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. 2014 Oct 29:7:25366.
doi: 10.3402/gha.v7.25366. eCollection 2014.

Mortality from external causes in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System Sites

P Kim Streatfield  1 , Wasif A Khan  2 , Abbas Bhuiya  3 , Syed M A Hanifi  3 , Nurul Alam  4 , Eric Diboulo  5 , Louis Niamba  5 , Ali Sié  5 , Bruno Lankoandé  6 , Roch Millogo  6 , Abdramane B Soura  6 , Bassirou Bonfoh  7 , Siaka Kone  7 , Eliezer K Ngoran  8 , Juerg Utzinger  9 , Yemane Ashebir  10 , Yohannes A Melaku  10 , Berhe Weldearegawi  10 , Pierre Gomez  11 , Momodou Jasseh  11 , Daniel Azongo  12 , Abraham Oduro  12 , George Wak  12 , Peter Wontuo  12 , Mary Attaa-Pomaa  13 , Margaret Gyapong  13 , Alfred K Manyeh  13 , Shashi Kant  14 , Puneet Misra  14 , Sanjay K Rai  14 , Sanjay Juvekar  15 , Rutuja Patil  15 , Abdul Wahab  16 , Siswanto Wilopo  16 , Evasius Bauni  17 , George Mochamah  17 , Carolyne Ndila  17 , Thomas N Williams  18 , Christine Khaggayi  19 , Amek Nyaguara  19 , David Obor  19 , Frank O Odhiambo  19 , Alex Ezeh  20 , Samuel Oti  20 , Marylene Wamukoya  20 , Menard Chihana  21 , Amelia Crampin  22 , Mark A Collinson  23 , Chodziwadziwa W Kabudula  24 , Ryan Wagner  24 , Kobus Herbst  25 , Joël Mossong  26 , Jacques B O Emina  27 , Osman A Sankoh  28 , Peter Byass  29
Affiliations

Mortality from external causes in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System Sites

P Kim Streatfield et al. Glob Health Action. .

Abstract

Background: Mortality from external causes, of all kinds, is an important component of overall mortality on a global basis. However, these deaths, like others in Africa and Asia, are often not counted or documented on an individual basis. Overviews of the state of external cause mortality in Africa and Asia are therefore based on uncertain information. The INDEPTH Network maintains longitudinal surveillance, including cause of death, at population sites across Africa and Asia, which offers important opportunities to document external cause mortality at the population level across a range of settings.

Objective: To describe patterns of mortality from external causes at INDEPTH Network sites across Africa and Asia, according to the WHO 2012 verbal autopsy (VA) cause categories.

Design: All deaths at INDEPTH sites are routinely registered and followed up with VA interviews. For this study, VA archives were transformed into the WHO 2012 VA standard format and processed using the InterVA-4 model to assign cause of death. Routine surveillance data also provide person-time denominators for mortality rates.

Results: A total of 5,884 deaths due to external causes were documented over 11,828,253 person-years. Approximately one-quarter of those deaths were to children younger than 15 years. Causes of death were dominated by childhood drowning in Bangladesh, and by transport-related deaths and intentional injuries elsewhere. Detailed mortality rates are presented by cause of death, age group, and sex.

Conclusions: The patterns of external cause mortality found here generally corresponded with expectations and other sources of information, but they fill some important gaps in population-based mortality data. They provide an important source of information to inform potentially preventive intervention designs.

Keywords: Africa; Asia; INDEPTH Network; InterVA; accidents; assault; drowning; external causes; mortality; suicide; transport; verbal autopsy.

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Figures

Fig. 1
Fig. 1
Map showing overall age-sex-time standardised mortality rates per 1,000 person-years due to external causes, also listing the specific cause category and age group accounting for the largest proportion of deaths due to external causes at each site, for 20 INDEPTH sites.
Fig. 2
Fig. 2
Age-sex-time standardised mortality rates per 1,000 person-years by category of external causes of death, from 20 INDEPTH sites.
Fig. 3
Fig. 3
Site-specific mortality rates per 1,000 person-years by age group and category of unintentional external causes of death.
Fig. 4
Fig. 4
Site-specific mortality rates per 1,000 person-years by age group and category of intentional external causes of death.
See this image and copyright information in PMC

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