Epidemiological transition in a rural community of northern India: 18-year mortality surveillance using verbal autopsy

J Epidemiol Community Health. 2012 Oct;66(10):890-3. doi: 10.1136/jech-2011-200336. Epub 2011 Nov 2.

Abstract

Background: Information on causes of death is vital for planning of health services. However, vital events registration systems are weak in developing countries. Therefore, verbal autopsy (VA) tools were incorporated in a community-based surveillance system to track causes of death.

Method and findings: Trained fieldworker identified all deaths and interviewed a living relative of those who had died during 1992-2009, using VA, in eight villages of Haryana (11,864 populations). These field reports detailing events preceding death were reviewed by two trained physicians, who independently assigned an International Classification of Disease-10 code to each death. Discrepancies were resolved through reconciliation and, if necessary, adjudication. Non-communicable conditions were the leading causes of death (47.6%) followed by communicable diseases including maternal, perinatal and nutritional conditions (34.0%), and injuries (11.4%). Cause of death could not be determined in 6.9% cases. Deaths due to cardiovascular diseases showed a significant rise, whereas deaths due to diarrhoeal diseases have declined (p<0.01). Majority (90.0%) of the deceased had contacted a healthcare provider during illness but only 11.5% were admitted in hospital before death.

Conclusion: Rising trend of cardiovascular diseases observed in a rural community of Haryana in India calls for reorientation of rural healthcare delivery system for prevention and control of chronic diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Autopsy / methods*
  • Cardiovascular Diseases / mortality
  • Cause of Death / trends*
  • Child
  • Child, Preschool
  • Communicable Diseases / mortality
  • Death Certificates
  • Female
  • Humans
  • India / epidemiology
  • Infant
  • Infant, Newborn
  • Interviews as Topic
  • Male
  • Middle Aged
  • Population Surveillance
  • Rural Health / trends*
  • Rural Population / statistics & numerical data*
  • Sex Distribution
  • Socioeconomic Factors
  • Young Adult