1
|
Population-Based Temporal Trends and Ethnic Disparity in Cervical Cancer Mortality in South Africa (1999-2018): A Join Point and Age-Period-Cohort Regression Analyses. Cancers (Basel) 2022; 14:cancers14246256. [PMID: 36551741 PMCID: PMC9816936 DOI: 10.3390/cancers14246256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/25/2022] [Accepted: 12/04/2022] [Indexed: 12/23/2022] Open
Abstract
Cervical cancer is one of the leading causes of cancer deaths among women in low- and middle-income countries such as South Africa. The current impact of national cervical cancer control and sexual and reproductive health interventions in South Africa reduce its burden. The aim of this study was to assess the trends in cervical cancer mortality and its relation to breast and gynaecological cancers in South Africa from 1999 to 2018. We conducted joinpoint regression analyses of the trends in crude and age-standardised mortality rates (ASMR) for cervical cancer mortality in South Africa from 1999 to 2018. An age−period−cohort regression analysis was also conducted to determine the impact of age, period, and cohort on cervical cancer mortality trends. Analyses were stratified by ethnicity. Cervical cancer (n = 59,190, 43.92%, 95% CI: 43.65−44.18%) was responsible for about 43.9% of breast and gynecological cancer deaths. The mortality rate of cervical cancer (from 11.7 to 14.08 per 100,000) increased at about 0.9% per annum (Average Annual Percent Change (AAPC): 0.9% (AAPC: 0.9%, p-value < 0.001)), and young women aged 25 to 49 years (AAPC: 1.2−3.5%, p-value < 0.001) had increased rates. The risk of cervical cancer mortality increased among successive birth cohorts. In 2018, cervical cancer mortality rate among Blacks (16.74 per 100,000 women) was about twice the rates among Coloureds (8.53 deaths per 100,000 women) and approximately four-fold among Indians/Asians (4.16 deaths per 100,000 women), and Whites (3.06 deaths per 100,000 women). Cervical cancer control efforts should be enhanced in South Africa and targeted at ethnic difference, age, period, and cohort effects.
Collapse
|
2
|
Dorrington RE, Moultrie TA, Laubscher R, Groenewald PJ, Bradshaw D. Rapid mortality surveillance using a national population register to monitor excess deaths during SARS-CoV-2 pandemic in South Africa. GENUS 2021; 77:19. [PMID: 34493876 PMCID: PMC8414474 DOI: 10.1186/s41118-021-00134-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/17/2021] [Indexed: 11/23/2022] Open
Abstract
This paper describes how an up-to-date national population register recording deaths by age and sex, whether deaths were due to natural or unnatural causes, and the offices at which the deaths were recorded can be used to monitor excess death during the SARS-CoV-2 pandemic, both nationally, and sub-nationally, in a country with a vital registration system that is neither up to date nor complete. Apart from suggesting an approach for estimating completeness of reporting at a sub-national level, the application produces estimates of the number of deaths in excess of those expected in the absence of the SARS-CoV-2 epidemic that are highly correlated with the confirmed number of COVID-19 deaths over time, but at a level 2.5 to 3 times higher than the official numbers of COVID-19 deaths. Apportioning the observed excess deaths more precisely to COVID, COVID-related and collateral deaths, and non-COVID deaths averted by interventions with reduced mobility and gatherings, etc., requires access to real-time cause-of-death information. It is suggested that the transition from ICD-10 to ICD-11 should be used as an opportunity to change from a paper-based system to electronic capture of the medical cause-of-death information.
Collapse
Affiliation(s)
- Rob E. Dorrington
- Centre for Actuarial Research, University of Cape Town, Private Bag, Rondebosch, Cape Town, 7700 South Africa
| | - Tom A. Moultrie
- Centre for Actuarial Research, University of Cape Town, Private Bag, Rondebosch, Cape Town, 7700 South Africa
| | - Ria Laubscher
- Biostatistics Unit, South African Medical Research Council, Francie van Zijl Drive, Tygerberg, Cape Town, 7505 South Africa
| | - Pam J. Groenewald
- Burden of Disease Research Unit, South African Medical Research Council, Francie van Zijl Drive, Tygerberg, Cape Town, 7505 South Africa
| | - Debbie Bradshaw
- Burden of Disease Research Unit, South African Medical Research Council, Francie van Zijl Drive, Tygerberg, Cape Town, 7505 South Africa
- Department of Family Medicine and Public Health, University of Cape Town, Private Bag, Rondebosch, Cape Town, 7700 South Africa
| |
Collapse
|
3
|
de Abreu L, Hoeffler A. Safer spaces: The impact of a reduction in road fatalities on the life expectancy of South Africans. ACCIDENT; ANALYSIS AND PREVENTION 2021; 157:106142. [PMID: 33940329 DOI: 10.1016/j.aap.2021.106142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/07/2021] [Accepted: 04/13/2021] [Indexed: 06/12/2023]
Abstract
In this paper we determine the burden on society of fatalities resulting from road traffic injuries (RTIs) in South Africa. We express the burden in terms of reduced life expectancy and years of potential life lost (YPLL). Our main data source is the Injury Mortality Survey (IMS), a retrospective descriptive study carried out in South Africa. Using the mortality rates by sex and age from the IMS we calculate actual life expectancy at birth. In our counterfactual analysis we assume a 15 % reduction in road fatalities per year over a period of 10 years. A comparison of the estimated actual and counterfactual life expectancies suggests that the average gain in life expectancy at birth would be 0.58 years. Since the overwhelming majority of road traffic fatalities are male (75.7 %), there is a considerable gender difference. Men would gain on average 0.85 years while women would gain 0.30 years in life expectancy, closing the gender gap in life expectancy by about 14 %. We then discuss how a reduction in RTIs could be achieved. South Africa's legislation addresses several of the important aspects of road safety (e.g. seat belt use, drink driving restrictions, speed limits, infrastructure improvements), however, enforcement is relatively weak and should be improved. There are a raft of measures that have been well researched in other countries, most interventions aim to modify the behaviour of road users and have been found to be cost effective. In addition to stricter enforcement, evidence from social science suggests that compliance could be increased through a change in social norms regarding road usage.
Collapse
Affiliation(s)
- Liliana de Abreu
- Development Research Group, Department of Politics and Public Administration University of Konstanz, Germany.
| | - Anke Hoeffler
- Development Research Group, Department of Politics and Public Administration University of Konstanz, Germany
| |
Collapse
|
4
|
Newberry Le Vay J, Fraser A, Byass P, Tollman S, Kahn K, D'Ambruoso L, Davies JI. Mortality trends and access to care for cardiovascular diseases in Agincourt, rural South Africa: a mixed-methods analysis of verbal autopsy data. BMJ Open 2021; 11:e048592. [PMID: 34172550 PMCID: PMC8237742 DOI: 10.1136/bmjopen-2020-048592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Cardiovascular diseases are the second leading cause of mortality behind HIV/AIDS in South Africa. This study investigates cardiovascular disease mortality trends in rural South Africa over 20+ years and the associated barriers to accessing care, using verbal autopsy data. DESIGN A mixed-methods approach was used, combining descriptive analysis of mortality rates over time, by condition, sex and age group, quantitative analysis of circumstances of mortality (CoM) indicators and free text narratives of the final illness, and qualitative analysis of free texts. SETTING This study was done using verbal autopsy data from the Health and Socio-Demographic Surveillance System site in Agincourt, rural South Africa. PARTICIPANTS Deaths attributable to cardiovascular diseases (acute cardiac disease, stroke, renal failure and other unspecified cardiac disease) from 1993 to 2015 were extracted from verbal autopsy data. RESULTS Between 1993 and 2015, of 15 305 registered deaths over 1 851 449 person-years of follow-up, 1434 (9.4%) were attributable to cardiovascular disease, corresponding to a crude mortality rate of 0.77 per 1000 person-years. Cardiovascular disease mortality rate increased from 0.34 to 1.12 between 1993 and 2015. Stroke was the dominant cause of death, responsible for 41.0% (588/1434) of all cardiovascular deaths across all years. Cardiovascular disease mortality rate was significantly higher in women and increased with age. The main delays in access to care during the final illness were in seeking and receiving care. Qualitative free-text analysis highlighted delays not captured in the CoM, principally communication between the clinician and patient or family. Half of cases initially sought care outside a hospital setting (50.9%, 199/391). CONCLUSIONS The temporal increase in deaths due to cardiovascular disease highlights the need for greater prevention and management strategies for these conditions, particularly for the women. Strategies to improve seeking and receiving care during the final illness are needed.
Collapse
Affiliation(s)
| | - Andrew Fraser
- Education Centre, Basildon University Hospital, Mid and South Essex NHS Foundation Trust, Basildon, UK
| | - Peter Byass
- Department of Epidemiology & Global Health, Umea Universitet, Umeå, Sweden
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, University of the Witwatersrand School of Public Health, Johannesburg, South Africa
- Aberdeen Centre for Health Data Science, Institute of Applied Health Sciences, School of Medicine Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Stephen Tollman
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, University of the Witwatersrand School of Public Health, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | - Kathleen Kahn
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, University of the Witwatersrand School of Public Health, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | - Lucia D'Ambruoso
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, University of the Witwatersrand School of Public Health, Johannesburg, South Africa
- Aberdeen Centre for Health Data Science, Institute of Applied Health Sciences, School of Medicine Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
- WHO Collaborating Centre for Verbal Autopsy, Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Justine I Davies
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, University of the Witwatersrand School of Public Health, Johannesburg, South Africa
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| |
Collapse
|
5
|
Motsuku L, Chen WC, Muchengeti MM, Naidoo M, Quene TM, Kellett P, Mohlala MI, Chu KM, Singh E. Colorectal cancer incidence and mortality trends by sex and population group in South Africa: 2002-2014. BMC Cancer 2021; 21:129. [PMID: 33549058 PMCID: PMC7866437 DOI: 10.1186/s12885-021-07853-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/28/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND South Africa (SA) has experienced a rapid transition in the Human Development Index (HDI) over the past decade, which had an effect on the incidence and mortality rates of colorectal cancer (CRC). This study aims to provide CRC incidence and mortality trends by population group and sex in SA from 2002 to 2014. METHODS Incidence data were extracted from the South African National Cancer Registry and mortality data obtained from Statistics South Africa (STATS SA), for the period 2002 to 2014. Age-standardised incidence rates (ASIR) and age-standardised mortality rates (ASMR) were calculated using the STATS SA mid-year population as the denominator and the Segi world standard population data for standardisation. A Joinpoint regression analysis was computed for the CRC ASIR and ASMR by population group and sex. RESULTS A total of 33,232 incident CRC cases and 26,836 CRC deaths were reported during the study period. Of the CRC cases reported, 54% were males and 46% were females, and among deaths reported, 47% were males and 53% were females. Overall, there was a 2.5% annual average percentage change (AAPC) increase in ASIR from 2002 to 2014 (95% CI: 0.6-4.5, p-value < 0.001). For ASMR overall, there was 1.3% increase from 2002 to 2014 (95% CI: 0.1-2.6, p-value < 0.001). The ASIR and ASMR among population groups were stable, with the exception of the Black population group. The ASIR increased consistently at 4.3% for black males (95% CI: 1.9-6.7, p-value < 0.001) and 3.4% for black females (95% CI: 1.5-5.3, p-value < 0.001) from 2002 to 2014, respectively. Similarly, ASMR for black males and females increased by 4.2% (95% CI: 2.0-6.5, p-value < 0.001) and 3.4% (, 95%CI: 2.0-4.8, p-value < 0.01) from 2002 to 2014, respectively. CONCLUSIONS The disparities in the CRC incidence and mortality trends may reflect socioeconomic inequalities across different population groups in SA. The rapid increase in CRC trends among the Black population group is concerning and requires further investigation and increased efforts for cancer prevention, early screening and diagnosis, as well as better access to cancer treatment.
