title: Hospital based infectious disease related proportional mortality study.
abstract: OBJECTIVE
  To understand the temporal trends in mortality in Rural Central India.
  
  
  METHODS
  Retrospective review of physician issued death certificates from a rural teaching hospital.
  
  
  METHODS
  Physician issued death certificates from 1979 to 2008, available with a rural teaching hospital were analyzed and information on age, gender, date, and cause of death was abstracted. We estimated cause-specific, proportional mortality ratio (PMR) stratified by age, and gender. We compared the difference in PMR in first fifteen years of the study period (period A, 1979-1993) with the later (period B, 1994-2008).
  
  
  RESULTS
  We found 20494 death certificates between 1979 and 2008. Proportion of infectious disease related mortality declined from 35% in 1979-1983-26% in 2004-2008. In the same periods, injury related mortality increased from 4.6% to 13.4%, and chronic disease mortality from 19% to 28%. The absolute difference in PMR (per 1000 deaths) was statistically significant between period B and period A, for infections (a decline of 80.67 [95% CI 66.97-94.03]), chronic diseases (an increase of 45.85 [95% CI 33.49-58.55]), and injuries (an increase of 42.98 [95% CI 33.87-52.26]).
  
  
  CONCLUSIONS
  Temporal trend in mortality from a single hospital in rural Central-India over the past three decades shows decline in infectious diseases, and rise in injuries and chronic diseases.
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
authors.forename: Rajnish
authors.initials: R
authors.lastname: Joshi
authors.affiliation: Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Lodhe
authors.affiliation: Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India.
authors.forename: Sachin
authors.initials: S
authors.lastname: Agrawal
authors.affiliation: Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India.
authors.forename: Ap
authors.initials: A
authors.lastname: Jain
keywords: Mortality; Rural India; Temporal pattern
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