Cause-specific mortality at INDEPTH Health and Demographic Surveillance System Sites in Africa and Asia: concluding synthesis.
Cause-specific mortality at INDEPTH Health and Demographic Surveillance System Sites in Africa and Asia: concluding synthesis.
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DOI：
10.3402/gha.v7.25590
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发表时间：
2014
影响因子：
2.6
通讯作者：
Byass P
中科院分区：
文献类型：
--
作者：
Sankoh O;Byass P
这份综合报告汇集了INDEPTH网络网站内通过口头尸检记录的关于非洲和亚洲110,000多名死亡病例的特定原因死亡率的调查结果。根据口头尸检(VA)访谈的数据确定死因的计算机化方法的发展使这些标准化分析成为可能，这些分析来自INDEPTH网络中22个非洲和亚洲卫生和人口监测系统地点的110,000多人。除了先前对InterVA-4概率模型的验证外，这些范围广泛的分析进一步证明了这一方法在确定死因方面的适用性。观察到了与现有疾病模式知识的可信比较，以及与时间段、国家和其他独立数据来源等模型外参数的实质性相关性。观察到不同地点之间的死亡率有很大差异，在某些情况下也是在国家内部。暴露的一些死亡负担清楚地构成了采取公共卫生行动的理由。从总体上看，这些问题包括产妇和新生儿死亡率高。更具体的例子是孟加拉国的儿童溺水和东部和南部非洲成年男子的杀人案。非传染性疾病的死亡率，特别是在较年轻的成年人中，是一个新出现的令人关切的原因。深度研究所记录特定人群中所有死亡的方法，并成功地将原因分配给大多数人，这对制定卫生政策很重要。作为这些分析基础的汇集数据集可在INDEPTH数据储存库中找到，以供进一步分析。深入研究将继续填补非洲和亚洲的特定死因死亡率知识空白，这也将成为2015年后发展目标的基线。在许多国家，在常规民事登记系统中更广泛地使用类似的退伍军人法很可能成为一项重要的中期战略。
This synthesis brings together findings on cause-specific mortality documented by means of verbal autopsies applied to over 110,000 deaths across Africa and Asia, within INDEPTH Network sites. Developments in computerised methods to assign causes of death on the basis of data from verbal autopsy (VA) interviews have made possible these standardised analyses of over 110,000 deaths from 22 African and Asian Health and Demographic Surveillance System sites in the INDEPTH Network. In addition to previous validations of the InterVA-4 probabilistic model, these wide-ranging analyses provide further evidence of the applicability of this approach to assigning the cause of death. Plausible comparisons with existing knowledge of disease patterns, as well as substantial correlations with out-of-model parameters such as time period, country, and other independent data sources were observed. Substantial variations in mortality between sites, and in some cases within countries, were observed. A number of the mortality burdens revealed clearly constitute grounds for public health actions. At an overall level, these included high maternal and neonatal mortality rates. More specific examples were childhood drowning in Bangladesh and homicide among adult males in eastern and southern Africa. Mortality from non-communicable diseases, particularly in younger adulthood, is an emerging cause for concern. INDEPTH’s approach of documenting all deaths in particular populations, and successfully assigning causes to the majority, is important for formulating health policies. The pooled dataset underlying these analyses is available at the INDEPTH Data Repository for further analysis. INDEPTH will continue to fill cause-specific mortality knowledge gaps across Africa and Asia, which will also serve as a baseline for post-2015 development goals. The more widespread use of similar VA methods within routine civil registration systems is likely to become an important medium-term strategy in many countries.