title: Adult deaths and the future: a cause-specific analysis of adult deaths from a longitudinal study in rural Tanzania 2003-2007.
abstract: OBJECTIVE
  To determine patterns and risk factors for cause-specific adult mortality in rural southern Tanzania.
  
  
  METHODS
  The study was a longitudinal open cohort and focused on adults aged 15-59 years between 2003 and 2007. Causes of deaths were ascertained by verbal autopsy (VA). Cox proportion hazards regression model was used to determine factors associated with cause-specific mortality over the 5-year period.
  
  
  RESULTS
  Thousand three hundred and fifty-two of 65 548 adults died, representing a crude adult mortality rate (AMR) of 7.3 per 1000 person years of observation (PYO). VA was performed for 1132 (84%) deaths. HIV/AIDS [231 (20.4%)] was the leading cause of death followed by malaria [150 (13.2%)]. AMR for communicable disease (CD) causes was 2.49 per 1000 PYO, 1.21 per 1000 PYO for non-communicable diseases (NCD) and 0.53 per 1000 PYO for accidents/injury causes. NCD deaths increased from 16% in 2003 to 24% in 2007. High level of education was associated with a reduction in the risk of dying from NCDs. Those with primary education (HR = 0.67, 95% CI: 0.49, 0.92) and with education beyond primary school (HR = 0.11, 95% CI: 0.02, 0.40) had lower mortality than those who had no formal education. Compared with local residents, in-migrants were 1.7 (95% CI: 1.37, 2.11) times more likely to die from communicable disease causes.
  
  
  CONCLUSIONS
  NCDs are increasing as a result of demographic and epidemiological transitions taking place in most African countries including Tanzania and require attention to prevent increased triple disease burden of CD, NCD and accident/injuries.
authors.affiliation: Dodowa Health Research Centre, Accra Region, Ghana  Dangme West District Health Administration, Ghana Health Service, Dodowa, Ghana  Division of Epidemiology and Biostatistics, University of Witwatersrand, Johannesburg, South Africa  Ifakara Health Institute, Dar es salaam, Tanzania.
authors.forename: S A
authors.initials: SA
authors.lastname: Narh-Bana
authors.forename: T F
authors.initials: TF
authors.lastname: Chirwa
authors.forename: M A
authors.initials: MA
authors.lastname: Mwanyangala
authors.forename: R
authors.initials: R
authors.lastname: Nathan
mesh_terms: D000293:Adolescent; D000328:Adult; D001344:Autopsy; D002423:Cause of Death; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult