Authors: Narh-Bana, S. A.; Chirwa, T. F.¹; Mwanyangala, M. A.²; Nathan, R.²

Source: Tropical Medicine & International Health, Volume 17, Number 11, 1 November 2012 , pp. 1396-1404(9)

Publisher: Wiley-Blackwell

Abstract:

<title type="main">Abstract</title>

Objectives  To determine patterns and risk factors for cause-specific adult mortality in rural southern Tanzania.

Methods  The study was a longitudinal open cohort and focused on adults aged 15-59 years between 2003 and 2007. Causes of deaths were ascertained by verbal autopsy (VA). Cox proportion hazards regression model was used to determine factors associated with cause-specific mortality over the 5-year period.

Results  Thousand three hundred and fifty-two of 65 548 adults died, representing a crude adult mortality rate (AMR) of 7.3 per 1000 person years of observation (PYO). VA was performed for 1132 (84%) deaths. HIV/AIDS [231 (20.4%)] was the leading cause of death followed by malaria [150 (13.2%)]. AMR for communicable disease (CD) causes was 2.49 per 1000 PYO, 1.21 per 1000 PYO for non-communicable diseases (NCD) and 0.53 per 1000 PYO for accidents/injury causes. NCD deaths increased from 16% in 2003 to 24% in 2007. High level of education was associated with a reduction in the risk of dying from NCDs. Those with primary education (HR = 0.67, 95% CI: 0.49, 0.92) and with education beyond primary school (HR = 0.11, 95% CI: 0.02, 0.40) had lower mortality than those who had no formal education. Compared with local residents, in-migrants were 1.7 (95% CI: 1.37, 2.11) times more likely to die from communicable disease causes.

Conclusion  NCDs are increasing as a result of demographic and epidemiological transitions taking place in most African countries including Tanzania and require attention to prevent increased triple disease burden of CD, NCD and accident/injuries.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-3156.2012.03080.x

Affiliations: 1:  Division of Epidemiology and Biostatistics, University of Witwatersrand, Johannesburg, South Africa 2:  Ifakara Health Institute, Dar es salaam, Tanzania

Publication date: 2012-11-01

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