addition to the mortality survey questions, we included an open question on challenges faced by the household. Results We completed 50 clusters with 591 participating households including 4000 household members on the interview day. The median household size was 7 (interquartile range (IQR): 4—9). The median age was 12 (IQR: 5—27). The birth rate was 59.0/1000 population (95% confidence interval (95%-CI): 51.7—67.4). The crude and under-five mortality rates (CMR & U5MR) were 1.33 (95%-CI: 1.09—1.61) and 1.87 (95%-CI: 1.37–2.54) deaths/10,000 persons/day, respectively. The most common specified causes of death were malaria/fever (16.0%; 95%-CI: 11.0–22.7), violence (13.2%; 95%-CI: 6.3–25.5), diarrhoea/vomiting (10.6%; 95%-CI: 6.2–17.5), and respiratory infections (8.4%; 95%-CI: 4.6–14.8). The maternal mortality ratio (MMR) was 2525/100,000 live births (95%-CI: 825—5794). Challenges reported by households included health problems and access to healthcare, high number of deaths, lack of potable water, insufficient means of subsistence, food insecurity and violence. Conclusions The CMR, U5MR and MMR exceed previous estimates, and the CMR exceeds the humanitarian emergency threshold. Violence is a major threat to life, and to physical and mental wellbeing. Other causes of death speak to poor living conditions and poor access to healthcare and preventive measures, corroborated by the challenges reported by households. Many areas of CAR face similar challenges to Ouaka. If these results were generalisable across CAR, the country would suffer one of the highest mortality rates in the world, a reminder that the longstanding “silent crisis” continues.

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Stillbirth, newborn and infant mortality: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015

International Journal of Epidemiology ◽

10.1093/ije/dyy129 ◽

2019 ◽

Vol 48 (Supplement_1) ◽

pp. i54-i62 ◽

Cited By ~ 6

Author(s):

Ana M B Menezes ◽

Fernando C Barros ◽

Bernardo L Horta ◽

Alicia Matijasevich ◽

Andréa Dâmaso Bertoldi ◽

...

Keyword(s):

Black Women ◽

Infant Mortality ◽

Low Income ◽

Causes Of Death ◽

Mortality Rates ◽

Population Based ◽

Birth Cohorts ◽

Mortality Trends ◽

Death Rates ◽

Economic Inequalities

Abstract Background Infant-mortality rates have been declining in many low- and middle-income countries, including Brazil. Information on causes of death and on socio-economic inequalities is scarce. Methods Four birth cohorts were carried out in the city of Pelotas in 1982, 1993, 2004 and 2015, each including all hospital births in the calendar year. Surveillance in hospitals and vital registries, accompanied by interviews with doctors and families, detected fetal and infant deaths and ascertained their causes. Late-fetal (stillbirth)-, neonatal- and post-neonatal-death rates were calculated. Results All-cause and cause-specific death rates were reduced. During the study period, stillbirths fell by 47.8% (from 16.1 to 8.4 per 1000), neonatal mortality by 57.0% (from 20.1 to 8.7) and infant mortality by 62.0% (from 36.4 to 13.8). Perinatal causes were the leading causes of death in the four cohorts; deaths due to infectious diseases showed the largest reductions, with diarrhoea causing 25 deaths in 1982 and none in 2015. Late-fetal-, neonatal- and infant-mortality rates were higher for children born to Brown or Black women and to low-income women. Absolute socio-economic inequalities based on income—expressed in deaths per 1000 births—were reduced over time but relative inequalities—expressed as ratios of mortality rates—tended to remain stable. Conclusion The observed improvements are likely due to progress in social determinants of health and expansion of health care. In spite of progress, current levels remain substantially greater than those observed in high-income countries, and social and ethnic inequalities persist.

