Kaatano G M, Mashauri F M, Kinung'hi S M, Mwanga J R, Malima R C, Kishamawe C, Nnko S E, Magesa S M, Mboera L E G
National Institute for Medical Research, Mwanza Research Centre, P.O. Box 1462, Mwanza, Tanzania.
Tanzan J Health Res. 2009 Oct;11(4):210-8. doi: 10.4314/thrb.v11i4.50185.
Reliable malaria related mortality data is important for planning appropriate interventions. However, there is scarce information on the pattern of malaria related mortality in epidemic prone districts of Tanzania. This study was carried out to determine malaria related mortality and establish its trend change over time in both epidemic and non-epidemic areas of Muleba District of north-western Tanzania. A verbal autopsy survey was conducted to obtain data on all deaths of individuals who died in six randomly selected villages from 1997 to 2006. Relatives of the deceased were interviewed using a standardized questionnaire. Communicable diseases accounted for about two thirds (61.9%) of deaths among > or =5 years individuals and 84.8% in < or =5 years. Non-communicable diseases accounted for 28.9% and 14.1% deaths in > or =5 years and < or =5 years, respectively. Malaria was the leading cause of deaths in all age groups (40.3%) and among children <5 years (73.8%). Infants accounted for about two third (64.5%) of all malaria related deaths in children <5 years. Peak of malaria proportional mortality was highest during malaria epidemics. Most of the malaria-related deaths in this group were among 1-12 months (64.5%) followed by 13-24 months (20.9%), and 25-59 months (14.8%). Cerebral malaria accounted for 18.9% (N=32) of death related to malaria in all age groups; 12.1% (17/141) were in under-five, 42.9% (6/14) were in 5-14 years and 64.3% (9/14) in 15-70 years old. More than half of malaria related deaths (61.0%) in <5 years children were associated with severe anaemia followed by diarrhoeal disease (24.1%), cerebral malaria (12.5%) and respiratory infection (8.5%) as common conditions. The majority of the deceased caretakers first sought treatment at health facilities within 24hr of the onset of illness. Significantly a higher proportion of caretakers of the underfives in the epidemic area sought treatment within 24hr than in non-epidemic area (39.3% vs. 18.5%; P = 0.0385). In conclusion, malaria accounts for majority of deaths in Muleba district, with substantial proportion being attributed to malaria epidemics.
可靠的疟疾相关死亡率数据对于规划适当的干预措施至关重要。然而，关于坦桑尼亚易发生疟疾流行地区疟疾相关死亡率模式的信息却很匮乏。本研究旨在确定坦桑尼亚西北部穆莱巴区流行和非流行地区疟疾相关死亡率，并确定其随时间的变化趋势。通过开展口头尸检调查，获取1997年至2006年期间在6个随机选取村庄死亡的所有个体的数据。使用标准化问卷对死者亲属进行访谈。在≥5岁个体中，传染病约占死亡人数的三分之二（61.9%），在≤5岁个体中占84.8%。非传染病在≥5岁和≤5岁个体中的死亡占比分别为28.9%和14.1%。疟疾是所有年龄组（40.3%）和<5岁儿童（73.8%）死亡的主要原因。婴儿约占<5岁儿童所有疟疾相关死亡人数的三分之二（64.5%）。疟疾比例死亡率在疟疾流行期间最高。该组中大多数疟疾相关死亡发生在1至12个月（64.5%），其次是13至24个月（20.9%）和25至59个月（14.8%）。在所有年龄组中，脑型疟疾占与疟疾相关死亡的18.9%（N = 32）；5岁以下儿童中占12.1%（17/141），5至14岁儿童中占42.9%（6/14），15至70岁人群中占64.3%（9/14）。<5岁儿童中超过一半（61.0%）的疟疾相关死亡与严重贫血有关，其次是腹泻病（24.1%）、脑型疟疾（12.5%）和呼吸道感染（8.5%）等常见病症。大多数死者的照料者在疾病发作后24小时内首先在医疗机构寻求治疗。值得注意的是，流行地区5岁以下儿童的照料者在24小时内寻求治疗的比例显著高于非流行地区（39.3%对18.5%；P = 0.0385）。总之，疟疾是穆莱巴区死亡的主要原因，其中很大一部分归因于疟疾流行。
