Childhood mortality and probable causes of death using verbal autopsy in Niakhar, Senegal, 1989-2000
Childhood mortality and probable causes of death using verbal autopsy in Niakhar, Senegal, 1989-2000
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DOI：
10.1093/ije/dyh259
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发表时间：
2004-12-01
影响因子：
7.7
通讯作者：
Delaunay, V
中科院分区：
文献类型：
--
作者：
Etard, JF;Le Hesran, JY;Delaunay, V
在非洲农村地区，关于死亡原因的医学证明信息基本上缺乏。作者应用死因推断，以确定死亡原因前15岁的人口监测系统在塞内加尔的农村地区operating.Methods在1989年和2000年之间，进行了尸检采访，使用标准化的问卷调查，这是独立的两个医生谁分配的可能的根本死因。不一致的诊断由一个医生小组讨论。死亡原因分为几个类别;原因特异性死亡率和分数generated.Results之间的1989年和1997年，全因死亡率波动。腹泻病、疟疾和急性呼吸道感染占10岁以下儿童死亡率的30%至70%。在1-9岁儿童中，疟疾死亡率在1989年至1994年期间有所上升，此后没有变化。1998-2000年的特点是死亡率的高峰，由于脑膜炎爆发的儿童超过1岁，死亡率的增加，原因不明的发热，脑膜炎疾病，急性呼吸道感染的儿童在5岁以下的5 years.Conclusions口头尸检提供了有用的信息，负责1998-2000年的死亡率高峰的死亡率结构。它强调，在疫情之外，疟疾是1-9岁儿童死亡的主要原因，腹泻、急性呼吸道感染或不明原因的发烧占5岁以下儿童死亡人数的50%。
Background In African rural settings, medically certified information on causes of death is largely lacking. The authors applied the verbal autopsy to identify causes of death before 15 years old in a rural area of Senegal where a demographic surveillance system is operating.Methods Between 1989 and 2000, a postmortem interview was conducted using a standardized questionnaire which was independently reviewed by two physicians who assigned the probable underlying cause of death. Discordant diagnoses were discussed by a panel of physicians. Causes of death were grouped into a few categories; cause-specific mortality rates and fractions were generated.Results Between 1989 and 1997, all-cause mortality fluctuated. Diarrhoeal diseases, malaria and acute respiratory infections explained between 30% and 70% of the mortality before 10 years of age. In children 1-9 years old, malaria death rate increased between 1989 and 1994 and thereafter did not change. The 1998-2000 years were marked by a peak in mortality, attributed to a meningitis outbreak in children more than one year old paralleled by an increase in death rate from fever of unknown origin, diarrhoeal diseases, and acute respiratory infections in children under 5 years.Conclusions Verbal autopsy provided useful information on the mortality structure responsible for the 1998-2000 peak in mortality. It underlined that, outside outbreak situations, malaria was a leading cause of death for 1-9 year old children and that diarrhoea, acute respiratory infections, or fever from unknown origin accounted for up to 50% of the deaths among the children under 5 years.