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GAMBARAN KEPATUHAN DIET PADA ANGGOTA PROLANIS SELAMA PANDEMI COVID-19 DI WILAYAH KERJA PUSKESMAS BOJONG 2

Jurnal Sehat Mandiri ◽

10.33761/jsm.v16i1.343 ◽

2021 ◽

Vol 16 (1) ◽

pp. 29-35

Author(s):

Moh. Khotibul Umam ◽

Windi Imaningtias ◽

Nurul Hidayati Listianingrum

Keyword(s):

Research Method ◽

Causes Of Death ◽

Health Workers ◽

Monitoring Program ◽

Mortality Rates ◽

The Public ◽

Descriptive Research ◽

The World ◽

Diet Counseling ◽

The Right

Non-communicable diseases (NCDs) are the leading causes of death and are responsible for the highest mortality rates in the world and in Indonesia. One of the programs for controlling NCDs especially hypertension and Diabetes at the Public Health Center (PHC) is Prolanis. One of the Prolanis programs is the monitoring of dietary adherence among Prolanis members. A descriptive research design was used as research method. The samples of this study were 34 Prolanis members in Sumurjomblang Bogo Village, the working area of Puskesmas Bojong 2. The results showed that the majority of Prolanis members in Sumurjomblang Bogo did not compliant the right schedule of diet (80%), the right type of diet (60%), and the right number of diet (60 %) for diabetes mellitus and hypertension. This may be due to lack of monitoring from health workers. Therefore, the results of this study are expected for an online diet counseling and monitoring program involving families of prolanis members during covid-19 pandemic.

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Long-Term Trends in Unintentional Fall Mortality in China: A Population-Based Age-Period-Cohort Study

Frontiers in Public Health ◽

10.3389/fpubh.2021.749295 ◽

2021 ◽

Vol 9 ◽

Author(s):

Zhenkun Wang ◽

Youzhen Hu ◽

Fang Peng

Keyword(s):

Public Health Problem ◽

Mortality Rates ◽

Population Based ◽

Mortality Data ◽

Major Public Health Problem ◽

Age Group ◽

Men And Women ◽

Long Term Trends ◽

Unintentional Falls

Background: Unintentional falls seriously threaten the life and health of people in China. This study aimed to assess the long-term trends of mortality from unintentional falls in China and to examine the age-, period-, and cohort-specific effects behind them.Methods: This population-based multiyear cross-sectional study of Chinese people aged 0–84 years was a secondary analysis of the mortality data of fall injuries from 1990 to 2019, derived from the Global Burden of Disease Study 2019. Age-standardized mortality rates of unintentional falls by year, sex, and age group were used as the main outcomes and were analyzed within the age-period-cohort framework.Results: Although the crude mortality rates of unintentional falls for men and women showed a significant upward trend, the age-standardized mortality rates for both sexes only increased slightly. The net drift of unintentional fall mortality was 0.13% (95% CI, −0.04 to 0.3%) per year for men and −0.71% (95% CI, −0.96 to −0.46%) per year for women. The local drift values for both sexes increased with age group. Significant age, cohort, and period effects were found behind the mortality trends of the unintentional falls for both sexes in China.Conclusions: Unintentional falls are still a major public health problem that disproportionately threatens the lives of men and women in China. Efforts should be put in place urgently to prevent the growing number of fall-related mortality for men over 40 years old and women over 70 years old. Gains observed in the recent period, relative risks (RRs), and cohort RRs may be related to improved healthcare and better education.

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Leukemia mortality in children from Latin America: Trends and predictions to 2030

10.21203/rs.3.rs-64774/v2 ◽

2020 ◽

Author(s):

J. Smith Torres-Roman ◽

Bryan Valcarcel ◽

Pedro Guerra-Canchari ◽

Camila Alves Dos Santos ◽

Isabelle Ribeiro Barbosa ◽

...

