埃塞俄比亚中南部成年人死亡率的趋势和模式：利用布塔吉拉健康和人口监测系统 2008-2019 年数据进行分析。

The trend and pattern of adult mortality in South-Central Ethiopia: analysis using the 2008-2019 data from Butajira Health and Demographic Surveillance System.

机构信息

School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

Glob Health Action. 2022 Dec 31;15(1):2118180. doi: 10.1080/16549716.2022.2118180.

DOI:10.1080/16549716.2022.2118180

PMID:36178408

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9542780/

Abstract

BACKGROUND

Understanding context-specific temporal trends in mortality is essential for setting health policy priorities.

OBJECTIVE

To investigate the trends and distribution of deaths due to communicable and non-communicable diseases and external causes in South-Central Ethiopia.

METHOD

All adult deaths captured by the Butajira Health and Demographic Surveillance System between January 2008 and December 2019 were included. A verbal autopsy method of collecting cause of death data was used. Physician review and a computerised algorithm, InterVA, were used to determine the cause of death. Coding was undertaken using the World Health Organization's International Classification of Diseases. Trends in adult mortality rate and proportional mortality were estimated by major cause of death categories. Significant trends were analysed using the Mann-Kendall statistical test with a significance set at < 0.05. Deaths were also disaggregated by age, sex, and residence.

RESULTS

There were 1,612 deaths in 279,681 person-years; 811 (50.3%) were females. The median age at death was 65 years. The proportional adult mortality and adult mortality rates (per 1000 person-years) attributed to communicable diseases, non-communicable diseases, and external causes were 31.1%, 58.9%, and 6.0%, and 1.9, 3.4, and 0.4, respectively. Adult mortality due to communicable diseases showed a declining trend (, the measure of the strength and direction of association, = -0.52; < 0.05), whereas the trend increased for non-communicable diseases ( = 0.67, < 0.05) and external causes ( = 0.29, > 0.05). Moreover, death rates were pronounced in the 65+ age group and rural areas but comparable among males and females.

CONCLUSION

The trend in deaths due to communicable diseases declined but increased for non-communicable diseases and external causes with significant public health burdens. These findings will provide essential input in formulating health policy reforms to reduce premature mortality.

摘要

背景

了解特定语境下的死亡率趋势对于制定卫生政策重点至关重要。

目的

调查埃塞俄比亚中南部传染性和非传染性疾病以及外部原因导致的死亡趋势和分布。

方法

纳入 2008 年 1 月至 2019 年 12 月期间布塔吉拉健康和人口监测系统记录的所有成人死亡。采用死因口头尸检方法收集死因数据。使用医生审查和计算机化算法 InterVA 确定死因。使用世界卫生组织的国际疾病分类进行编码。通过主要死因类别估计成人死亡率和比例死亡率的趋势。使用曼-肯德尔统计检验分析显著趋势，显著性水平设定为<0.05。还按年龄、性别和居住地对死亡进行了细分。

结果

在 279681 人年中，有 1612 人死亡；其中 811 人（50.3%）为女性。死亡时的中位年龄为 65 岁。传染性疾病、非传染性疾病和外部原因导致的成人比例死亡率和成人死亡率（每 1000 人年）分别为 31.1%、58.9%和 6.0%和 1.9、3.4 和 0.4。传染病导致的成人死亡率呈下降趋势（，关联的强度和方向的度量，= -0.52；<0.05），而非传染性疾病和外部原因导致的死亡率呈上升趋势（= 0.67，<0.05；= 0.29，>0.05）。此外，65 岁及以上年龄组和农村地区的死亡率较高，但男女之间相当。