title: Epidemiological transition in a rural community of northern India: 18-year mortality surveillance using verbal autopsy.
abstract: BACKGROUND
  Information on causes of death is vital for planning of health services. However, vital events registration systems are weak in developing countries. Therefore, verbal autopsy (VA) tools were incorporated in a community-based surveillance system to track causes of death.
  
  
  RESULTS
  Trained fieldworker identified all deaths and interviewed a living relative of those who had died during 1992-2009, using VA, in eight villages of Haryana (11,864 populations). These field reports detailing events preceding death were reviewed by two trained physicians, who independently assigned an International Classification of Disease-10 code to each death. Discrepancies were resolved through reconciliation and, if necessary, adjudication. Non-communicable conditions were the leading causes of death (47.6%) followed by communicable diseases including maternal, perinatal and nutritional conditions (34.0%), and injuries (11.4%). Cause of death could not be determined in 6.9% cases. Deaths due to cardiovascular diseases showed a significant rise, whereas deaths due to diarrhoeal diseases have declined (p<0.01). Majority (90.0%) of the deceased had contacted a healthcare provider during illness but only 11.5% were admitted in hospital before death.
  
  
  CONCLUSIONS
  Rising trend of cardiovascular diseases observed in a rural community of Haryana in India calls for reorientation of rural healthcare delivery system for prevention and control of chronic diseases.
authors: School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India. dr.rajeshkumar@gmail.com
authors: Rajesh
authors: R
authors: Kumar
authors: Dinesh
authors: D
authors: Kumar
authors: J
authors: J
authors: Jagnoor
authors: Arun K
authors: AK
authors: Aggarwal
authors: P V M
authors: PV
authors: Lakshmi
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy / Q000379:methods*; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death / Q000639:trends*; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000401:mortality; D003644:Death Certificates; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012423:Rural Health / Q000639:trends*; D012424:Rural Population / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012959:Socioeconomic Factors; D055815:Young Adult