Epidemiological transition in rural Bangladesh, 1986-2006.
BACKGROUND
For understanding epidemiological transition, Health and Demographic Surveillance System plays an important role in developing and resource-constraint setup where accurate information on vital events (e.g. births, deaths) and cause of death is not available.


METHODS
This study aimed to assess existing level and trend of causes of 18,917 deaths in Matlab, a rural area of Bangladesh, during 1986-2006 and to project future scenarios for selected major causes of death.


RESULTS
The results demonstrated that Matlab experienced a massive change in the mortality profile from acute, infectious, and parasitic diseases to non-communicable, degenerative, and chronic diseases during the last 20 years. It also showed that over the period 1986-2006, age-standardized mortality rate (for both sexes) due to diarrhea and dysentery reduced by 86%, respiratory infections by 79%, except for tuberculosis which increased by 173%. On the other hand, during the same period, mortality due to cardiovascular and cerebrovascular diseases increased by a massive 3,527% and malignant neoplasms by 495%, whereas mortality due to chronic obstructive pulmonary disease and injury remained in the similar level (12-13% increase).


CONCLUSIONS
The trend of selected causes of death demonstrates that in next two decades, deaths due to communicable diseases will decline substantially and the mortality due to non-communicable diseases (NCDs) will increase at massive proportions. Despite Matlab's significant advances in socio-demographic indicators, emergence of NCDs and mortality associated with it would be the major cause for concern in the coming years.
Ahsan Karar
Zunaid
Z
South Asia Human Development Sector, The World Bank/Dhaka, Bangladesh.
Alam
Nurul
N
Kim Streatfield
Peter
P