Keyword(s):

Latin American ◽

Mortality Rates ◽

World Health ◽

Mortality Data ◽

Mortality Trends ◽

Annual Percent Change ◽

Universal Healthcare ◽

The World ◽

Health Organization ◽

Universal Healthcare Coverage

Abstract Background: Reports suggest that Latin American and Caribbean (LAC) countries have not reduced in leukemia mortality compared to high-income countries. However, updated trends remain largely unknown in the region. Given that leukemia is the leading cause of cancer-related death in LAC children, we evaluated mortality trends in children (0-14y) from 15 LAC countries for the period 2000-2017 and predicted mortality to 2030.Methods: We retrieved cancer mortality data using the World Health Organization Mortality Database. Mortality rates (standardized to the world standard SEGI population) were analyzed for 15 LAC countries. We evaluated the average mortality rates for the last 5 years (2013-2017). Joinpoint regression analysis was used to evaluate leukemia mortality trends and provide an estimated annual percent change (EAPC). Nordpred was utilized for the calculation of predictions until 2030.Results: Between 2013 and 2017, the highest mortality rates were reported in Venezuela, Ecuador, Nicaragua, Mexico, and Peru. Upward mortality trends were reported in Nicaragua (EAPC by 2.9% in boys, and EAPC by 2.0% in girls), and Peru (EAPC by 1.4% in both sexes). Puerto Rico experienced large declines in mortality among both boys (EAPC by −9.7%), and girls (EAPC by −6.0%). Leukemia mortality will increase in Argentina, Ecuador, Guatemala, Panama, Peru, and Uruguay by 2030.Conclusion: Leukemia mortality is predicted to increase in some LAC countries by 2030. Interventions to prevent this outcome should be tailor to reduce the socioeconomic inequalities and ensure universal healthcare coverage.

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Race disparities in mortality by breast cancer from 2000 to 2017 in São Paulo, Brazil: a population-based retrospective study

BMC Cancer ◽

10.1186/s12885-021-08735-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ana Cláudia Marcelino ◽

Bruno Gozzi ◽

Cássio Cardoso-Filho ◽

Helymar Machado ◽

Luiz Carlos Zeferino ◽

...

Keyword(s):

Breast Cancer ◽

Retrospective Study ◽

Black Women ◽

Causes Of Death ◽

White Women ◽

Mortality Rates ◽

Population Based ◽

Sao Paulo ◽

São Paulo ◽

Race Disparities

Abstract Background In Brazil, inequalities in access may interfere with cancer care. This study aimed to evaluate the influence of race on breast cancer mortality in the state of São Paulo, from 2000 to 2017, contextualizing with other causes of death. Methods A population-based retrospective study using mortality rates, age and race as variables. Information on deaths was collected from the Ministry of Health Information System. Only white and black categories were used. Mortality rates were age-adjusted by the standard method. For statistical analysis, linear regression was carried out. Results There were 60,940 deaths registered as breast cancer deaths, 46,365 in white and 10,588 in black women. The mortality rates for 100,000 women in 2017 were 16.46 in white and 9.57 in black women, a trend to reduction in white (p = 0.002), and to increase in black women (p = 0.010). This effect was more significant for white women (p < 0.001). The trend to reduction was consistent in all age groups in white women, and the trend to increase was observed only in the 40–49 years group in black women. For ‘all-cancer causes’, the trend was to a reduction in white (p = 0.031) and to increase in black women (p < 0.001). For ‘ill-defined causes’ and ‘external causes’, the trend was to reduce both races (p < 0.001). Conclusion The declared race influenced mortality rates due to breast cancer in São Paulo. The divergences observed between white and black women also were evident in all cancer causes of death, which may indicate inequities in access to highly complex health care in our setting.

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Trend analysis of mortality rates and causes of death in children under 5 years old in Beijing, China from 1992 to 2015 and forecast of mortality into the future: an entire population-based epidemiological study

BMJ Open ◽

10.1136/bmjopen-2017-015941 ◽

2017 ◽

Vol 7 (9) ◽

pp. e015941 ◽

Cited By ~ 12

Author(s):

