title: Main causes of death in Dande, Angola: results from Verbal Autopsies of deaths occurring during 2009-2012.
abstract: The Dande Health and Demographic Surveillance System (HDSS) located in Bengo Province, Angola, covers nearly 65,500 residents living in approximately 19,800 households. This study aims to describe the main causes of deaths (CoD) occurred within the HDSS, from 2009 to 2012, and to explore associations between demographic or socioeconomic factors and broad mortality groups (Group I-Communicable diseases, maternal, perinatal and nutritional conditions; Group II-Non-communicable diseases; Group III-Injuries; IND-Indeterminate).
  
  
  
  Verbal Autopsies (VA) were performed after death identification during routine HDSS visits. Associations between broad groups of CoD and sex, age, education, socioeconomic position, place of residence and place of death, were explored using chi-square tests and fitting logistic regression models.
  
  
  
  From a total of 1488 deaths registered, 1009 verbal autopsies were performed and 798 of these were assigned a CoD based on the 10(th) revision of the International Classification of Diseases (ICD-10). Mortality was led by CD (61.0 %), followed by IND (18.3 %), NCD (11.6 %) and INJ (9.1 %). Intestinal infectious diseases, malnutrition and acute respiratory infections were the main contributors to under-five mortality (44.2 %). Malaria was the most common CoD among children under 15 years old (38.6 %). Tuberculosis, traffic accidents and malaria led the CoD among adults aged 15-49 (13.5 %, 10.5 % and 8.0 % respectively). Among adults aged 50 or more, diseases of the circulatory system (23.2 %) were the major CoD, followed by tuberculosis (8.2 %) and malaria (7.7 %). CD were more frequent CoD among less educated people (adjusted odds ratio, 95 % confidence interval for none vs. 5 or more years of school: 1.68, 1.04-2.72).
  
  
  
  Infectious diseases were the leading CoD in this region. Verbal autopsies proved useful to identify the main CoD, being an important tool in settings where vital statistics are scarce and death registration systems have limitations.
authors: Health Research Centre of Angola (CISA), Caxito, Bengo, Angola. edite.rosario@cisacaxito.org.
authors: Edite Vila Nova
authors: EV
authors: Rosário
authors: Health Research Centre of Angola (CISA), Caxito, Bengo, Angola.|EPIUnit-Institute of Public Health, University of Porto (ISPUP), Porto, Portugal.
authors: Diogo
authors: D
authors: Costa
authors: Hospital Geral do Bengo, Caxito, Bengo, Angola.
authors: Luís
authors: L
authors: Timóteo
authors: National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal.
authors: Ana Ambrósio
authors: AA
authors: Rodrigues
authors: CRIA, Department of Life Sciences, University of Coimbra, Coimbra, Portugal.|Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Lisboa, Portugal.
authors: Jorge
authors: J
authors: Varanda
authors: ANU College of Medicine, Biology and Environment, The Australian National University, Camberra, Australia.
authors: Susana Vaz
authors: SV
authors: Nery
authors: Health Research Centre of Angola (CISA), Caxito, Bengo, Angola.|Lisbon School of Health Technology (ESTeSL), Lisboa, Portugal.
authors: Miguel
authors: M
authors: Brito
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000810:Angola / Q000453:epidemiology; D001344:Autopsy; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007239:Infections / Q000401:mortality*; D008288:Malaria / Q000401:mortality*; D008297:Male; D044342:Malnutrition / Q000401:mortality*; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D011247:Pregnancy; D012141:Respiratory Tract Infections / Q000401:mortality; D012959:Socioeconomic Factors; D014376:Tuberculosis / Q000401:mortality*; D055815:Young Adult
keywords: Angola; Causes of death; Health and demographic surveillance system; Verbal Autopsy