Largest ever dataset on individual deaths in Africa & SE Asia reveals changing health of developing world

An unprecedented insight into the changing health of people across Africa and Asia - including the fluctuating burdens of HIV, malaria and childhood mortality - is revealed today (29th Oct 2014) by the publication of the largest ever dataset of individual deaths recorded on-the-ground.

More than 110,000 individual deaths and their causes across 13 countries including India, Ghana, South Africa, Kenya, Bangladesh and Vietnam are part of the new INDEPTH dataset. The data, collected by hundreds of researchers over two decades, are the first meaningful community-based information about cause of death in countries where individual deaths are not recorded automatically by national governments. Vadu Rural Health Program (VRHP), KEMHRC Pune is part of this work since 2003 and since then is monitoring the population for demographic events in 22 villages from Shirur and Haveli block.

The INDEPTH Network is one of the few international population health agencies based in the global South. VRHP is one of the very active member centres of INDEPTH Network. The INDEPTH cause of death findings are published in a special issue of the journal Global Health Action, which is fully open access. There are six multisite papers dealing with specific causes of death: HIV/AIDS, malaria, pregnancy-related, external causes (including accidental death and suicide), adult non-communicable diseases and childhood illness. Other papers describe methods, and many sites have contributed papers with local details.

VRHP has collected demographic data on births, deaths, marriages and migration occurring in Vadu HDSS area comprising of nearly 1 40,000 individuals since 2003. Each death was recorded by a researcher, who are locals residing in Vadu area, in the field who conducted a standardised verbal autopsy, a structured interview with a family member of the deceased. Data were computer-processed to establish likely causes of death. The entire dataset (also now available in the public domain), which at some sites includes cause of death data collected as far back as 1992 for some countries, represents more than a century of working time. It also proves that data relating to cause of death can be reliably collected by non-medical staff outside of a clinical setting.

Overall, the data provide a strong case for the value of recording cause of death for planning and improving public health services. They show high variability in cause of death across sites the estimates of which are based on information about real deaths in defined areas of the population. Although the picture is complex, there is some evidence to link mortality with differing investment in healthcare over the two decades of the study. This collaboration is able to estimate the global burden of major diseases. Encouragingly for researchers, these findings are very similar to the outputs from the mathematical modelling techniques, indicating that they confirm each other. 

There are other important specific findings. Across the countries, the data show consistently high rates of maternal and childhood mortality. Mortality from non-communicable diseases, particularly in younger adulthood, is an emerging problem, accounting for a high proportion of deaths in Asian countries. Another concern which came up through data on external causes of deaths in Vadu HDSS is deaths caused in road accidents in male population mainly in age group of 15-49 years. The specific causes would enable policy makers to take relevant action to reduce the deaths occurring.

Sanjay Juvekar, Officer in charge of VRHP said: “such longitudinal datasets would provide platform for researchers, local policy makers as also state and country level policy makers to identify the disease burden in the country which is the need of the hour. Million death study in India has strongly advocated need for creating disease burden cohorts across the country”.

Dr. Juvekar added, “in the current day scenario where quality datasets are scarcely available in public domain in the country; it is very crucial for India to have more and more HDSS added across the country. Hence we have initiated providing technical support to all those in the country who want to establish HDSS”

Reference

The permanent URL for the special issue will be: http://www.globalhealthaction.net/index.php/gha/issue/view/1602#INDEPTH%20Network%20Cause-Specific%20Mortality

The citation for these publications are as follows-

 

1.        Streatfield PK, Khan WA, Bhuiya A, Hanifi SMA, ...., Sanjay Juvekar, Veena Muralidharan et. al. HIV/AIDS-related mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites. Glob Health Action. 2014;25370(7):1–11.

2.           P. Kim Streatfield, Wasif A. Khan, Abbas Bhuiya, Nurul Alam, Ali Sie´, ...........Shashi Kant, Sanjay Juvekar, Osman A. Sankoh MT and PB. Cause-specific mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites. Glob Health Action [Internet]. 2014;25362(Suppli 7: INDEPTH Network Cause-Specific Mortality):1–10. Available from: http://www.globalhealthaction.net/index.php/gha/article/view/25362

3.           Streatfield PK, Khan WA, Bhuiya A, Hanifi SMA, .... Sanjay Juvekar, Pallavi Lele et. al. Adult non-communicable disease mortality in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System sites. Glob Health Action. 2014;25365(7).

4.           Streatfield PK, Khan WA, Bhuiya A, Hanifi SMA, .... Bharat Choudhary, Sanjay Juvekar et. al. Malaria mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites. Glob Health Action [Internet]. 2014;25369(7):1–12. Available from: http://dx.doi.org/10.3402/gha.v7.25369

5.           Streatfield PK, Khan WA, Bhuiya A, Hanifi SMA, .... Sanjay Juvekar, Rutuja Patil et. al. Mortality from external causes in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System Sites. Glob Health Action [Internet]. 2014;25366(7). Available from: http://dx.doi.org/10.3402/gha.v7.25366

 

 

 

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