Collapse
Affiliation(s)
- Lactatia Motsuku
- National Cancer Registry, National Health Laboratory Service, 1 Modderfontein road, Sandringham, Johannesburg, 2131, South Africa
- Department of Global Health, South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
| | - Wenlong Carl Chen
- National Cancer Registry, National Health Laboratory Service, 1 Modderfontein road, Sandringham, Johannesburg, 2131, South Africa
- Faculty of Health Sciences, Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Mazvita Molleen Muchengeti
- National Cancer Registry, National Health Laboratory Service, 1 Modderfontein road, Sandringham, Johannesburg, 2131, South Africa
- Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Megan Naidoo
- Department of Global Health, Centre for Global Surgery, Stellenbosch University, Cape Town, South Africa
| | - Tamlyn Mac Quene
- Department of Global Health, Centre for Global Surgery, Stellenbosch University, Cape Town, South Africa
| | - Patricia Kellett
- National Cancer Registry, National Health Laboratory Service, 1 Modderfontein road, Sandringham, Johannesburg, 2131, South Africa
| | - Matshediso Ivy Mohlala
- National Cancer Registry, National Health Laboratory Service, 1 Modderfontein road, Sandringham, Johannesburg, 2131, South Africa
| | - Kathryn M Chu
- Department of Global Health, Centre for Global Surgery, Stellenbosch University, Cape Town, South Africa
| | - Elvira Singh
- National Cancer Registry, National Health Laboratory Service, 1 Modderfontein road, Sandringham, Johannesburg, 2131, South Africa.
- Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| |
Collapse
|
6
|
Excess Mortality Due to External Causes in Women in the South African Mining Industry: 2013-2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061875. [PMID: 32183181 PMCID: PMC7143399 DOI: 10.3390/ijerph17061875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 11/28/2022]
Abstract
Mining is a recognized high-risk industry with a relatively high occurrence of occupational injuries and disease. In this study, we looked at the differences in mortality between male and female miners in South Africa. Data from Statistics South Africa regarding occupation and cause of death in the combined years 2013–2015 were analyzed. Proportional mortality ratios (PMRs) were calculated to investigate excess mortality due to external causes of death by sex in miners and in manufacturing laborers. Results: Women miners died at a significantly younger age on average (44 years) than all women (60 years), women manufacturers (53 years), and male miners (55 yrs). There was a significantly increased proportion of deaths due to external causes in women miners (12.4%) compared to all women (4.8%) and women manufacturers (4.6%). Significantly increased PMRs were seen in car occupant accidents (467, 95% confidence interval (CI) 151–1447), firearm discharge (464, 95% CI 220–974), and contact with blunt objects (2220 95% CI 833–5915). Conclusion: This descriptive study showed excess deaths in women miners due to external causes. Road accidents, firearm discharge, and contact with blunt objects PMRs were significantly increased. Further research is required to confirm the underlying reasons for external causes of death and to develop recommendations to protect women miners.
Collapse
|
7
|
Trends in Suicide Mortality in South Africa, 1997 to 2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061850. [PMID: 32178393 PMCID: PMC7142470 DOI: 10.3390/ijerph17061850] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/25/2022]
Abstract
Suicide rates worldwide are declining; however, less is known about the patterns and trends in mortality from suicide in sub-Saharan Africa. This study evaluates trends in suicide rates and years of potential life lost from death registration data in South Africa from 1997 to 2016. Suicide (X60–X84 and Y87) was coded using the 10th Revision of the International Classification of Diseases (ICD-10). Changes in mortality rate trends were analysed using joinpoint regression analysis. The 20-year study examines 8573 suicides in South Africa, comprising 0.1% of all deaths involving persons 15 years and older. Rates of suicide per 100,000 population were 2.07 in men and 0.49 in women. Joinpoint regression analyses showed that, while the overall mortality rate for male suicides remained stable, mortality rates due to hanging and poisoning increased by 3.9% and 3.5% per year, respectively. Female suicide mortality rates increased by 12.6% from 1997 to 2004 before stabilising; while rates due to hanging increased by 3.0% per year. The average annual YPLL due to suicide was 9559 in men and 2612 in women. The results show that suicide contributes substantially to premature death and demonstrates the need for targeted interventions, especially among young men in South Africa.
Collapse
|
8
|
Adair T, Richards N, Streatfield A, Rajasekhar M, McLaughlin D, Lopez AD. Addressing critical knowledge and capacity gaps to sustain CRVS system development. BMC Med 2020; 18:46. [PMID: 32146902 PMCID: PMC7061462 DOI: 10.1186/s12916-020-01523-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 02/11/2020] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Improving civil registration and vital statistics (CRVS) systems requires strengthening the capacity of the CRVS workforce. The improvement of data collection and diagnostic practices must be accompanied by efforts to ensure that the workforce has the skills and knowledge to assess the quality of, and analyse, CRVS data using demographic and epidemiological techniques. While longer-term measures to improve data collection practices must continue to be implemented, it is important to build capacity in the cautious use of imperfect data. However, a lack of training programmes, guidelines and tools make capacity shortages a common issue in CRVS systems. As such, any strategy to build capacity should be underpinned by (1) a repository of knowledge and body of evidence on CRVS, and (2) targeted strategies to train the CRVS workforce. MAIN TEXT During the 4 years of the Bloomberg Philanthropies Data for Health (D4H) Initiative at the University of Melbourne, an extensive repository of knowledge and practical tools to support CRVS system improvements was developed for use by various audiences and stakeholders (the 'CRVS Knowledge Gateway'). Complementing this has been a targeted strategy to build CRVS capacity in countries that comprised two approaches - in-country or regional training and a visiting Fellowship Program. These approaches address the need to build competence in countries to collect, analyse and effectively use good quality birth and death data, and a longer-term need to ensure that local staff in countries possess the comprehensive knowledge of CRVS strategies and practices necessary to ensure sustainable CRVS development. CONCLUSION The Knowledge Gateway is a dynamic, useful and long-lasting repository of CRVS knowledge for countries and development partners to use to formulate and evaluate CRVS development strategies. Capacity-building through in-country or regional training and the University of Melbourne D4H Fellowship Program will ensure that CRVS capacity and knowledge is developed and maintained, facilitating improvements in CRVS data systems that can be used by policymakers to support better decision-making in health.
Collapse
Affiliation(s)
- Tim Adair
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, 3053, Australia.
| | - Nicola Richards
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, 3053, Australia
| | - Avita Streatfield
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, 3053, Australia
| | - Megha Rajasekhar
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, 3053, Australia
| | - Deirdre McLaughlin
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, 3053, Australia
| | - Alan D Lopez
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, 3053, Australia
| |
Collapse
|
9
|
Rao C. Elements of a strategic approach for strengthening national mortality statistics programmes. BMJ Glob Health 2019; 4:e001810. [PMID: 31681480 PMCID: PMC6797430 DOI: 10.1136/bmjgh-2019-001810] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/03/2019] [Accepted: 09/21/2019] [Indexed: 01/10/2023] Open
Abstract
Information on cause-specific mortality from civil registration and vital statistics (CRVS) systems is essential for health policy and epidemiological research. Currently, there are critical gaps in the international availability of timely and reliable mortality data, which limits planned progress towards the UN Sustainable Development Goals. This article describes an evidence-based strategic approach for strengthening mortality data from CRVS systems. National mortality data availability scores from the Global Burden of Disease study were used to group countries into those with adequate, partial or negligible mortality data. These were further categorised by geographical region and population size, which showed that there were shortcomings in availability of mortality data in approximately two-thirds of all countries. Existing frameworks for evaluating design and functional status of mortality components of CRVS systems were reviewed to identify themes and topics for assessment. Detailed national programme assessments can be used to investigate systemic issues that are likely to affect death reporting, cause of death ascertainment and data management. Assessment findings can guide interventions to strengthen system performance. The strategic national approach should be customised according to data availability and population size and supported by human and institutional capacity building. Countries with larger populations should use an incremental sampling approach to strengthen CRVS systems and use interim data for mortality estimation. Periodic data quality evaluation is required to monitor system performance and scale up interventions. A comprehensive implementation and operations research programme should be concurrently launched to evaluate the feasibility, success and sustainability of system strengthening activities.
