Addis Ababa Mortality Surveillance Program, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Prev Chronic Dis. 2012;9:E84. doi: 10.5888/pcd9.110142. Epub 2012 Apr 12.
In Ethiopia, lack of reliable data on causes of death prevents full understanding of the double mortality burden of communicable and noncommunicable diseases. Our objective was to help bridge this research gap by analyzing surveillance data on causes of death in Addis Ababa.
Burial surveillance identified 58,010 deaths in Addis Ababa from 2006 through 2009, of which 49,309 were eligible for verbal autopsies, a method of interviewing caregivers of the deceased about the circumstances, signs, and symptoms preceding death. We randomly selected 10% from the eligible sample, of whom 91% were defined as adults (aged ≥ 15 y). Verbal autopsies were completed and causes of death were assigned for 3,709 adults.
Overall, 51% (95% confidence interval [CI], 49.7%-52.9%) of deaths were attributed to noncommunicable diseases, 42% (95% CI, 40.6%-43.8%) to communicable diseases, and 6% (95% CI, 5.5%-7.0%) to injuries. Similar proportions of male and female deaths were caused by noncommunicable and communicable diseases. Adults aged 55 to 84 were more likely, and those aged 15 to 44 were less likely, to die from noncommunicable diseases compared with the age group 85 or older. Premature deaths (defined as earlier than age 65) from noncommunicable diseases were mainly due to certain cancers, type 1 and type 2 diabetes, hypertension, stroke, and genitourinary disease.
Noncommunicable diseases are the leading cause of death among adults in Addis Ababa, where the health care system is still geared toward addressing communicable diseases. Health policy attention is needed to remedy this situation. This observed double mortality burden is unlikely to be unique to Addis Ababa and provides new insight into the epidemiological transition in urban Ethiopia. Nationwide studies should be conducted in Ethiopia to examine the pattern of epidemiological transition and the magnitude of double mortality burden.
在埃塞俄比亚，由于缺乏可靠的死因数据，人们对传染性和非传染性疾病的双重死亡负担还没有充分的了解。我们的目标是通过分析亚的斯亚贝巴的死因监测数据，帮助填补这一研究空白。
通过丧葬监测，我们发现 2006 年至 2009 年期间亚的斯亚贝巴有 58010 人死亡，其中 49309 人符合进行死因口头叙述调查的条件，该方法是对死者的照顾者进行访谈，询问其死亡前后的情况、症状和体征。我们从合格样本中随机抽取了 10%，其中 91%被定义为成年人（年龄≥15 岁）。完成了 3709 名成年人的死因口头叙述调查，并确定了死因。
总体而言，51%（95%置信区间[CI]，49.7%-52.9%）的死亡归因于非传染性疾病，42%（95%CI，40.6%-43.8%）归因于传染性疾病，6%（95%CI，5.5%-7.0%）归因于伤害。男女死亡的非传染性和传染性疾病比例相似。与 85 岁或以上的年龄组相比，55 岁至 84 岁的成年人死于非传染性疾病的可能性更大，而 15 岁至 44 岁的成年人死于非传染性疾病的可能性更小。非传染性疾病导致的过早死亡（定义为早于 65 岁）主要是由于某些癌症、1 型和 2 型糖尿病、高血压、中风和泌尿生殖系统疾病。
非传染性疾病是亚的斯亚贝巴成年人死亡的主要原因，而当地的医疗保健系统仍侧重于解决传染性疾病。需要关注卫生政策以改变这种状况。这种观察到的双重死亡负担不太可能仅在亚的斯亚贝巴存在，并为埃塞俄比亚城市的流行病学转变提供了新的见解。埃塞俄比亚应开展全国性研究，以检验流行病学转变的模式和双重死亡负担的程度。
