title: Using verbal autopsy to identify and proportionally assign cause of death in Ibadan, southwest Nigeria.
abstract: Reliable and accurate data remain scarce on the cause and rates of mortality among adults in sub-Saharan Africa. The Idikan Adult Mortality Study, a prospective community-based study was initiated in order to obtain the overall as well as cause-specific mortality data for a community of adults (15 years and above). Standardised verbal autopsy questionnaire was used to investigate and assign the mode and cause of death. There were 232 reported deaths in the baseline population of 4127 adults over 5 years, giving an unadjusted death rate of 11.2 per 1000 per year. Thirty-nine (16.8% ) of these death occurred suddenly. The commonest known cause of death was due to cardiovascular disease, which was responsible for 43 (18.5% ) of all deaths. It was also the commonest known cause of sudden death accounting for 30.8% of such deaths. Infection was responsible for 28 (12.1% ) deaths while injury accounted for 7 (2.6% ) deaths. Subjects, 50 years and above were more likely to die and also die suddenly than were the younger subject (p<0.0001, p<0.0001) and significantly more death occurred in males than females (6.9% versus 4.7% ) (P<0.01). Deaths were also more likely to have occurred at home and outside the hospital, increasing the probability of these deaths being underreported. Following multivariate logistic regression analysis, respondents between the age of 20 -49 years had significantly reduced risk of dying (p=0.029), while cigarette smoking significantly increased the risk of dying (p=0.012). In the absence of the urgently needed vital statistics, use of verbal autopsies is a potentially useful investigative method for identifying and assigning cause of adult deaths in a community.
authors.affiliation: Department of Community Medicine, College of Medicine, University College Hospital, Ibadan, Nigeria. tlawoyin@skannet.com
authors.forename: T O
authors.initials: TO
authors.lastname: Lawoyin
authors.forename: M C
authors.initials: MC
authors.lastname: Asuzu
authors.forename: J
authors.initials: J
authors.lastname: Kaufman
authors.forename: C
authors.initials: C
authors.lastname: Rotimi
authors.forename: L
authors.initials: L
authors.lastname: Johnson
authors.forename: E
authors.initials: E
authors.lastname: Owoaje
authors.forename: R
authors.initials: R
authors.lastname: Cooper
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001344:Autopsy / Q000379:methods*; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D011446:Prospective Studies