Collapse
Affiliation(s)
- Chalapati Rao
- Department of Global Health, Research School of Population Health, Australian National University College of Medicine Biology and Environment, Canberra, Australian Capital Territory, Australia
| |
Collapse
|
10
|
Suthar AB, Khalifa A, Yin S, Wenz K, Ma Fat D, Mills SL, Nichols E, AbouZahr C, Mrkic S. Evaluation of approaches to strengthen civil registration and vital statistics systems: A systematic review and synthesis of policies in 25 countries. PLoS Med 2019; 16:e1002929. [PMID: 31560684 PMCID: PMC6764661 DOI: 10.1371/journal.pmed.1002929] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/30/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Civil registration and vital statistics (CRVS) systems play a key role in upholding human rights and generating data for health and good governance. They also can help monitor progress in achieving the United Nations Sustainable Development Goals. Although many countries have made substantial progress in strengthening their CRVS systems, most low- and middle-income countries still have underdeveloped systems. The objective of this systematic review is to identify national policies that can help countries strengthen their systems. METHODS AND FINDINGS The ABI/INFORM, Embase, JSTOR, PubMed, and WHO Index Medicus databases were systematically searched for policies to improve birth and/or death registration on 24 January 2017. Global stakeholders were also contacted for relevant grey literature. For the purposes of this review, policies were categorised as supply, demand, incentive, penalty, or combination (i.e., at least two of the preceding policy approaches). Quantitative results on changes in vital event registration rates were presented for individual comparative articles. Qualitative systematic review methodology, including meta-ethnography, was used for qualitative syntheses on operational considerations encompassing acceptability to recipients and staff, human resource requirements, information technology or infrastructure requirements, costs to the health system, unintended effects, facilitators, and barriers. This study is registered with PROSPERO, number CRD42018085768. Thirty-five articles documenting experience in implementing policies to improve birth and/or death registration were identified. Although 25 countries representing all global regions (Africa, the Americas, Southeast Asia, the Western Pacific, Europe, and the Eastern Mediterranean) were reflected, there were limited countries from the Eastern Mediterranean and Europe regions. Twenty-four articles reported policy effects on birth and/or death registration. Twenty-one of the 24 articles found that the change in registration rate after the policy was positive, with two supply and one penalty articles being the exceptions. The qualitative syntheses identified 15 operational considerations across all policy categories. Human and financial resource requirements were not quantified. The primary limitation of this systematic review was the threat of publication bias wherein many countries may not have documented their experience; this threat is most concerning for policies that had neutral or negative effects. CONCLUSIONS Our systematic review suggests that combination policy approaches, consisting of at least a supply and demand component, were consistently associated with improved registration rates in different geographical contexts. Operational considerations should be interpreted based on health system, governance, and sociocultural context. More evaluations and research are needed from the Eastern Mediterranean and Europe regions. Further research and evaluation are also needed to estimate the human and financial resource requirements required for different policies.
Collapse
Affiliation(s)
- Amitabh Bipin Suthar
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Aleya Khalifa
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sherry Yin
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kristen Wenz
- Programme Division, United Nations Children’s Fund, New York City, New York, United States of America
| | - Doris Ma Fat
- Health Statistics and Informatics Department, World Health Organization, Geneva, Switzerland
| | - Samuel Lantei Mills
- Health, Nutrition, and Population Global Practice, World Bank Group, Washington DC, United States of America
| | - Erin Nichols
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, United States of America
| | - Carla AbouZahr
- Bloomberg Data for Health Initiative, New York City, New York, United States of America
| | - Srdjan Mrkic
- Statistics Division, United Nations, New York City, New York, United States of America
| |
Collapse
|
11
|
Wilson KS, Naicker N, Kootbodien T, Ntlebi V, Made F, Tlotleng N. Usefulness of occupation and industry information in mortality data in South Africa from 2006 to 2015. BMC Public Health 2019; 19:866. [PMID: 31269939 PMCID: PMC6609411 DOI: 10.1186/s12889-019-7177-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 06/17/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is no population based occupational health surveillance system in South Africa, thus mortality data may be a cost effective means of monitoring trends and possible associations with occupation. The aim of this study was to use deaths due to pneumoconiosis (a known occupational disease) to determine if the South African mortality data are a valid data source for occupational health surveillance in South Africa. METHODS Proportions of complete occupation and industry information for the years 2006-2015 were calculated for working age and retired adults. Deaths due to pneumoconiosis were identified in the data set and mortality odds ratios calculated for specific occupations and industry in reference to those who reported being unemployed using logistic regression. RESULTS Only 16.1% of death notifications provided a usual occupation despite 43.1% of the population being employed in the year. The MORs for occupation provided significant increased odds of pneumoconiosis for miners (9.04), those involved in manufacturing (4.77), engineers and machinery mechanics (6.85). Along with these jobs the Mining (9.8), Manufacture (2.2) and Maintenance and repair industries (6.0) have significantly increased odds of pneumoconiosis deaths. The data can be said to provide a useful source of occupational disease information for surveillance where active surveillance systems do not exist. CONCLUSION The findings indicate valid associations were found between occupational disease and expected jobs and industry. The most useful data are from 2013 onwards due to more detailed coding of occupation and industry.
Collapse
Affiliation(s)
- Kerry S Wilson
- National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa. .,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Nisha Naicker
- National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Tahira Kootbodien
- National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa
| | - Vusi Ntlebi
- National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa
| | - Felix Made
- National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa
| | - Nonhlanhla Tlotleng
- National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa.
| |
Collapse
|
12
|
Oung MT, Richter K, Prasartkul P, Aung Y, Soe KT, Tin TC, Tangcharoensathien V. Reliable mortality statistics in Myanmar: a qualitative assessment of challenges in two townships. BMC Public Health 2019; 19:356. [PMID: 30925875 PMCID: PMC6441185 DOI: 10.1186/s12889-019-6671-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 03/18/2019] [Indexed: 11/18/2022] Open
Abstract
Background The vital registration system is universally recognized as the main source of mortality data which is essential for policy formulation, proper interventions and resource allocation to address priority health challenges. To improve availability and quality of mortality statistics by strengthening the vital registration system, understanding the current vital registration system is essential. This study identified challenges in generating reliable mortality statistics in the vital registration system of Myanmar. Methods Qualitative methods were used to collect data in two selected townships of Mandalay Region. Grey literature related to the management of mortality registration was reviewed; in-depth interviews of sixteen key informants and fourteen focus group discussions were conducted with those involved in death registration at the local level, such as healthcare providers, local administrators and knowledgeable adults in households where deaths occurred during the past three years. Thematic analysis was performed to identify system barriers in the death registration process. Results Weaknesses in the death registration system are classified in three areas: a) administrative which includes the lack of enforcement of mandatory death registration, limited issuance of death certificates and no formal mandatory notification of death events by households and; b) technical which includes absence of proper and regular on-the-job trainings, ineffective cause-of-death certification practice for deaths in the communities and the absence of routine data plausibility checks at the local level; and c) societal which includes poor community awareness and inadequate participation in death registration. Conclusion The study highlighted challenges in the death registration system at the operational level, which undermines the achievement of a satisfactory level of completeness and accuracy of mortality data. We recommend establishing a strong legal framework, improving technical capacities and raising public awareness and cooperation to strengthen the system that can generate reliable mortality statistics. Electronic supplementary material The online version of this article (10.1186/s12889-019-6671-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Myitzu Tin Oung
- Institute for Population and Social Research, Mahidol University, Bangkok, Thailand. .,Department of Medical Research (Pyin Oo Lwin Branch), Pyin Oo Lwin, Myanmar.
| | - Kerry Richter
- Institute for Population and Social Research, Mahidol University, Bangkok, Thailand
| | - Pramote Prasartkul
- Institute for Population and Social Research, Mahidol University, Bangkok, Thailand
| | - Yadanar Aung
- Department of Medical Research (Pyin Oo Lwin Branch), Pyin Oo Lwin, Myanmar
| | - Kyaw Thu Soe
- Department of Medical Research (Pyin Oo Lwin Branch), Pyin Oo Lwin, Myanmar
| | | | | |
Collapse
|
13
|
Saikia N, Bora JK, Luy M. Socioeconomic disparity in adult mortality in India: estimations using the orphanhood method. GENUS 2019. [DOI: 10.1186/s41118-019-0054-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
14
|
Tobacco Use in South African Emergency Centre Patients: Opportunities for Intervention. Int J Ment Health Addict 2018. [DOI: 10.1007/s11469-018-0042-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
15
|
Mremi IR, Rumisha SF, Chiduo MG, Mangu CD, Mkwashapi DM, Kishamawe C, Lyimo EP, Massawe IS, Matemba LE, Bwana VM, Mboera LEG. Hospital mortality statistics in Tanzania: availability, accessibility, and quality 2006-2015. Popul Health Metr 2018; 16:16. [PMID: 30458804 PMCID: PMC6247530 DOI: 10.1186/s12963-018-0175-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 11/07/2018] [Indexed: 05/30/2023] Open
Abstract
Background Accurate and reliable hospital information on the pattern and causes of death is important to monitor and evaluate the effectiveness of health policies and programs. The objective of this study was to assess the availability, accessibility, and quality of hospital mortality data in Tanzania. Methods This cross-sectional study involved selected hospitals of Tanzania and was carried out from July to October 2016. Review of hospital death registers and forms was carried out to cover a period of 10 years (2006–2015). Interviews with hospital staff were conducted to seek information as regards to tools used to record mortality data, staff involved in recording and availability of data storage and archiving facilities. Results A total of 247,976 death records were reviewed. The death register was the most (92.3%) common source of mortality data. Other sources included the International Classification of Diseases (ICD) report forms, Inpatient registers, and hospital administrative reports. Death registers were available throughout the 10-year period while ICD-10 forms were available for the period of 2013–2015. In the years between 2006 and 2010 and 2011–2015, the use of death register increased from 82 to 94.9%. Three years after the introduction of ICD-10 procedure, the forms were available and used in 28% (11/39) hospitals. The level of acceptable data increased from 69% in 2006 to 97% in 2015. Inconsistency in the language used, use of non-standard nomenclature for causes of death, use of abbreviations, poorly and unreadable handwriting, and missing variables were common data quality challenges. About 6.3% (n = 15,719) of the records had no patient age, 3.5% (n = 8790) had no cause of death and ~ 1% had no sex indicated. The frequency of missing sex variable was most common among under-5 children. Data storage and archiving in most hospitals was generally poor. Registers and forms were stored in several different locations, making accessibility difficult. Conclusion Overall, this study demonstrates gaps in hospital mortality data availability, accessibility, and quality, and highlights the need for capacity strengthening in data management and periodic record reviews. Policy guidelines on the data management including archiving are necessary to improve data.
