Causes of Death of Adults and Elderly and Healthcareseeking before Death in Rural Bangladesh.
Loading...
Date
2010-10
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
The health system of a country needs to be adjusted to patterns of morbidity and mortality to
mitigate the income-erosion consequences of prolonged ill-health and premature death of adults.
Population-based data on mortality by cause are a key to modifying the health system. However,
these data are scarce, particularly for rural populations in developing countries. The objectives of
this study were to determine the burdens of health due to major causes of death obtained from
verbal autopsy of adults and the elderly and their healthcare-seeking patterns before death in a welldefined
rural population. There were 2,397 deaths—613 were among adults aged 15-59 years and
1,784 among the elderly aged 60+ years—during 2003-2004 in the health and demographic surveillance
area in Matlab, a rural area of Bangladesh. Trained interviewers interviewed close relatives of
the deceased using a structured verbal-autopsy questionnaire to record signs and symptoms of diseases/
conditions that led to death and medical consultations before death. Two physicians independently
assigned the underlying causes of deaths with disagreements resolved by a third physician.
The physicians were able to assign a specific cause in 91% of the cases. Rates and proportions were
used for estimating the burden of diseases by cause. Of all deaths of adults and the elderly, communicable
diseases accounted for 18% and non-communicable diseases for 66%, with the proportion of
non-communicable diseases increasing with age. Leading non-communicable diseases were diseases
of the circulatory system (35%), neoplasms (11%), diseases of the respiratory system (10%), diseases
of the digestive system (6%), and endocrine and metabolic disorders (6%), all of which accounted for
68% of deaths. Injury and other external causes accounted for another 5% of the deaths. During
terminal illness, 31% of the adults and 25% of the elderly sought treatment from medical doctors,
and 14% of the adults and 4% of the elderly died in healthcare facilities. The findings suggest
that the health managers and policy-makers of Bangladesh should recognize the importance of prevention
and management of chronic diseases and place it on the health agenda for rural people.
Description
Keywords
Adult, Causes of death, Elderly, Healthcare-seeking behaviour, Mortality, Rural health, Bangladesh
Citation
Alam Nurul, Chowdhury Hafizur Rahman, Bhuiyan Monirul Alam, Streatfield Peter Kim. Causes of Death of Adults and Elderly and Healthcareseeking before Death in Rural Bangladesh. Journal of Health, Population and Nutrition. 2010 Oct; 28(5): 520-528.