Reversal in mortality trends: evidence from the Agincourt field site, South Africa, 1992-1995
Reversal in mortality trends: evidence from the Agincourt field site, South Africa, 1992-1995
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DOI：
10.1097/00002030-199906180-00013
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发表时间：
1999-06-18
期刊：
影响因子：
3.8
通讯作者：
Gear, JSS
中科院分区：
文献类型：
--
作者：
Tollman, SM;Kahn, K;Gear, JSS
目的：研究1992-1995年期间南非农村地区死亡率的变化，按年龄、性别和死因分列。阿金库尔的人口和健康监测系统的建立，告知卫生政策和做法，农村分区population.Methods：前瞻性的社区为基础的研究，涉及每年更新的家庭人口普查，调查到所有的出生，死亡和迁移事件。所有报告的死亡（n = 1001）的主题是死因推断。结果：总体死亡率相对于总人口增长在研究领域的增长趋势是明显的。有证据表明，20-44岁妇女死亡率以前下降的趋势出现了逆转。1992-1993年与1994-1995年的比较表明，死亡率增加的大部分集中在较年轻的成年人（20-49岁）年龄组。艾滋病和有关疾病，特别是肺结核，似乎是主要原因。伤害和暴力（特别是凶杀）和循环系统疾病是重要的，认识不足的死亡原因，虽然他们的水平一直保持恒定的period.Conclusions：艾滋病和相关疾病的死亡率似乎负责的死亡率出现在南非的农村东北部的可能逆转。研究结果对新兴的分散式医疗保健系统产生了影响。(C)1999年利平科特威廉姆斯&威尔金斯。
Objective: To examine changes in mortality in rural South Africa over the period 1992-1995 by age, sex and cause of death.Design: As with much of sub-Saharan Africa, South Africa lacks effective vital registration and information on mortality is lacking. The Agincourt demographic and health surveillance system was established to inform health policy and practice with regard to rural subdistrict populations.Methods: Prospective community-based study involving annual update of a household census with enquiry into all birth, death and migration events. All reported deaths (n = 1001) are the subject of a verbal autopsy.Results: An increasing trend in overall mortality relative to general population growth in the study area is apparent. There is evidence for a reversal in the previously declining trend in mortality among women 20-44 years. A comparison of 1992-1993 with 1994-1995 shows that most of the increase in mortality is concentrated in the younger adult (20-49 year) age group. AIDS and related diseases, particularly tuberculosis, appear primarily responsible. Injuries and violence (especially homicide) and circulatory disease are important, under-recognized causes of death, although their levels have remained constant over the period.Conclusions: Mortality from AIDS and related diseases appears responsible for the probable reversal in mortality emerging in South Africa's rural northeast. Findings carry implications for the emerging system of decentralized health care. (C) 1999 Lippincott Williams & Wilkins.