Collapse
Affiliation(s)
- Irene R Mremi
- National Institute for Medical Research, Headquarters, P.O. Box 9653, 11101, Dar es Salaam, Tanzania.,Southern African Centre for Infectious Disease Surveillance, Centre of Excellence for Infectious Diseases of Humans and Animals, P.O. Box 3297, Morogoro, Tanzania
| | - Susan F Rumisha
- National Institute for Medical Research, Headquarters, P.O. Box 9653, 11101, Dar es Salaam, Tanzania
| | - Mercy G Chiduo
- National Institute for Medical Research, Tanga Research Centre, P.O. Box 5004, Tanga, Tanzania
| | - Chacha D Mangu
- National Institute for Medical Research, Mbeya Research Centre, P.O. Box 2410, Mbeya, Tanzania
| | - Denna M Mkwashapi
- National Institute for Medical Research, Mwanza Research Centre, P.O. Box 1462, Mwanza, Tanzania
| | - Coleman Kishamawe
- National Institute for Medical Research, Mwanza Research Centre, P.O. Box 1462, Mwanza, Tanzania
| | - Emanuel P Lyimo
- National Institute for Medical Research, Headquarters, P.O. Box 9653, 11101, Dar es Salaam, Tanzania
| | - Isolide S Massawe
- National Institute for Medical Research, Tanga Research Centre, P.O. Box 5004, Tanga, Tanzania
| | - Lucas E Matemba
- National Institute for Medical Research, Headquarters, P.O. Box 9653, 11101, Dar es Salaam, Tanzania
| | - Veneranda M Bwana
- National Institute for Medical Research, Amani Research Centre, P.O. Box 81, Muheza, Tanzania
| | - Leonard E G Mboera
- National Institute for Medical Research, Headquarters, P.O. Box 9653, 11101, Dar es Salaam, Tanzania. .,Southern African Centre for Infectious Disease Surveillance, Centre of Excellence for Infectious Diseases of Humans and Animals, P.O. Box 3297, Morogoro, Tanzania.
| |
Collapse
|
16
|
Olorunfemi G, Ndlovu N, Masukume G, Chikandiwa A, Pisa PT, Singh E. Temporal trends in the epidemiology of cervical cancer in South Africa (1994-2012). Int J Cancer 2018; 143:2238-2249. [PMID: 29786136 PMCID: PMC6195436 DOI: 10.1002/ijc.31610] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 05/02/2018] [Accepted: 05/07/2018] [Indexed: 02/06/2023]
Abstract
Cervical cancer (CC) is the leading cause of cancer death among female South Africans (SA). Improved access to reproductive health services following multi-ethnic democracy in 1994, HIV epidemic, and the initiation of CC population-based screening in early 2000s have influenced the epidemiology of CC in SA. We therefore evaluated the trends in CC age-standardised incidence (ASIR) (1994-2009) and mortality rates (ASMR) (2004-2012) using data from the South African National Cancer Registry and the Statistics South Africa, respectively. Five-year relative survival rates and average per cent change (AAPC) stratified by ethnicity and age-groups was determined. The average annual CC cases and mortalities were 4,694 (75,099 cases/16 years) and 2,789 (25,101 deaths/9 years), respectively. The ASIR was 22.1/100,000 in 1994 and 23.3/100,000 in 2009, with an average annual decline in incidence of 0.9% per annum (AAPC = -0.9%, p-value < 0.001). The ASMR decreased slightly by 0.6% per annum from 13.9/100,000 in 2004 to 13.1/100,000 in 2012 (AAPC = -0.6%, p-value < 0.001). In 2012, ASMR was 5.8-fold higher in Blacks than in Whites. The 5-year survival rates were higher in Whites and Indians/Asians (60-80%) than in Blacks and Coloureds (40-50%). The incidence rate increased (AAPC range: 1.1-3.1%, p-value < 0.001) among young women (25-34 years) from 2000 to 2009. Despite interventions, there were minimal changes in overall epidemiology of CC in SA but there were increased CC rates among young women and ethnic disparities in CC burden. A review of the CC national policy and directed CC prevention and treatment are required to positively impact the burden of CC in SA.
Collapse
Affiliation(s)
- Gbenga Olorunfemi
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Ntombizodwa Ndlovu
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Gwinyai Masukume
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Admire Chikandiwa
- Wits Reproductive Health & HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Pedro T. Pisa
- Wits Reproductive Health & HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
- Department of Human Nutrition and Dietetics, Sefako Makgatho Health Sciences University, South Africa
| | - Elvira Singh
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
17
|
Degli Esposti M, Taylor J, Humphreys DK, Bowes L. iCoverT: A rich data source on the incidence of child maltreatment over time in England and Wales. PLoS One 2018; 13:e0201223. [PMID: 30148834 PMCID: PMC6110478 DOI: 10.1371/journal.pone.0201223] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022] Open
Abstract
Child maltreatment is a major public health problem, which is plagued with research challenges. Good epidemiological data can help to establish the nature and scope of past and present child maltreatment, and monitor its progress going forward. However, high quality data sources are currently lacking for England and Wales. We employed systematic methodology to harness pre-existing datasets (including non-digitalised datasets) and develop a rich data source on the incidence of Child maltreatment over Time (iCoverT) in England and Wales. The iCoverT consists of six databases and accompanying data documentation: Child Protection Statistics, Children In Care Statistics, Criminal Statistics, Homicide Index, Mortality Statistics and NSPCC Statistics. Each database is a unique indicator of child maltreatment incidence with 272 data variables in total. The databases span from 1858 to 2016 and therefore extends current data sources by over 80 years. We present a proof-of-principle analysis of a subset of the data to show how time series methods may be used to address key research challenges. This example demonstrates the utility of iCoverT and indicates that it will prove to be a valuable data source for researchers, clinicians and policy-makers concerned with child maltreatment. The iCoverT is freely available at the Open Science Framework (osf.io/cf7mv).
Collapse
Affiliation(s)
- Michelle Degli Esposti
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- * E-mail:
| | - Jonathan Taylor
- Faculty of History, University of Oxford, Oxford, United Kingdom
| | - David K. Humphreys
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Lucy Bowes
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
18
|
Mak D, Sengayi M, Chen WC, Babb de Villiers C, Singh E, Kramvis A. Liver cancer mortality trends in South Africa: 1999-2015. BMC Cancer 2018; 18:798. [PMID: 30086727 PMCID: PMC6081797 DOI: 10.1186/s12885-018-4695-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/26/2018] [Indexed: 12/11/2022] Open
Abstract
Background In South Africa (SA), liver cancer (LC) is a public health problem and information is limited. Methods Joinpoint regression analysis was computed for the most recent LC mortality data from Statistics South Africa (StatsSA), by age group, sex and population group. The mortality-to-incidence ratios (MIRs) were calculated as the age-adjusted mortality rate divided by the age-adjusted incidence rate. Results From 1999 to 2015, the overall LC mortality significantly decreased in men (− 4.9%) and women (− 2.7%). Overall a significant decrease was noted in black African men aged 20–29 and 40–49 years, and white women older than 60 years but mortality rates increased among 50–59 and 60–69 year old black African men (from 2010/2009–2015) and women (from 2004/2009–2015). The mortality rates increased with age, and were higher among blacks Africans compared to whites in all age groups - with a peak black African-to-white mortality rate ratio of six in men and three in women at ages 30–39 years. The average MIR for black African men and women was 4 and 3.3 respectively, and 2.2 and 1.8 in their white counterparts. Moreover, decreasing LC mortality rates among younger and the increase in rates in older black Africans suggest that the nadir of the disease may be near or may have passed. Conclusions Findings of population-age subgroup variations in LC mortality and the number of underdiagnosed cases can inform surveillance efforts, while more extensive investigations of the aetiological risk factors are needed. Impact: There was a large race, sex and age differences in trends of LC mortality in SA. These findings should inform more extensive evaluation of the aetiology and risk factors of LC in the country in order to guide control efforts.
Collapse
Affiliation(s)
- Daniel Mak
- Hepatitis Virus Diversity Research Unit (HVDRU), Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Mazvita Sengayi
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa.,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Wenlong C Chen
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa.,Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Chantal Babb de Villiers
- Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Elvira Singh
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa. .,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - Anna Kramvis
- Hepatitis Virus Diversity Research Unit (HVDRU), Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
| |
Collapse
|
19
|
Karat AS, Maraba N, Tlali M, Charalambous S, Chihota VN, Churchyard GJ, Fielding KL, Hanifa Y, Johnson S, McCarthy KM, Kahn K, Chandramohan D, Grant AD. Performance of verbal autopsy methods in estimating HIV-associated mortality among adults in South Africa. BMJ Glob Health 2018; 3:e000833. [PMID: 29997907 PMCID: PMC6035502 DOI: 10.1136/bmjgh-2018-000833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/02/2018] [Accepted: 06/04/2018] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Verbal autopsy (VA) can be integrated into civil registration and vital statistics systems, but its accuracy in determining HIV-associated causes of death (CoD) is uncertain. We assessed the sensitivity and specificity of VA questions in determining HIV status and antiretroviral therapy (ART) initiation and compared HIV-associated mortality fractions assigned by different VA interpretation methods. METHODS Using the WHO 2012 instrument with added ART questions, VA was conducted for deaths among adults with known HIV status (356 HIV positive and 103 HIV negative) in South Africa. CoD were assigned using physician-certified VA (PCVA) and computer-coded VA (CCVA) methods and compared with documented HIV status. RESULTS The sensitivity of VA questions in detecting HIV status and ART initiation was 84.3% (95% CI 80 to 88) and 91.0% (95% CI 86 to 95); 283/356 (79.5%) HIV-positive individuals were assigned HIV-associated CoD by PCVA, 166 (46.6%) by InterVA-4.03, 201 (56.5%) by InterVA-5, and 80 (22.5%) and 289 (81.2%) by SmartVA-Analyze V.1.1.1 and V.1.2.1. Agreement between PCVA and older CCVA methods was poor (chance-corrected concordance [CCC] <0; cause-specific mortality fraction [CSMF] accuracy ≤56%) but better between PCVA and updated methods (CCC 0.21-0.75; CSMF accuracy 65%-98%). All methods were specific (specificity 87% to 96%) in assigning HIV-associated CoD. CONCLUSION All CCVA interpretation methods underestimated the HIV-associated mortality fraction compared with PCVA; InterVA-5 and SmartVA-Analyze V.1.2.1 performed better than earlier versions. Changes to VA methods and classification systems are needed to track progress towards targets for reducing HIV-associated mortality.
