Cause-specific mortality rates in sub-Saharan Africa and Bangladesh.
OBJECTIVE
To provide internationally comparable data on the frequencies of different causes of death.


METHODS
We analysed verbal autopsies obtained during 1999 -2002 from 12 demographic surveillance sites in sub-Saharan Africa and Bangladesh to find cause-specific and age-specific mortality rates. The cause-of-death codes used by the sites were harmonized to conform to the ICD-10 system, and summarized with the classification system of the Global Burden of Disease 2000 (Version 2).


RESULTS
Causes of death in the African sites differ strongly from those in Bangladesh, where there is some evidence of a health transition from communicable to noncommunicable diseases, and little malaria. HIV dominates in causes of mortality in the South African sites, which contrast with those in highly malaria endemic sites elsewhere in sub-Saharan Africa (even in neighbouring Mozambique). The contributions of measles and diarrhoeal diseases to mortality in sub-Saharan Africa are lower than has been previously suggested, while malaria is of relatively greater importance.


CONCLUSIONS
The different patterns of mortality we identified may be a result of recent changes in the availability and effectiveness of health interventions against childhood cluster diseases.
Navrongo Health Research Centre, Ghana.
Martin
M
Adjuik
Tom
T
Smith
Sam
S
Clark
Jim
J
Todd
Anu
A
Garrib
Yohannes
Y
Kinfu
Kathy
K
Kahn
Mitiki
M
Mola
Ali
A
Ashraf
Honorati
H
Masanja
Kubaje
K
Adazu
Ubaje
U
Adazu
Jahit
J
Sacarlal
Nurul
N
Alam
Adama
A
Marra
Adjima
A
Gbangou
Eleuther
E
Mwageni
Fred
F
Binka
D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D001459:Bangladesh / Q000453:epidemiology; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D011446:Prospective Studies