Kebede Yigzaw, Andargie Gashaw, Gebeyehu Abebaw, Awoke Tadesse, Yitayal Mezgebu, Mekonnen Solomon, Wubshet Mamo, Azmeraw Temesgen, Lakew Yihunie, Alemu Kassahun
Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, PoBox, 196, Gondar, Ethiopia.
Department of Health Service Management, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
Popul Health Metr. 2017 Jul 17;15(1):27. doi: 10.1186/s12963-017-0139-z.
Reliable data on causes of death form the basis for building evidence on health policy, planning, monitoring, and evaluation. In Ethiopia, the majority of deaths occur at home and civil registration systems are not yet functional. The main objective of verbal autopsy (VA) is to describe the causes of death at the community or population level where civil registration and death certification systems are weak and where most people die at home without having had contact with the health system.
Causes of death were classified and prepared based on the International Classification of Diseases (ICD-10). The cause of a death was ascertained based on an interview with next of kin or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history, and circumstances preceding death. The cause of death, or the sequence of causes that led to death, is assigned based on the data collected by the questionnaire. The complete VA questionnaires were given to two blinded physicians and reviewed independently. A third physician was assigned to review the case when disagreements in diagnosis arose.
Communicable diseases (519 deaths [48.0%]), non-communicable diseases (377 deaths [34.8%]), and external causes (113 deaths [10.4%]) were the main causes of death between 2007 and 2013. Of communicable diseases, tuberculosis (207 deaths [19.7%]), HIV/AIDS (96 deaths [8.9%]) and meningitis (76 deaths [7.0%]) were the most common causes of death.
Tuberculosis, HIV/AIDS, and meningitis were the most common causes of deaths among adults. Death due to non-communicable diseases showed an increasing trend. Increasing community awareness of infections and their interrelationships, tuberculosis case finding, effective local TB programs, successful treatment, and interventions for HIV are supremely important.
可靠的死亡原因数据是构建健康政策、规划、监测和评估证据的基础。在埃塞俄比亚，大多数死亡发生在家中，民事登记系统尚未发挥作用。口头尸检（VA）的主要目的是在民事登记和死亡证明系统薄弱且大多数人在家中死亡而未与卫生系统接触的社区或人群层面描述死亡原因。
根据《国际疾病分类》（ICD - 10）对死亡原因进行分类和整理。通过使用标准化问卷对近亲或其他护理人员进行访谈来确定死亡原因，该问卷收集有关体征、症状、病史以及死亡前情况的信息。根据问卷收集的数据确定死亡原因或导致死亡的原因序列。完整的VA问卷交给两位不知情的医生并独立进行审查。当诊断出现分歧时，指定第三位医生审查该病例。
2007年至2013年期间，传染病（519例死亡[48.0%]）、非传染病（377例死亡[34.8%]）和外部原因（113例死亡[10.4%]）是主要死亡原因。在传染病中，结核病（207例死亡[19.7%]）、艾滋病毒/艾滋病（96例死亡[8.9%]）和脑膜炎（76例死亡[7.0%]）是最常见的死亡原因。
结核病、艾滋病毒/艾滋病和脑膜炎是成年人中最常见的死亡原因。非传染病导致的死亡呈上升趋势。提高社区对感染及其相互关系的认识、结核病病例发现、有效的地方结核病项目、成功的治疗以及针对艾滋病毒的干预措施极为重要。