Collapse
Affiliation(s)
- Aaron S Karat
- TB Centre, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Mpho Tlali
- The Aurum Institute, Johannesburg, South Africa
| | - Salome Charalambous
- The Aurum Institute, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Violet N Chihota
- The Aurum Institute, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Gavin J Churchyard
- TB Centre, London School of Hygiene & Tropical Medicine, London, UK
- The Aurum Institute, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Katherine L Fielding
- TB Centre, London School of Hygiene & Tropical Medicine, London, UK
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Yasmeen Hanifa
- TB Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Suzanne Johnson
- Foundation for Professional Development, Pretoria, South Africa
| | - Kerrigan M McCarthy
- The Aurum Institute, Johannesburg, South Africa
- Division of Public Health, Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeâ University, Umeâ, Sweden
| | - Daniel Chandramohan
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Alison D Grant
- TB Centre, London School of Hygiene & Tropical Medicine, London, UK
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Africa Health Research Institute, Somkhele, South Africa
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
20
|
Bebington B, Singh E, Fabian J, Jan Kruger C, Prodehl L, Surridge D, Penny C, McNamara L, Ruff P. Design and methodology of a study on colorectal cancer in Johannesburg, South Africa. JGH OPEN 2018; 2:139-143. [PMID: 30483579 PMCID: PMC6152464 DOI: 10.1002/jgh3.12061] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 11/27/2017] [Accepted: 04/02/2018] [Indexed: 12/29/2022]
Abstract
Background and Aim Cancer is one of the foremost causes of morbidity and mortality worldwide. Globally, colorectal cancer (CRC) is the third most diagnosed and fourth most important cause of cancer death. A total of 70% of all CRC‐related deaths occur in low‐ and middle‐income countries. In Sub‐Saharan Africa (SSA), estimating the burden of CRC is difficult. Only 27 of 43 SSA countries have formalized cancer registration systems; data quality is variable and national coverage rare. Methods This is a multidisciplinary, longitudinal cohort study started in January 2016. Patients >18 years with histologically confirmed primary adenocarcinoma of the colon and rectum, diagnosed within the previous 12 months, are eligible. Participants were assessed and were followed up for 3 years. Baseline information, including demographics, socioeconomic status, family history, medical and surgical non‐cancer‐related history, dietary history, colonoscopic findings, staging at presentation, treatment, and disease recurrence, is collected, as well as blood tests and histology results. Outcomes include disease recurrence (local and metastatic) and survival. Results and Conclusion This study aims to describe the clinical presentation, management, and outcomes of adults with CRC in a multiethnic, urban South African population. It will be the first prospective study to describe clinical presentation, demographics, risk factors, treatment, and outcomes according to population group, from both private and state health‐care facilities in Johannesburg, South Africa. The results of this study will be relevant not only to South Africa but also to other SSA countries undergoing similar rates of rapid urbanization and epidemiological transition. This paper summarizes the design and methodology being used for a prospective cohort study of colorectal cancer (CRC) in Johannesburg, South Africa. It aims to describe the clinical presentation, management and outcomes of adults with CRC in a multi‐ethnic, urban South African population. It will be the first prospective study to describe clinical presentation, demographics, risk factors, treatment and outcomes according to population group, from both private and state healthcare facilities.
Collapse
Affiliation(s)
- Brendan Bebington
- Department of Surgery, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,Wits Donald Gordon Medical Center Johannesburg South Africa
| | - Elvira Singh
- National Cancer Registry National Health Laboratory Service Johannesburg South Africa.,School of Public Health University of the Witwatersrand Johannesburg South Africa
| | - June Fabian
- Wits Donald Gordon Medical Center Johannesburg South Africa.,Division of Medical Oncology, Department of Internal Medicine, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Christine Jan Kruger
- Department of Surgery, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Leanne Prodehl
- Department of Surgery, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Daniel Surridge
- Department of Surgery, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Clem Penny
- Division of Medical Oncology, Department of Internal Medicine, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Lynne McNamara
- Division of Medical Oncology, Department of Internal Medicine, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Paul Ruff
- Wits Donald Gordon Medical Center Johannesburg South Africa.,Division of Medical Oncology, Department of Internal Medicine, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| |
Collapse
|
21
|
Gillum RF. The Burden of Cardiovascular Disease in Sub-Saharan Africa and the Black Diaspora. J Racial Ethn Health Disparities 2018; 5:1155-1158. [PMID: 29557048 DOI: 10.1007/s40615-018-0474-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/16/2018] [Accepted: 02/20/2018] [Indexed: 11/24/2022]
Abstract
For over four decades the National Medical Association (NMA) and the Association of Black Cardiologists (ABC) have sought to bring to national attention the disparate burden of cardiovascular disease (CVD) among African Americans. However, systematic inquiry has been inadequate into the burden of CVD in the poor countries of Sub-Saharan Africa (SSA) and the African diaspora in the Americas outside the USA. However, recently, the Global Burden of Disease Study (GBD) has offered new tools for such inquiry. Several initial efforts in that direction using 2010 data have been published. This article highlights some new findings for SSA for 2016. It also suggests that NMA and ABC further this effort by direct advocacy and collaboration with the GBD to make estimates of CVD burden in African Americans and South American Blacks explicitly available in future iterations.
Collapse
|
22
|
Hullur N, D'Ambruoso L, Edin K, Wagner RG, Ngobeni S, Kahn K, Tollman S, Byass P. Community perspectives on HIV, violence and health surveillance in rural South Africa: a participatory pilot study. J Glob Health 2018; 6:010406. [PMID: 27231542 PMCID: PMC4871061 DOI: 10.7189/jogh.06.010406] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND South Africa faces a complex burden of disease consisting of infectious and non-communicable conditions, injury and interpersonal violence, and maternal and child mortality. Inequalities in income and opportunity push disease burdens towards vulnerable populations, a situation to which the health system struggles to respond. There is an urgent need for health planning to account for the needs of marginalized groups in this context. The study objectives were to develop a process to elicit the perspectives of local communities in the established Agincourt health and socio-demographic surveillance site (HDSS) in rural north-east South Africa on two leading causes of death: HIV/AIDS and violent assault, and on health surveillance as a means to generate information on health in the locality. METHODS Drawing on community-based participatory research (CBPR) methods, three village-based groups of eight participants were convened, with whom a series of discussions were held to identify and define the causes of, treatments for, and problems surrounding, deaths due to HIV/AIDS and violent assault. The surveillance system was also discussed and recommendations generated. The discussion narratives were the main data source, examined using framework analysis. RESULTS The groups identified a range of social and health systems issues including risky sexual health behaviors, entrenched traditional practices, alcohol and substance abuse, unstable relationships, and debt as causative. Participants also explained how compromised patient confidentiality in clinics, insensitive staff, and a biased judicial system were problematic for the treatment and reporting of both conditions. Views on health surveillance were positive. Recommendations to strengthen an already well-functioning system related to maintaining confidentiality and sensitivity, and extending ancillary care obligations. CONCLUSION The discussions provided information not available from other sources on the social and health systems processes through which access to good quality health care is constrained in this setting. On this basis, further CBPR in routine HDSS to extend partnerships between researchers, communities and health authorities to connect evidence with the means for action is underway.
Collapse
Affiliation(s)
- Nitya Hullur
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
| | - Lucia D'Ambruoso
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK; Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Kerstin Edin
- Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ryan G Wagner
- Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sizzy Ngobeni
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH - An International Network for the Demographic Evaluation of Populations and Their Health, Accra, Ghana
| | - Stephen Tollman
- Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH - An International Network for the Demographic Evaluation of Populations and Their Health, Accra, Ghana
| | - Peter Byass
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK; Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
23
|
Pillay-van Wyk V, Msemburi W, Laubscher R, Dorrington RE, Groenewald P, Glass T, Nojilana B, Joubert JD, Matzopoulos R, Prinsloo M, Nannan N, Gwebushe N, Vos T, Somdyala N, Sithole N, Neethling I, Nicol E, Rossouw A, Bradshaw D. Mortality trends and differentials in South Africa from 1997 to 2012: second National Burden of Disease Study. LANCET GLOBAL HEALTH 2018; 4:e642-53. [PMID: 27539806 DOI: 10.1016/s2214-109x(16)30113-9] [Citation(s) in RCA: 207] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 06/03/2016] [Accepted: 06/06/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND The poor health of South Africans is known to be associated with a quadruple disease burden. In the second National Burden of Disease (NBD) study, we aimed to analyse cause of death data for 1997-2012 and develop national, population group, and provincial estimates of the levels and causes of mortality. METHOD We used underlying cause of death data from death notifications for 1997-2012 obtained from Statistics South Africa. These data were adjusted for completeness using indirect demographic techniques for adults and comparison with survey and census estimates for child mortality. A regression approach was used to estimate misclassified HIV/AIDS deaths and so-called garbage codes were proportionally redistributed by age, sex, and population group population group (black African, Indian or Asian descent, white [European descent], and coloured [of mixed ancestry according to the preceding categories]). Injury deaths were estimated from additional data sources. Age-standardised death rates were calculated with mid-year population estimates and the WHO age standard. Institute of Health Metrics and Evaluation Global Burden of Disease (IHME GBD) estimates for South Africa were obtained from the IHME GHDx website for comparison. FINDINGS All-cause age-standardised death rates increased rapidly since 1997, peaked in 2006 and then declined, driven by changes in HIV/AIDS. Mortality from tuberculosis, non-communicable diseases, and injuries decreased slightly. In 2012, HIV/AIDS caused the most deaths (29·1%) followed by cerebrovascular disease (7·5%) and lower respiratory infections (4·9%). All-cause age-standardised death rates were 1·7 times higher in the province with the highest death rate compared to the province with the lowest death rate, 2·2 times higher in black Africans compared to whites, and 1·4 times higher in males compared with females. Comparison with the IHME GBD estimates for South Africa revealed substantial differences for estimated deaths from all causes, particularly HIV/AIDS and interpersonal violence. INTERPRETATION This study shows the reversal of HIV/AIDS, non-communicable disease, and injury mortality trends in South Africa during the study period. Mortality differentials show the importance of social determinants, raise concerns about the quality of health services, and provide relevant information to policy makers for addressing inequalities. Differences between GBD estimates for South Africa and this study emphasise the need for more careful calibration of global models with local data. FUNDING South African Medical Research Council's Flagships Awards Project.
