@article{Chu:2024:10.1016/S2214-109X(24)00171-2,
author = {Chu, Y and Marston, M and Dube, A and Festo, C and Geubbels, E and Gregson, S and Herbst, K and Kabudula, C and Kahn, K and Lutalo, T and Moorhouse, L and Newton, R and Nyamukapa, C and Makanga, R and Slaymaker, E and Urassa, M and Ziraba, A and Calvert, C and Clark, SJ},
doi = {10.1016/S2214-109X(24)00171-2},
journal = {Lancet Glob Health},
pages = {e1278--e1287},
title = {Temporal changes in cause of death among adolescents and adults in six countries in eastern and southern Africa in 1995-2019: a multi-country surveillance study of verbal autopsy data.},
url = {http://dx.doi.org/10.1016/S2214-109X(24)00171-2},
volume = {12},
year = {2024}
}

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TY  - JOUR
AB  - BACKGROUND: The absence of high-quality comprehensive civil registration and vital statistics systems across many settings in Africa has led to little empirical data on causes of death in the region. We aimed to use verbal autopsy data to provide comparative, population-based estimates of cause-specific mortality among adolescents and adults in eastern and southern Africa. METHODS: In this surveillance study, we harmonised verbal autopsy and residency data from nine health and demographic surveillance system (HDSS) sites in Kenya, Malawi, Tanzania, South Africa, Uganda, and Zimbabwe, each with variable coverage from Jan 1, 1995, to Dec 31, 2019. We included all deaths to adolescents and adults aged 12 or over that were residents of the study sites and had a verbal autopsy conducted. InSilicoVA, a probabilistic model, was used to assign cause of death on the basis of the signs and symptoms reported in the verbal autopsy. Levels and trends in all-cause and cause-specific mortality rates and cause-specific mortality fractions were calculated, stratified by HDSS site, sex, age, and calendar periods. FINDINGS: 52484 deaths and 5157802 person-years were reported among 1071913 individuals across the nine sites during the study period. 47961 (91·4%) deaths had a verbal autopsy, of which 46570 (97·1%) were assigned a cause of death. All-cause mortality generally decreased across the HDSS sites during this period, particularly for adults aged 20-59 years. In many of the HDSS sites, these decreases were driven by reductions in HIV and tuberculosis-related deaths. In 2010-14, the top causes of death were: road traffic accidents, HIV or tuberculosis, and meningitis or sepsis in adolescents (12-19 years); HIV or tuberculosis in adults aged 20-59 years; and neoplasms and cardiovascular disease in adults aged 60 years and older. There was greater between-HDSS and between-sex variation in causes of death for adolescents compared with adults. INTERPRETATION: This
AU  - Chu,Y
AU  - Marston,M
AU  - Dube,A
AU  - Festo,C
AU  - Geubbels,E
AU  - Gregson,S
AU  - Herbst,K
AU  - Kabudula,C
AU  - Kahn,K
AU  - Lutalo,T
AU  - Moorhouse,L
AU  - Newton,R
AU  - Nyamukapa,C
AU  - Makanga,R
AU  - Slaymaker,E
AU  - Urassa,M
AU  - Ziraba,A
AU  - Calvert,C
AU  - Clark,SJ
DO  - 10.1016/S2214-109X(24)00171-2
EP  - 1287
PY  - 2024///
SP  - 1278
TI  - Temporal changes in cause of death among adolescents and adults in six countries in eastern and southern Africa in 1995-2019: a multi-country surveillance study of verbal autopsy data.
T2  - Lancet Glob Health
UR  - http://dx.doi.org/10.1016/S2214-109X(24)00171-2
UR  - https://www.ncbi.nlm.nih.gov/pubmed/39030059
VL  - 12
ER  - 

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