Research Article: Adult mortality trends in Matlab, Bangladesh: an analysis of cause-specific risks
Abstract:
Objective With socioeconomic development, improvement in preventing and curing infectious diseases, and increased exposure to non-communicable diseases (NCDs) risk factors (eg, overweight/obesity, sedentary lifestyle), the majority of adult deaths in Bangladesh in recent years are due to NCDs. This study examines trends in cause-specific mortality risks using data from the Matlab Health and Demographic Surveillance System (HDSS). Design, settings and participants We conducted a follow-up study from 2003 to 2017 using data from Matlab HDSS, which covers a rural population of 0.24?million (in 2018) in Chandpur, Bangladesh. HDSS assessed the causes of all deaths using verbal autopsy and classified the causes using the 10th revision of the International Statistical Classification of Diseases. We examined 19?327 deaths involving 2?279?237 person-years. Methods We calculated annual cause-specific mortality rates and estimated adjusted proportional HRs using a Cox proportional hazards model. Results All-cause mortality risk declined over the study period among people aged 15 and older, but the risk from stroke increased, and from heart disease and cancers remained unchanged. These causes were more common among middle-aged and older people and thus bore the most burden. Mortality from causes other than NCDs—namely, infectious and respiratory diseases, injuries, endocrine disorders and others—declined yet still constituted over 30% of all deaths. Thus, the overall mortality decline was associated with the decline of causes other than NCDs. Mortality risk sharply increased with age. Men had higher mortality than women from heart disease, cancers and other causes, but not from stroke. Lower household wealth quintile people have higher mortality than higher household wealth quintile people, non-Muslims than Muslims. Conclusion Deaths from stroke, heart disease and cancers were either on the rise or remained unchanged, but other causes declined continuously from 2003 to 2017. Immediate strengthening of the preventive and curative healthcare systems for NCDs management is a burning need.
Introduction:
Adult mortality in developing countries has received little attention, until recently. This is especially so in Bangladesh, mainly due to prioritising child survival and more pressing social issues. 1 With substantial improvements in child survival, an increasing proportion of deaths are now from the adult population—the majority of which are from non-communicable diseases (NCDs). NCDs are the world’s major killers, with cerebrovascular and cardiovascular diseases (CVDs), cancers, chronic respiratory diseases and…
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