Collapse
Affiliation(s)
- Victoria Pillay-van Wyk
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.
| | - William Msemburi
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Ria Laubscher
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Rob E Dorrington
- Centre for Actuarial Research, University of Cape Town, South Africa
| | - Pam Groenewald
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Tracy Glass
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Beatrice Nojilana
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Jané D Joubert
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Richard Matzopoulos
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Megan Prinsloo
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Nadine Nannan
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Nomonde Gwebushe
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Theo Vos
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nontuthuzelo Somdyala
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Nomfuneko Sithole
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Ian Neethling
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Edward Nicol
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Anastasia Rossouw
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Debbie Bradshaw
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Public Health and Family Medicine, University of Cape Town, South Africa
| |
Collapse
|
24
|
Qaddumi JAS, Nazzal Z, Yacoub A, Mansour M. Physicians' knowledge and practice on death certification in the North West Bank, Palestine: across sectional study. BMC Health Serv Res 2018; 18:8. [PMID: 29310633 PMCID: PMC5759221 DOI: 10.1186/s12913-017-2814-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 12/19/2017] [Indexed: 12/04/2022] Open
Abstract
Background Mortality data are essential for many aspects of everyday public health practices at both national and international levels. Despite the current developments in various aspects of the medical field, the apparent inability of physicians to complete death notification forms (DNF) accurately is still worldwide concern. The aim of this study is to assess the physicians’ knowledge and practice on completing the DNF. Methods A self-administered questionnaire was distributed to 200 physicians in governmental and non-governmental hospitals in the North West-Bank in Palestine. Furthermore, a case scenario was included in the questionnaire and physicians were asked to fill the cause of death section. The percentage of errors committed while completing the cause of death section were computed. A Chi square test was used to assess the association between physicians’ characteristics and their responses. Results Only 40.6% of the participants completed the cause of death section correctly. The immediate and underlying causes of death were correctly identified by 48.7% and 71.3% of physicians, respectively. Almost one-fifth (17.3%) of physicians wrote the mechanism of death without reporting the underlying cause of death and 14.7% of them reported the sequence of events leading to death incorrectly. Conclusions Physicians’ knowledge and practice on completing the DNF is poor and insufficient, which may seriously affect the accuracy of mortality data. Complicated cases, problems in the current design of the DNFs and lack of training were the most common factors contributing to inaccuracy in death certification. We recommend offering periodical training workshops on completing the DNF to all physicians, and developing a manual on completing the DNFs with clear instructions and guidelines. Electronic supplementary material The online version of this article (10.1186/s12913-017-2814-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Jamal A S Qaddumi
- Faculty of Medicine and Health Sciences, An-Najah National University, PO box 7, Nablus, Palestine.
| | - Zaher Nazzal
- Faculty of Medicine and Health Sciences, An-Najah National University, PO box 7, Nablus, Palestine
| | - Allam Yacoub
- Department of anesthesia, An-Najah National University Hospital, Nablus, Palestine
| | - Mahmoud Mansour
- Department of general surgery, Palestine medical complex, Ramallah, Palestine
| |
Collapse
|
25
|
Abstract
In a Perspective, Amitabh Suthar and Till Bärnighausen discuss progress made so far in reducing HIV-related mortality in South Africa and keys towards further population mortality reductions going forward.
Collapse
Affiliation(s)
- Amitabh B. Suthar
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Till Bärnighausen
- Africa Health Research Institute, Mtubatuba, South Africa
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Heidelberg Institute of Public Health, Heidelberg, Germany
| |
Collapse
|
26
|
Mukherjee PS, Vishnubhatla S, Amarapurkar DN, Das K, Sood A, Chawla YK, Eapen CE, Boddu P, Thomas V, Varshney S, Hidangmayum DS, Bhaumik P, Thakur B, Acharya SK, Chowdhury A. Etiology and mode of presentation of chronic liver diseases in India: A multi centric study. PLoS One 2017; 12:e0187033. [PMID: 29073197 PMCID: PMC5658106 DOI: 10.1371/journal.pone.0187033] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/12/2017] [Indexed: 12/27/2022] Open
Abstract
There is a paucity of health policy relevant data for chronic liver disease from India, impeding formulation of an interventional strategy to address the issue. A prospective, multicentric study to delineate the etiology and clinical profile of chronic liver disease in India is reported here. A centrally coordinated and monitored web-based data repository was developed (Feb, 2010 to Jan, 2013) and analyzed. Eleven hospitals from different parts of India participated. Data were uploaded into a web based proforma and monitored by a single centre according to a standardized protocol. 1.28% (n = 266621) of all patients (n = 20701383) attending the eleven participating hospitals of India had liver disease. 65807 (24·68%) were diagnosed for the first time (new cases). Of these, 13014 (19·77%, median age 43 years, 73% males) cases of chronic liver disease were finally analyzed. 33.9% presented with decompensated cirrhosis. Alcoholism (34·3% of 4413) was the commonest cause of cirrhosis while Hepatitis B (33·3%) was predominant cause of chronic liver disease in general and non-cirrhotic chronic liver disease (40·8% out of 8163). There was significant interregional differences (hepatitis C in North, hepatitis B in East and South, alcohol in North-east, Non-alcoholic Fatty Liver Disease in West) in the predominant cause of chronic liver disease. Hepatitis B (46·8% of 438 cases) was the commonest cause of hepatocellular Cancer.11·7% had diabetes. Observations of our study will help guide a contextually relevant liver care policy for India and could serve as a framework for similar endeavor in other developing countries as well.
Collapse
Affiliation(s)
| | - Sreenivas Vishnubhatla
- Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | | | - Kausik Das
- Department of Hepatology, School of Digestive and liver Diseases, Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Ajit Sood
- Department of Gastroenterology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Yogesh K. Chawla
- Department of Hepatology, Post Graduate Institute of Medical Sciences, Chandigarh, India
| | | | - Prabhakar Boddu
- Department of Gastroenterology, Osmania General Hospital, Afzalgunj, Hyderabad, Telangana, India
| | - Varghese Thomas
- Department of Gastroenterology, Calicut Medical College, Kozhikode, Kerala, India
| | - Subodh Varshney
- Department of Surgical Gastroenterology, Bhopal Memorial Hospital and Research Centre, Bhopal, Madhya Pradesh, India
| | | | - Pradip Bhaumik
- Department of medicine, Agartala Govt Medical College, Agartala, Tripura, India
| | - Bhaskar Thakur
- Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Subrat K. Acharya
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Abhijit Chowdhury
- Department of Hepatology, School of Digestive and liver Diseases, Institute of Post Graduate Medical Education & Research, Kolkata, India
- Indian Institute of Liver and Digestive Sciences, Sitala (East), Jagadishpur, Sonarpur, 24 Pgs(S), Kolkata, India
- * E-mail:
| |
Collapse
|
27
|
Comparing laboratory surveillance with the notifiable diseases surveillance system in South Africa. Int J Infect Dis 2017; 59:141-147. [PMID: 28532981 DOI: 10.1016/j.ijid.2017.03.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 03/06/2017] [Accepted: 03/08/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare laboratory surveillance with the notifiable diseases surveillance system (NDSS) in South Africa. METHODS Data on three tracer notifiable diseases - measles, meningococcal meningitis, and typhoid - were compared to assess data quality, stability, representativeness, sensitivity and positive predictive value (PPV), using the Wilcoxon and Chi-square tests, at the 5% significance level. RESULTS For all three diseases, fewer cases were notified than confirmed in the laboratory. Completeness for the laboratory system was higher for measles (63% vs. 47%, p<0.001) and meningococcal meningitis (63% vs. 57%, p<0.001), but not for typhoid (60% vs. 63%, p=0.082). Stability was higher for the laboratory (all 100%) compared to notified measles (24%, p<0.001), meningococcal meningitis (74%, p<0.001), and typhoid (36%, p<0.001). Representativeness was also higher for the laboratory (all 100%) than for notified measles (67%, p=0.058), meningococcal meningitis (56%, p=0.023), and typhoid (44%, p=0.009). The sensitivity of the NDSS was 50%, 98%, and 93%, and the PPV was 20%, 57%, and 81% for measles, meningococcal meningitis, and typhoid, respectively. CONCLUSIONS Compared to laboratory surveillance, the NDSS performed poorly on most system attributes. Revitalization of the NDSS in South Africa is recommended to address the completeness, stability, and representativeness of the system.
Collapse
|
28
|
Tabutin D, Masquelier B. Tendances et inégalités de mortalité de 1990 à 2015 dans les pays à revenu faible et intermédiaire. POPULATION 2017. [DOI: 10.3917/popu.1702.0227] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
29
|
Martins DF, Felzemburg RDM, Dias AB, Costa TM, Santos PNP. Trends in mortality from ill-defined causes among the elderly in Brazil, 1979-2013: ecological study. SAO PAULO MED J 2016; 134:437-445. [PMID: 27901244 PMCID: PMC10871859 DOI: 10.1590/1516-3180.2016.0070010616] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 06/01/2016] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE: Mortality measurements are traditionally used as health indicators and are useful in describing a population's health situation through reporting injuries that lead to death. The aim here was to analyze the temporal trend of proportional mortality from ill-defined causes (IDCs) among the elderly in Brazil from 1979 to 2013. DESIGN AND SETTING: Ecological study using data from the Mortality Information System of the Brazilian Ministry of Health. METHODS: The proportional mortality from IDCs among the elderly was calculated for each year of the study series (1979 to 2013) in Brazil, and the data were disaggregated according to sex and to the five geographical regions and states. To analyze time trends, simple linear regression coefficients were calculated. RESULTS: During the study period, there were 2,646,194 deaths from IDCs among the elderly, with a decreasing trend (ß -0.545; confidence interval, CI: -0.616 to -0.475; P < 0.000) for both males and females. This reduction was also observed in the macroregions and states, except for Amapá. The states in the northeastern region reported an average reduction of 80%. CONCLUSIONS: Mortality from IDCs among the elderly has decreased continuously since 1985, but at different rates among the different regions and states. Actions aimed at improving data records on death certificates need to be strengthened in order to continue the trend observed.
