Population Health and Demography Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
School of Health and Society and Early Start, University of Wollongong, Wollongong, NSW, Australia.
Int J Epidemiol. 2023 Jun 6;52(3):867-886. doi: 10.1093/ije/dyac232.
Changing causes of deaths in the mortality transition in Papua New Guinea (PNG) are poorly understood. This study analysed community-level data to identify leading causes of death in the population and variations across age groups and sexes, urban-rural sectors and provinces.
Mortality surveillance data were collected from 2018-20 as part of the Comprehensive Health and Epidemiological Surveillance System (CHESS), using the World Health Organization 2016 verbal autopsy (VA) instrument. Data from 926 VA interviews were analysed, using the InterVA-5 cause of death analytical tool to assign specific causes of death among children (0-14 years), those of working age (15-64 years) and the elderly (65+ years).
Nearly 50% of the total deaths were attributed to non-communicable diseases (NCDs), followed by infectious and parasitic diseases (35%), injuries and external causes (11%) and maternal and neonatal deaths (4%). Leading causes of death among children were acute respiratory tract infections (ARTIs) and diarrhoeal diseases, each contributing to 13% of total deaths. Among the working population, tuberculosis (TB) contributed to 12% of total deaths, followed by HIV/AIDS (11%). TB- and HIV/AIDS-attributed deaths were highest in the age group 25-34 years, at 20% and 18%, respectively. These diseases killed more females of working age (n = 79, 15%) than males (n = 52, 8%). Among the elderly, the leading causes of death were ARTIs (13%) followed by digestive neoplasms (10%) and acute cardiac diseases (9%).
The variations in leading causes of death across the populations in PNG suggest diversity in mortality transition. This requires different strategies to address specific causes of death in particular populations.
巴布亚新几内亚（PNG）在死亡转变过程中导致死亡的原因变化尚不清楚。本研究分析了社区层面的数据，以确定人群中的主要死因，并分析了不同年龄组、性别、城乡部门和省份之间的差异。
2018-20 年期间，作为综合卫生和流行病学监测系统（CHESS）的一部分，使用世界卫生组织 2016 年的口头尸检（VA）工具收集了死亡率监测数据。使用 InterVA-5 死因分析工具对 926 次 VA 访谈的数据进行了分析，以确定儿童（0-14 岁）、劳动年龄人口（15-64 岁）和老年人（65 岁以上）的具体死因。
近 50%的总死亡归因于非传染性疾病（NCDs），其次是传染病和寄生虫病（35%）、伤害和外部原因（11%）以及孕产妇和新生儿死亡（4%）。儿童的主要死因是急性呼吸道感染（ARTIs）和腹泻病，各占总死亡人数的 13%。在劳动年龄人口中，结核病（TB）占总死亡人数的 12%，其次是艾滋病毒/艾滋病（HIV/AIDS）（11%）。TB 和 HIV/AIDS 导致的死亡在 25-34 岁年龄组中最高，分别为 20%和 18%。这些疾病导致的劳动年龄女性死亡人数（n=79，15%）多于男性（n=52，8%）。在老年人中，主要死因是急性呼吸道感染（13%），其次是消化系统肿瘤（10%）和急性心脏疾病（9%）。
PNG 人群中主要死因的差异表明死亡转变的多样性。这需要针对特定人群的特定死因制定不同的策略。
