Estimation of cause-specific mortality in Rakai, Uganda, using verbal autopsy 1999-2019
Background There are scant data on the causes of adult deaths in sub-Saharan Africa. We estimated the level and trends in adult mortality, overall and by different causes, in rural Rakai, Uganda, by age, sex, and HIV status. Objectives To estimate and analyse adult cause-specific mortality trends in...
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Taylor & Francis Group
2024-12-01
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| Series: | Global Health Action |
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| Online Access: | http://dx.doi.org/10.1080/16549716.2024.2338635 |
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| author | Dorean Nabukalu Júlia Almeida Calazans Milly Marston Clara Calvert Hadijja Nakawooya Brendah Nansereko Robert Sekubugu Gertrude Nakigozi David Serwadda Nelson Sewankambo Godfrey Kigozi Ronald H Gray Fred Nalugoda Fredrick Makumbi Tom Lutalo Jim Todd |
| author_facet | Dorean Nabukalu Júlia Almeida Calazans Milly Marston Clara Calvert Hadijja Nakawooya Brendah Nansereko Robert Sekubugu Gertrude Nakigozi David Serwadda Nelson Sewankambo Godfrey Kigozi Ronald H Gray Fred Nalugoda Fredrick Makumbi Tom Lutalo Jim Todd |
| author_sort | Dorean Nabukalu |
| collection | DOAJ |
| description | Background There are scant data on the causes of adult deaths in sub-Saharan Africa. We estimated the level and trends in adult mortality, overall and by different causes, in rural Rakai, Uganda, by age, sex, and HIV status. Objectives To estimate and analyse adult cause-specific mortality trends in Rakai, Uganda. Methodology Mortality information by cause, age, sex, and HIV status was recorded in the Rakai Community Cohort study using verbal autopsy interviews, HIV serosurveys, and residency data. We estimated the average number of years lived in adulthood. Using demographic decomposition methods, we estimated the contribution of each cause of death to adult mortality based on the average number of years lived in adulthood. Results Between 1999 and 2019, 63082 adults (15–60 years) were censused, with 1670 deaths registered. Of these, 1656 (99.2%) had completed cause of death data from verbal autopsy. The crude adult death rate was 5.60 (95% confidence interval (CI): 5.33–5.87) per 1000 person-years of observation (pyo). The crude death rate decreased from 11.41 (95% CI: 10.61–12.28) to 3.27 (95% CI: 2.89–3.68) per 1000 pyo between 1999–2004 and 2015–2019. The average number of years lived in adulthood increased in people living with HIV and decreased in HIV-negative individuals between 2000 and 2019. Communicable diseases, primarily HIV and Malaria, had the biggest decreases, which improved the average number of years lived by approximately extra 12 years of life in females and 6 years in males. There were increases in deaths due to non-communicable diseases and external causes, which reduced the average number of years lived in adulthood by 2.0 years and 1.5 years in females and males, respectively. Conclusion There has been a significant decline in overall mortality from 1999 to 2019, with the greatest decline seen in people living with HIV since the availability of antiretroviral therapy in 2004. By 2020, the predominant causes of death among females were non-communicable diseases, with external causes of death dominating in males. |
| format | Article |
| id | doaj-art-064986340bb941b1a3e42c6dd91d552b |
| institution | Kabale University |
| issn | 1654-9880 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
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| series | Global Health Action |