Collapse
Affiliation(s)
- Davi Félix Martins
- MD. Assistant Professor, Department of Health, Universidade Estadual de Feira de Santana (UEFS), Feira de Santana, BA, Brazil.
| | | | - Acácia Batista Dias
- PhD. Adjunct Professor, Department of Humanities and Philosophy, Universidade Estadual de Feira de Santana (UEFS), Feira de Santana, BA, Brazil.
| | - Tania Maria Costa
- MD. Adjunct Professor, Department of Health, Universidade Estadual de Feira de Santana (UEFS), Feira de Santana, BA, Brazil.
| | - Pedro Nascimento Prates Santos
- MD. Assistant Professor, Department of Health, Universidade Estadual de Feira de Santana (UEFS), Feira de Santana, BA, Brazil.
| |
Collapse
|
30
|
Mortality from Unspecified Unintentional Injury among Individuals Aged 65 Years and Older by U.S. State, 1999-2013. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080763. [PMID: 27472356 PMCID: PMC4997449 DOI: 10.3390/ijerph13080763] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 07/17/2016] [Accepted: 07/22/2016] [Indexed: 11/24/2022]
Abstract
Introduction: Recent changes in unspecified unintentional injury mortality for the elderly by U.S. state remain unreported. This study aims to examine U.S. state variations in mortality from unspecified unintentional injury among Americans aged 65+, 1999–2013; Methods: Using mortality rates from the U.S. CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS™), we examined unspecified unintentional injury mortality for older adults aged 65+ from 1999 to 2013 by state. Specifically, the proportion of unintentional injury deaths with unspecified external cause in the data was considered. Linear regression examined the statistical significance of changes in proportion of unspecified unintentional injury from 1999 to 2013; Results: Of the 36 U.S. states with stable mortality rates, over 8-fold differences were observed for both the mortality rates and the proportions of unspecified unintentional injury for Americans aged 65+ during 1999–2013. Twenty-nine of the 36 states showed reductions in the proportion of unspecified unintentional injury cause, with Oklahoma (−89%), Massachusetts (−86%) and Oregon (−81%) displaying the largest changes. As unspecified unintentional injury mortality decreased, mortality from falls in 28 states and poisoning in 3 states increased significantly. Mortality from suffocation in 15 states, motor vehicle traffic crashes in 12 states, and fire/burn in 8 states also decreased; Conclusions: The proportion of unintentional injuries among older adults with unspecified cause decreased significantly for many states in the United States from 1999 to 2013. The reduced proportion of unspecified injury has implications for research and practice. It should be considered in state-level trend analysis during 1999–2013. It also suggests comparisons between states for specific injury mortality should be conducted with caution, as large differences in unspecified injury mortality across states and over time could create bias for specified injury mortality comparisons.
Collapse
|
31
|
Singh E, Ruff P, Babb C, Sengayi M, Beery M, Khoali L, Kellett P, Underwood JM. Establishment of a cancer surveillance programme: the South African experience. Lancet Oncol 2015; 16:e414-21. [PMID: 26248849 DOI: 10.1016/s1470-2045(15)00162-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/03/2015] [Accepted: 02/05/2015] [Indexed: 12/30/2022]
Abstract
Cancer is projected to become a leading cause of morbidity and mortality in low-income and middle-income countries in the future. However, cancer incidence in South Africa is largely under-reported because of a lack of nationwide cancer surveillance networks. We describe present cancer surveillance activities in South Africa, and use the International Agency for Research on Cancer framework to propose the development of four population-based cancer registries in South Africa. These registries will represent the ethnic and geographical diversity of the country. We also provide an update on a cancer surveillance pilot programme in the Ekurhuleni Metropolitan District, and the successes and challenges in the implementation of the IARC framework in a local context. We examine the development of a comprehensive cancer surveillance system in a middle-income country, which might serve to assist other countries in establishing population-based cancer registries in a resource-constrained environment.
Collapse
Affiliation(s)
- Elvira Singh
- Cancer Epidemiology Research Group, National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa; University of Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa.
| | - Paul Ruff
- Division of Medical Oncology, Johannesburg, South Africa; University of Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Chantal Babb
- Cancer Epidemiology Research Group, National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa; University of Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Mazvita Sengayi
- Cancer Epidemiology Research Group, National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
| | - Moira Beery
- Cancer Epidemiology Research Group, National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa; South African Field Epidemiology and Laboratory Training Programme, University of Pretoria, School of Public Health, Pretoria, South Africa
| | - Lerato Khoali
- Cancer Epidemiology Research Group, National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
| | - Patricia Kellett
- Cancer Epidemiology Research Group, National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
| | - J Michael Underwood
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
32
|
Otieno G, Marinda E, Bärnighausen T, Tanser F. High rates of homicide in a rural South African population (2000-2008): findings from a population-based cohort study. Popul Health Metr 2015; 13:20. [PMID: 26300697 PMCID: PMC4545817 DOI: 10.1186/s12963-015-0054-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 07/28/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND South Africa has continued to receive increasing attention due to unprecedented high levels of violence. Homicide-related violence accounts for a significant proportion of unnatural deaths and contributes significantly to loss of years of expected life. We investigated levels and factors associated with homicide-related deaths and identify communities with excessively high homicide risk in a typical rural South African population. METHOD Data drawn from verbal autopsies conducted on all deaths recorded during annual demographic and health surveillance in KwaZulu Natal, South Africa were used to derive the cumulative probability of death from homicide over a nine-year period (2000-2008). Weibull regression methods were used to investigate factors associated with homicide deaths. A Kulldorff spatial scan statistic was used to identify spatial clusters of homicide-related deaths. RESULTS With 536 homicide-related deaths, and a median seven years of follow-up, the study found an overall homicide incidence rate of 66 deaths per 100, 000 person-years of observation (PYOs) (95 % CI 60-72) for the period under study. Death related to the use of firearms was the leading reported method of homicide (65 %) and most deaths occurred over weekends (43 %). Homicides are the second-most common cause of death in men aged 25-34 after HIV-related deaths (including TB) in this community, at 210 deaths per 100,000 PYOs, and was highest among 55-64 year old women, at 78 deaths per 100,000 PYOs. Residency status, age, socioeconomic status, and highest education level attained independently predicted the risk of homicide death. The spatial distribution of homicide deaths was not homogenous and the study identified two clear geographical clusters with significantly elevated homicide risk. CONCLUSION The high rates of homicide observed in this typical rural South African population - particularly among men - underscore the need for urgent interventions to reduce this tragic and theoretically preventable loss of life in this population and similar South African settings.
Collapse
Affiliation(s)
- George Otieno
- Kenya Medical Research Institute, P.O Box 1578, 40100 Kisumu, Kenya ; Centre for Disease Control and Prevention, Atlanta, GA USA ; School of Public Health, University of Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa
| | - Edmore Marinda
- School of Public Health, University of Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa
| | - Till Bärnighausen
- Wellcome Trust Africa Centre for Health and Population Studies, P.O Box 198, Mtubatuba, South Africa ; Department of Global Health and Population, Harvard School of Public Health, Boston, USA
| | - Frank Tanser
- Wellcome Trust Africa Centre for Health and Population Studies, P.O Box 198, Mtubatuba, South Africa
| |
Collapse
|
33
|
The Quality and Completeness of 2008 Perinatal and Under-five Mortality Data from Vital Registration, Jamaica. W INDIAN MED J 2015; 64:3-16. [PMID: 26035810 DOI: 10.7727/wimj.2015.115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 03/18/2015] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To evaluate the completeness and timeliness of registration of stillbirths and under-five deaths and the validity of the certification and coding process. SUBJECTS AND METHODS Registered stillbirths and under-five deaths occurring in 2008 were compared to hospital, police, forensic pathologist and coroner's records. Missed cases and new information such as birthweight, gestation and date of birth were added to the database. A 10% random sample was evaluated to measure the quality of certification and coding. RESULTS Of 646 stillbirths [≥ 1000 g] and 933 under-five deaths, 69% and 79%, respectively were registered by December 31, 2009, for inclusion in the 2008 final demographic returns. Non-reporting of stillbirths was associated with infant gender, region and place of death (seven of 21 public hospitals accounted for 96% of unregistered stillbirths). Among under-five deaths, age at death, region, place and cause of death were important. Injury and community deaths increased with age. Registration delays including non-registration were associated with coroner's inquests. Most [80%] stillbirth certificates lacked usable cause of death data. Neonatal deaths due to prematurity and perinatal asphyxia were often misclassified by coders. The stillbirth [≥ 1000 g], infant and under-five mortality rates were 15, 20 and 22/1000 births/live births, respectively. CONCLUSIONS While registration of stillbirths and under-five deaths improved between 1998 and 2008, persistent under-reporting reduced official rates by 20-31%. A new perinatal death certificate documenting maternal and fetal causes of death and risk factors such as birthweight, gestation and age at death would improve stillbirth and neonatal death (0-28 days) data quality.
Collapse
|
34
|
Oza S, Lawn JE, Hogan DR, Mathers C, Cousens SN. Neonatal cause-of-death estimates for the early and late neonatal periods for 194 countries: 2000-2013. Bull World Health Organ 2014; 93:19-28. [PMID: 25558104 PMCID: PMC4271684 DOI: 10.2471/blt.14.139790] [Citation(s) in RCA: 229] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 10/18/2014] [Accepted: 10/20/2014] [Indexed: 01/16/2023] Open
Abstract
Objective To estimate cause-of-death distributions in the early (0–6 days of age) and late (7–27 days of age) neonatal periods, for 194 countries between 2000 and 2013. Methods For 65 countries with high-quality vital registration, we used each country’s observed early and late neonatal proportional cause distributions. For the remaining 129 countries, we used multinomial logistic models to estimate these distributions. For countries with low child mortality we used vital registration data as inputs and for countries with high child mortality we used neonatal cause-of-death distribution data from studies in similar settings. We applied cause-specific proportions to neonatal death estimates from the United Nations Inter-agency Group for Child Mortality Estimation, by country and year, to estimate cause-specific risks and numbers of deaths. Findings Over time, neonatal deaths decreased for most causes. Of the 2.8 million neonatal deaths in 2013, 0.99 million deaths (uncertainty range: 0.70–1.31) were estimated to be caused by preterm birth complications, 0.64 million (uncertainty range: 0.46–0.84) by intrapartum complications and 0.43 million (uncertainty range: 0.22–0.66) by sepsis and other severe infections. Preterm birth (40.8%) and intrapartum complications (27.0%) accounted for most early neonatal deaths while infections caused nearly half of late neonatal deaths. Preterm birth complications were the leading cause of death in all regions of the world. Conclusion The neonatal cause-of-death distribution differs between the early and late periods and varies with neonatal mortality rate level. To reduce neonatal deaths, effective interventions to address these causes must be incorporated into policy decisions.