Han Cao ◽

Jing Wang ◽

Yichen Li ◽

Dongyang Li ◽

Jin Guo ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Birth Weight ◽

Congenital Heart ◽

Causes Of Death ◽

Congenital Abnormalities ◽

Birth Asphyxia ◽

Mortality Rates ◽

Population Based ◽

Beijing China

ObjectivesTo analyse trends in mortality and causes of death among children aged under 5 years in Beijing, China between 1992 and 2015 and to forecast under-5 mortality rates (U5MRs) for the period 2016–2020.MethodsAn entire population-based epidemiological study was conducted. Data collection was based on the Child Death Reporting Card of the Beijing Under-5 Mortality Rate Surveillance Network. Trends in mortality and leading causes of death were analysed using the χ2test and SPSS 19.0 software. An autoregressive integrated moving average (ARIMA) model was fitted to forecast U5MRs between 2016 and 2020 using the EViews 8.0 software.ResultsMortality in neonates, infants and children aged under 5 years decreased by 84.06%, 80.04% and 80.17% from 1992 to 2015, respectively. However, the U5MR increased by 7.20% from 2013 to 2015. Birth asphyxia, congenital heart disease, preterm/low birth weight and other congenital abnormalities comprised the top five causes of death. The greatest, most rapid reduction was that of pneumonia by 92.26%, with an annual average rate of reduction of 10.53%. The distribution of causes of death differed among children of different ages. Accidental asphyxia and sepsis were among the top five causes of death in children aged 28 days to 1 year and accident was among the top five causes in children aged 1–4 years. The U5MRs in Beijing are projected to be 2.88‰, 2.87‰, 2.90‰, 2.97‰ and 3.09‰ for the period 2016–2020, based on the predictive model.ConclusionBeijing has made considerable progress in reducing U5MRs from 1992 to 2015. However, U5MRs could show a slight upward trend from 2016 to 2020. Future considerations for child healthcare include the management of birth asphyxia, congenital heart disease, preterm/low birth weight and other congenital abnormalities. Specific preventative measures should be implemented for children of various age groups.

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Why do young children die in the UK? A comparison with Sweden

Archives of Disease in Childhood ◽

10.1136/archdischild-2014-308059 ◽

2015 ◽

Vol 100 (10) ◽

pp. 928-931 ◽

Cited By ~ 13

Author(s):

Parag Tambe ◽

Helen M Sammons ◽

Imti Choonara

Keyword(s):

Mortality Rate ◽

Young Children ◽

Causes Of Death ◽

Mortality Rates ◽

Mortality Data ◽

National Board ◽

Under Five ◽

Child Mortality Rate ◽

The Individual ◽

The Uk

BackgroundThe UK has a high child mortality rate, whereas Sweden's is lower (under-five mortality rates of five and three, respectively, in 2011).We therefore wished to compare causes of death in young children aged <5 years in the two countries.MethodsUnder-five mortality data were obtained from the Office of National Statistics for each of the individual countries within the UK for 3 years (2006–2008). Data for Sweden for the same period were obtained from the National Board of Health and Welfare. Causes of death were compared statistically using χ2 test.ResultsThere were a total of 14 104 and 1036 deaths aged <5 years in the UK and Sweden, respectively, between 2006 and 2008. The total numbers of live births during the same period were 2 295 964 and 315 884, respectively. The overall mortality rate in the UK was 614 per 100 000 children which was significantly higher than that in Sweden (328; p<0.001). The mortality rates for the three main causes of death in the UK (prematurity, congenital malformations and infections) were 138.5, 112.1 and 63.9, respectively, per 100 000 children. The mortality rates for the same three conditions in Sweden were 10.1, 88.6 and 34.8, respectively. They were all significantly more frequent in the UK than in Sweden (p<0.001), as were the majority of the disorders. Treatable infections, such as pneumonia, meningitis and septicaemia, in both neonates and young children had significantly higher mortality rates in the UK than in Sweden (p<0.001).ConclusionsIn order to reduce the mortality rate in the UK, we need to try and reduce the causes of prematurity. Additionally, the care of children with treatable infections should be reviewed to understand ways in which to reduce the differences in mortality seen.

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Changes in mortality rates and causes of death in a population-based cohort of persons living with and without HIV from 1996 to 2012

BMC Infectious Diseases ◽

10.1186/s12879-017-2254-7 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 36

Author(s):

Oghenowede Eyawo ◽

◽

Conrado Franco-Villalobos ◽

Mark W. Hull ◽

Adriana Nohpal ◽

...

