School of Public Health, University of Queensland, Brisbane, QLD, Australia.
University of Melbourne, School of Population and Global Health, Melbourne, VIC, Australia.
Int J Epidemiol. 2019 Jun 1;48(3):966-977. doi: 10.1093/ije/dyz018.
Recent economic growth in Papua New Guinea (PNG) would suggest that the country may be experiencing an epidemiological transition, characterized by a reduction in infectious diseases and a growing burden from non-communicable diseases (NCDs). However, data on cause-specific mortality in PNG are very sparse, and the extent of the transition within the country is poorly understood.
Mortality surveillance was established in four small populations across PNG: West Hiri in Central Province, Asaro Valley in Eastern Highlands Province, Hides in Hela Province and Karkar Island in Madang Province. Verbal autopsies (VAs) were conducted on all deaths identified, and causes of death were assigned by SmartVA and classified into five broad disease categories: endemic NCDs; emerging NCDs; endemic infections; emerging infections; and injuries. Results from previous PNG VA studies, using different VA methods and spanning the years 1970 to 2001, are also presented here.
A total of 868 deaths among adolescents and adults were identified and assigned a cause of death. NCDs made up the majority of all deaths (40.4%), with the endemic NCD of chronic respiratory disease responsible for the largest proportion of deaths (10.5%), followed by the emerging NCD of diabetes (6.2%). Emerging infectious diseases outnumbered endemic infectious diseases (11.9% versus 9.5%). The distribution of causes of death differed across the four sites, with emerging NCDs and emerging infections highest at the site that is most socioeconomically developed, West Hiri. Comparing the 1970-2001 VA series with the present study suggests a large decrease in endemic infections.
Our results indicate immediate priorities for health service planning and for strengthening of vital registration systems, to more usefully serve the needs of health priority setting.
巴布亚新几内亚（PNG）最近的经济增长表明，该国可能正在经历一个流行病学转变，其特征是传染病减少，非传染性疾病（NCDs）负担增加。然而，PNG 特定病因死亡率的数据非常稀少，该国的转变程度也知之甚少。
在 PNG 的四个小人群中建立了死亡率监测：中央省的西赫里、东高地省的阿萨罗谷、赫拉省的希兹和马当省的卡尔卡岛。对所有确定的死亡病例进行了口头尸检（VA），死因由 SmartVA 分配，并分为五大疾病类别：地方性 NCDs；新出现的 NCDs；地方性传染病；新出现的传染病；和伤害。这里还展示了之前使用不同 VA 方法且跨越 1970 年至 2001 年的 PNG VA 研究的结果。
共确定了 868 名青少年和成年人死亡，并确定了死因。NCDs 占所有死亡的大多数（40.4%），其中地方性 NCD 慢性呼吸道疾病导致的死亡比例最大（10.5%），其次是新兴的 NCD 糖尿病（6.2%）。新兴传染病多于地方性传染病（11.9%比 9.5%）。四个地点的死因分布不同，最具社会经济发展的西赫里地点新兴 NCDs 和新兴传染病最高。将 1970-2001 年 VA 系列与本研究进行比较表明，地方性传染病大量减少。
我们的研究结果表明，当前卫生服务规划和加强生命登记系统的优先级很高，以更有效地满足卫生重点设定的需求。
