Chronic diseases now a leading cause of death in rural India--mortality data from the Andhra Pradesh Rural Health Initiative

Rohina Joshi, Magnolia Cardona, Srinivas Iyengar, A Sukumar, Ravi Raju, K Rama Raju, Krishnam Raju, K Srinath Reddy, Alan Lopez and Bruce Neal (2006) Chronic diseases now a leading cause of death in rural India--mortality data from the Andhra Pradesh Rural Health Initiative. International Journal of Epidemiology, 35 6: 1522-1529. doi:10.1093/ije/dyl168


Author Rohina Joshi
Magnolia Cardona
Srinivas Iyengar
A Sukumar
Ravi Raju
K Rama Raju
Krishnam Raju
K Srinath Reddy
Alan Lopez
Bruce Neal
Title Chronic diseases now a leading cause of death in rural India--mortality data from the Andhra Pradesh Rural Health Initiative
Journal name International Journal of Epidemiology   Check publisher's open access policy
ISSN 0300-5771
1464-3685
Publication date 2006-12
Sub-type Article (original research)
DOI 10.1093/ije/dyl168
Volume 35
Issue 6
Start page 1522
End page 1529
Total pages 8
Editor G. Davey Smith
S. Ebrahim
Place of publication Oxford, U.K.
Publisher Oxford University Press
Language eng
Subject 321202 Epidemiology
C1
0104 Statistics
1117 Public Health and Health Services
Formatted abstract
Introduction: India is undergoing rapid epidemiological transition as a consequence of economic and social change. The pattern of mortality is a key indicator of the consequent health effects but up-to-date, precise, and reliable statistics are few, particularly in rural areas.
Methods: Deaths occurring in 45 villages (population 180 162) were documented during a 12-month period in 2003-04 by multipurpose primary healthcare workers trained in the use of a verbal autopsy tool. Algorithms were used to define causes of death according to a limited list derived from the international classification of disease version 10. Causes were assigned by two independent physicians with disagreements resolved by a third.
Results: A total of 1354 deaths were recorded with verbal autopsies completed for 98%. A specific underlying cause of death was assigned for 82% of all verbal autopsies done. The crude death rate was 7.5/1000 (95% confidence interval, 7.1-7.9). Diseases of the circulatory system were the leading causes of mortality (32%), with similar proportions of deaths attributable to ischaemic heart disease and stroke. Second was injury and external causes of mortality (13%) with one-third of these deaths attributable to deliberate self harm. Third were infectious and parasitic diseases (12%). Tuberculosis and intestinal conditions each caused one-third of deaths within this category. HIV was assigned as the cause for 2% of all deaths. The fourth and fifth leading causes of death were neoplasms (7%) and diseases of the respiratory system (5%).
Conclusion: Non-communicable and chronic diseases are the leading causes of death in this part of rural India. The observed pattern of death is unlikely to be unique to these villages and provides new insight into the rapid progression of epidemiological transition in rural India.
© 2006 Oxford University Press.
Keyword Verbal autopsy
Mortality surveillance
Cause of death
Chronic disease
Rural India
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Public Health Publications
 
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