Keyword(s):

Causes Of Death ◽

Mortality Rates ◽

Population Based

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Changing mortality trends in countries and cities of the UK: a population-based trend analysis

BMJ Open ◽

10.1136/bmjopen-2020-038135 ◽

2020 ◽

Vol 10 (11) ◽

pp. e038135

Author(s):

David Walsh ◽

Gerry McCartney ◽

Jon Minton ◽

Jane Parkinson ◽

Deborah Shipton ◽

...

Keyword(s):

Trend Analysis ◽

Causes Of Death ◽

Age Groups ◽

Mortality Rates ◽

Population Based ◽

Secondary Outcome ◽

Mortality Trends ◽

Relative Index ◽

Index Of Inequality ◽

The Uk

ObjectivesPreviously improving life expectancy and all-cause mortality in the UK has stalled since the early 2010s. National analyses have demonstrated changes in mortality rates for most age groups and causes of death, and with deprived populations most affected. The aims here were to establish whether similar changes have occurred across different parts of the UK (countries, cities), and to examine cause-specific trends in more detail.DesignPopulation-based trend analysis.Participants/settingWhole populations of countries and selected cities of the UK.Primary and secondary outcome measuresEuropean age-standardised mortality rates (calculated by cause of death, country, city, year (1981–2017), age group, sex and—for all countries and Scottish cities—deprivation quintiles); changes in rates between 5-year periods; summary measures of both relative (relative index of inequality) and absolute (slope index of inequality) inequalities.ResultsChanges in mortality from around 2011/2013 were observed throughout the UK for all adult age groups. For example, all-age female rates decreased by approximately 4%–6% during the 1980s and 1990s, approximately 7%–9% during the 2000s, but by <1% between 2011/2013 and 2015/2017. Equivalent figures for men were 4%–7%, 8%–12% and 1%–3%, respectively. This later period saw increased mortality among the most deprived populations, something observed in all countries and cities analysed, and for most causes of death: absolute and relative inequalities therefore increased. Although similar trends were seen across all parts of the UK, particular issues apply in Scotland, for example, higher and increasing drug-related mortality (with the highest rates observed in Dundee and Glasgow).ConclusionsThe study presents further evidence of changing mortality in the UK. The timing, geography and socioeconomic gradients associated with the changes appear to support suggestions that they may result, at least in part, from UK Government ‘austerity’ measures which have disproportionately affected the poorest.

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Temporal trends in incidence and mortality rates of laryngeal cancer at the global, regional and national levels, 1990–2017

BMJ Open ◽

10.1136/bmjopen-2021-050387 ◽

2021 ◽

Vol 11 (10) ◽

pp. e050387

Author(s):

Jing-Yuan Wang ◽

Qiang-Wei Zhang ◽

Kaixue Wen ◽

Chen Wang ◽

Xiaolin Ji ◽

...

Keyword(s):

Laryngeal Cancer ◽

Disease Burden ◽

Temporal Trends ◽

Mortality Rates ◽

Population Based ◽

Mortality Data ◽

Average Percentage ◽

Incidence And Mortality ◽

Disease Study ◽

Incident Cases

ObjectivesLaryngeal cancer is the most prevalent entity of head and neck cancer. Knowing the trends of incidence and mortality of laryngeal cancer is important for the reduction in related disease burden.DesignPopulation-based observational study.Main outcomes and measuresThe incidence and mortality data of laryngeal cancer were retrieved from the Global Burden of Disease study 2017 online database. The estimated average percentage change was used to quantify the trends of laryngeal cancer incidence and mortality at the global, regional and national levels.ResultsGlobally, the numbers of incident cases and deaths due to laryngeal cancer increased 58.7% and 33.9%, respectively, from 1990 to 2017. However, the overall age-standardised incidence rate (ASIR) and age-standardised mortality rate decreased by 0.99% (95% CI 0.83% to 1.14%) and 1.62% (95% CI 1.50% to 1.74%) per year, respectively. These decreases were ubiquitous worldwide. However, unfavourable trends in the ASIR of laryngeal cancer were also observed in a total of 51 developing countries.ConclusionsThe incidence and mortality rates of laryngeal cancer have significantly decreased at the global level and in most countries over the past three decades. The regions that showed an increasing incidence trend deserve more attention.

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