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Who died of what in rural KwaZulu-Natal, South Africa: a cause of death analysis using InterVA-4
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.ORCID iD: 0000-0001-5474-4361
2014 (English)In: Global health action, ISSN 1654-9880, E-ISSN 1654-9880, Vol. 7, 25496Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: For public health purposes, it is important to see whether men and women in different age groups die of the same causes in South Africa.

OBJECTIVE: We explored sex- and age-specific patterns of causes of deaths in a rural demographic surveillance site in northern KwaZulu-Natal in South Africa over the period 2000-2011.

DESIGN: Deaths reported through the demographic surveillance were followed up by a verbal autopsy (VA) interview using a standardised questionnaire. Causes of death were assigned likelihoods using the publicly available tool InterVA-4. Cause-specific mortality fractions were determined by age and sex.

RESULTS: Over the study period, a total of 5,416 (47%) and 6,081 (53%) deaths were recorded in men and women, respectively. Major causes of death proportionally affecting more women than men were (all p<0.0001): human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (20.1% vs. 13.6%), other and unspecified cardiac disease (5.9% vs. 3.2%), stroke (4.5% vs. 2.7%), reproductive neoplasms (1.7% vs. 0.4%), diabetes (2.4% vs. 1.2%), and breast neoplasms (0.4% vs. 0%). Major causes of deaths proportionally affecting more men than women were (all p<0.0001) assault (6.1% vs. 1.7%), pulmonary tuberculosis (34.5% vs. 30.2%), road traffic accidents (3.0% vs. 1.0%), intentional self-harm (1.3% vs. 0.3%), and respiratory neoplasms (2.5% vs. 1.5%). Causes of death due to communicable diseases predominated in all age groups except in older persons.

CONCLUSIONS: While mortality during the 2000s was dominated by tuberculosis and HIV/AIDS, we found substantial sex-specific differences both for communicable and non-communicable causes of death, some which can be explained by a differing sex-specific age structure. InterVA-4 is likely to be a valuable tool for investigating causes of death patterns in other similar Southern African settings.

Place, publisher, year, edition, pages
2014. Vol. 7, 25496
Keyword [en]
mortality, cause of death, demographic surveillance, South Africa, HIV/AIDS, tuberculosis, verbal autopsy
National Category
Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:umu:diva-97433DOI: 10.3402/gha.v7.25496PubMedID: 25377332OAI: diva2:772811
Wellcome trust, WT 097410
Available from: 2014-12-17 Created: 2014-12-17 Last updated: 2015-07-07Bibliographically approved

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