Collapse
Affiliation(s)
- Shefali Oza
- MARCH, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1N 7HT, England
| | - Joy E Lawn
- MARCH, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1N 7HT, England
| | - Daniel R Hogan
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
| | - Colin Mathers
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
| | - Simon N Cousens
- MARCH, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1N 7HT, England
| |
Collapse
|
35
|
Frias PGD, Szwarcwald CL, Lira PICD. Avaliação dos sistemas de informações sobre nascidos vivos e óbitos no Brasil na década de 2000. CAD SAUDE PUBLICA 2014; 30:2068-280. [DOI: 10.1590/0102-311x00196113] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 03/27/2014] [Indexed: 11/22/2022] Open
Abstract
Resumo No Nordeste brasileiro, a morte por fogo é uma ameaça onipresente e banalizada entre mulheres empobrecidas. Este estudo antropológico descreve a experiência do sofrimento de ser queimada. Em 2009, foram investigados seis casos “ricos em informação” no Centro de Queimados, Fortaleza, Ceará, Brasil. Entrevistas etnográficas abertas com informantes-chave, narrativas de experiências vividas e observação participante na clínica e no domicílio foram realizadas. Utilizamos os métodos Análise de Conteúdo, Sistemas de Signos, Significados e Ações e Interpretação Semântica Contextualizada. Revelou-se que as metáforas emergentes são carregadas de significância cultural da “monstruosidade” e da violência de gênero pelo fogo – inscrita impiedosamente no corpo feminino. O “acidente por combustível” (álcool) esconde a cruel realidade de “carne crua e torrada”. A cicatriz é capaz de desfigurá-las em “não-pessoas”, maculando sua reputação moral e gerando a rejeição social. No Nordeste brasileiro, a vulnerabilidade social provocada pela sequela da queimadura exige uma política de humanização do cuidado.
Collapse
Affiliation(s)
- Paulo Germano de Frias
- Instituto de Medicina Integral de Pernambuco Prof. Fernando Figueira, Brasil; Universidade Federal de Pernambuco, Brasil
| | | | | |
Collapse
|
36
|
Evaluation of record linkage of mortality data between a health and demographic surveillance system and national civil registration system in South Africa. Popul Health Metr 2014. [DOI: 10.1186/s12963-014-0023-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
37
|
Joubert J, Bradshaw D, Kabudula C, Rao C, Kahn K, Mee P, Tollman S, Lopez AD, Vos T. Record-linkage comparison of verbal autopsy and routine civil registration death certification in rural north-east South Africa: 2006-09. Int J Epidemiol 2014; 43:1945-58. [PMID: 25146564 PMCID: PMC4276059 DOI: 10.1093/ije/dyu156] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: South African civil registration (CR) provides a key data source for local health decision making, and informs the levels and causes of mortality in data-lacking sub-Saharan African countries. We linked mortality data from CR and the Agincourt Health and Socio-demographic Surveillance System (Agincourt HDSS) to examine the quality of rural CR data. Methods: Deterministic and probabilistic techniques were used to link death data from 2006 to 2009. Causes of death were aggregated into the WHO Mortality Tabulation List 1 and a locally relevant short list of 15 causes. The matching rate was compared with informant-reported death registration. Using the VA diagnoses as reference, misclassification patterns, sensitivity, positive predictive values and cause-specific mortality fractions (CSMFs) were calculated for the short list. Results: A matching rate of 61% [95% confidence interval (CI): 59.2 to 62.3] was attained, lower than the informant-reported registration rate of 85% (CI: 83.4 to 85.8). For the 2264 matched cases, cause agreement was 15% (kappa 0.1083, CI: 0.0995 to 0.1171) for the WHO list, and 23% (kappa 0.1631, CI: 0.1511 to 0.1751) for the short list. CSMFs were significantly different for all but four (tuberculosis, cerebrovascular disease, other heart disease, and ill-defined natural) of the 15 causes evaluated. Conclusion: Despite data limitations, it is feasible to link official CR and HDSS verbal autopsy data. Data linkage proved a promising method to provide empirical evidence about the quality and utility of rural CR mortality data. Agreement of individual causes of death was low but, at the population level, careful interpretation of the CR data can assist health prioritization and planning.
Collapse
Affiliation(s)
- Jané Joubert
- Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia and Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia and Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Debbie Bradshaw
- Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia and Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Chodziwadziwa Kabudula
- Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia and Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Chalapati Rao
- Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia and Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Kathleen Kahn
- Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia and Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia and Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The Uni
| | - Paul Mee
- Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia and Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia and Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Stephen Tollman
- Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia and Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia and Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The Uni
| | - Alan D Lopez
- Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia and Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Theo Vos
- Burden of Disease Research Unit, South African Medical Research Council, Parow Vallei, Western Cape, South Africa, School of Population Health, The University of Queensland, Brisbane, QLD, Australia, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, INDEPTH Network, Accra, Ghana, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia and Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
| |
Collapse
|
38
|
Stoneburner R, Korenromp E, Lazenby M, Tassie JM, Letebele J, Motlapele D, Granich R, Boerma T, Low-Beer D. Using health surveillance systems data to assess the impact of AIDS and antiretroviral treatment on adult morbidity and mortality in Botswana. PLoS One 2014; 9:e100431. [PMID: 25003870 PMCID: PMC4086724 DOI: 10.1371/journal.pone.0100431] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 05/27/2014] [Indexed: 11/26/2022] Open
Abstract
Introduction Botswana's AIDS response included free antiretroviral treatment (ART) since 2002, achieving 80% coverage of persons with CD4<350 cells/µl by 2009–10. We explored impact on mortality and HIV prevalence, analyzing surveillance and civil registration data. Methods Hospital natural cause admissions and deaths from the Health Statistics Unit (HSU) over 1990–2009, all-cause deaths from Midnight Bed Census (MNC) over 1990–2011, institutional and non-institutional deaths recorded in the Registry of Birth and Deaths (RBD) over 2003–2010, and antenatal sentinel surveillance (ANC) over 1992–2011 were compared to numbers of persons receiving ART. Mortality was adjusted for differential coverage and completeness of institutional and non-institutional deaths, and compared to WHO and UNAIDS Spectrum projections. Results HSU deaths per 1000 admissions declined 49% in adults 15–64 years over 2003–2009. RBD mortality declined 44% (807 to 452/100,000 population in adults 15–64 years) over 2003–2010, similarly in males and females. Generally, death rates were higher in males; declines were greater and earlier in younger adults, and in females. In contrast, death rates in adults 65+, particularly females increased over 2003–2006. MNC all-age post-neonatal mortality declined 46% and 63% in primary and secondary level hospitals, over 2003–2011. We estimated RBD captured 80% of adult deaths over 2006–2011. Comparing empirical, completeness-adjusted deaths to Spectrum estimates, declines over 2003–2009 were similar overall (47% vs. 54%); however, Spectrum projected larger and earlier declines particularly in women. Following stabilization and modest decreases over 1998–2002, HIV prevalence in pregnant women 15–24 and 25–29-years declined by >50% and >30% through 2011, while continuing to increase in older women. Conclusions Adult mortality in Botswana fell markedly as ART coverage increased. HIV prevalence declines may reflect ART-associated reductions in sexual transmission. Triangulation of surveillance system data offers a reasonable approach to evaluate impact of HIV/AIDS interventions, complementing cohort approaches that monitor individual-level health outcomes.
Collapse
Affiliation(s)
| | - Eline Korenromp
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - Mark Lazenby
- Yale University School of Nursing, New Haven, Connecticut, United States of America
| | | | | | | | | | - Ties Boerma
- World Health Organization, Geneva, Switzerland
| | - Daniel Low-Beer
- Global Health Program, The Graduate Institute of International and Development Studies, Geneva, Switzerland
| |
Collapse
|
39
|
Batidzirai JM, Heeren GA, Marange CS, Gwaze AR, Mandeya A, Ngwane Z, Jemmott JB, Tyler JC. Wake-Up. A Health Promotion Project for Sub-Saharan University Students: Results of Focus Group Sessions. MEDITERRANEAN JOURNAL OF SOCIAL SCIENCES 2014; 5:346-254. [PMID: 25763177 PMCID: PMC4352689 DOI: 10.5901/mjss.2014.v5n7p346] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
HIV/AIDS is seen as the major killer in developing countries however, non-communicable diseases (NCDs), also referred to as chronic diseases, are the leading causes of death worldwide. University students are an important target for health promotion programmes because they are exposed to a new lifestyle where they have to determine on their own which diet to follow, whether or not to exercise, how much they drink alcohol or smoke, whether to have sex or abstain, as well as whether to practice safe sex or not Focus group sessions were held at a rural Sub-Saharan African University to assess students' knowledge on how to lead a healthy lifestyle. The results suggest a need for a health promotion intervention programme which should be culture-sensitive and considerate of the needs of university students.
Collapse
Affiliation(s)
- Jesca Mercy Batidzirai
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Private Bag X01, Scottsville, 3209, Pietermaritzburg , South Africa
| | - G Anita Heeren
- Department of Psychiatry, Department of Communication and Health Behavior, Perelman School of Medicine, University of Pennsylvania, Market Street 3535, Suite 520, Philadelphia PA 19104, USA
| | - C Show Marange
- Department of Biostatistics, University of Fort Hare, Private Bag X1314, Alice, South Africa
| | - Arnold Rumosa Gwaze
- Department of Biostatistics, University of Fort Hare, Private Bag X1314, Alice, South Africa
| | - Andrew Mandeya
- Department of Biostatistics, University of Fort Hare, Private Bag X1314, Alice, South Africa
| | - Zolani Ngwane
- Department of Anthropology, Haverford College, Lancaster Road, Haverford PA 19030, USA
| | - John B Jemmott
- Department of Psychiatry, Department of Communication and Health Behavior, Perelman School of Medicine, University of Pennsylvania, Market Street 3535, Suite 520, Philadelphia PA 19104, USA
| | - Joanne C Tyler
- Department of Biostatistics, University of Fort Hare, Private Bag X1314, Alice, South Africa
| |
Collapse
|