| spelling | doaj-art-064986340bb941b1a3e42c6dd91d552b2025-02-05T12:46:13ZengTaylor & Francis GroupGlobal Health Action1654-98802024-12-0117110.1080/16549716.2024.23386352338635Estimation of cause-specific mortality in Rakai, Uganda, using verbal autopsy 1999-2019Dorean Nabukalu0Júlia Almeida Calazans1Milly Marston2Clara Calvert3Hadijja Nakawooya4Brendah Nansereko5Robert Sekubugu6Gertrude Nakigozi7David Serwadda8Nelson Sewankambo9Godfrey Kigozi10Ronald H Gray11Fred Nalugoda12Fredrick Makumbi13Tom Lutalo14Jim Todd15Rakai Health Sciences ProgramUniversitat Autònoma de BarcelonaLondon School of Hygiene and Tropical MedicineUniversity of EdinburghRakai Health Sciences ProgramRakai Health Sciences ProgramRakai Health Sciences ProgramRakai Health Sciences ProgramRakai Health Sciences ProgramRakai Health Sciences ProgramRakai Health Sciences ProgramJohns Hopkins Bloomberg School of Public HealthRakai Health Sciences ProgramRakai Health Sciences ProgramRakai Health Sciences ProgramLondon School of Hygiene and Tropical MedicineBackground There are scant data on the causes of adult deaths in sub-Saharan Africa. We estimated the level and trends in adult mortality, overall and by different causes, in rural Rakai, Uganda, by age, sex, and HIV status. Objectives To estimate and analyse adult cause-specific mortality trends in Rakai, Uganda. Methodology Mortality information by cause, age, sex, and HIV status was recorded in the Rakai Community Cohort study using verbal autopsy interviews, HIV serosurveys, and residency data. We estimated the average number of years lived in adulthood. Using demographic decomposition methods, we estimated the contribution of each cause of death to adult mortality based on the average number of years lived in adulthood. Results Between 1999 and 2019, 63082 adults (15–60 years) were censused, with 1670 deaths registered. Of these, 1656 (99.2%) had completed cause of death data from verbal autopsy. The crude adult death rate was 5.60 (95% confidence interval (CI): 5.33–5.87) per 1000 person-years of observation (pyo). The crude death rate decreased from 11.41 (95% CI: 10.61–12.28) to 3.27 (95% CI: 2.89–3.68) per 1000 pyo between 1999–2004 and 2015–2019. The average number of years lived in adulthood increased in people living with HIV and decreased in HIV-negative individuals between 2000 and 2019. Communicable diseases, primarily HIV and Malaria, had the biggest decreases, which improved the average number of years lived by approximately extra 12 years of life in females and 6 years in males. There were increases in deaths due to non-communicable diseases and external causes, which reduced the average number of years lived in adulthood by 2.0 years and 1.5 years in females and males, respectively. Conclusion There has been a significant decline in overall mortality from 1999 to 2019, with the greatest decline seen in people living with HIV since the availability of antiretroviral therapy in 2004. By 2020, the predominant causes of death among females were non-communicable diseases, with external causes of death dominating in males.http://dx.doi.org/10.1080/16549716.2024.2338635verbal autopsyadult mortalityugandahealth and demographic surveillance sitescause of death |
| spellingShingle | Dorean Nabukalu Júlia Almeida Calazans Milly Marston Clara Calvert Hadijja Nakawooya Brendah Nansereko Robert Sekubugu Gertrude Nakigozi David Serwadda Nelson Sewankambo Godfrey Kigozi Ronald H Gray Fred Nalugoda Fredrick Makumbi Tom Lutalo Jim Todd Estimation of cause-specific mortality in Rakai, Uganda, using verbal autopsy 1999-2019 Global Health Action verbal autopsy adult mortality uganda health and demographic surveillance sites cause of death |
| title | Estimation of cause-specific mortality in Rakai, Uganda, using verbal autopsy 1999-2019 |
| title_full | Estimation of cause-specific mortality in Rakai, Uganda, using verbal autopsy 1999-2019 |
| title_fullStr | Estimation of cause-specific mortality in Rakai, Uganda, using verbal autopsy 1999-2019 |
| title_full_unstemmed | Estimation of cause-specific mortality in Rakai, Uganda, using verbal autopsy 1999-2019 |
| title_short | Estimation of cause-specific mortality in Rakai, Uganda, using verbal autopsy 1999-2019 |
| title_sort | estimation of cause specific mortality in rakai uganda using verbal autopsy 1999 2019 |
| topic | verbal autopsy adult mortality uganda health and demographic surveillance sites cause of death |
| url | http://dx.doi.org/10.1080/16549716.2024.2338635 |
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