Mortality transition over a quarter century in rural South Africa: findings from population surveillance in Agincourt 1993-2018
Background Mortality burden in South Africa since the mid-1990s has been characterized by a quadruple disease burden: HIV/AIDS and tuberculosis (TB); other communicable diseases (excluding HIV/AIDS and TB), maternal causes, perinatal conditions and nutritional deficiencies; non-communicable diseases...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2021-10-01
|
| Series: | Global Health Action |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/16549716.2021.1990507 |
| _version_ | 1828839394682863616 |
|---|---|
| author | Chodziwadziwa Whiteson Kabudula Brian Houle Daniel Ohene-Kwofie Daniel Mahlangu Nawi Ng Hoang Van Minh Francesc Xavier Gómez-Olivé Stephen Tollman Kathleen Kahn |
| author_facet | Chodziwadziwa Whiteson Kabudula Brian Houle Daniel Ohene-Kwofie Daniel Mahlangu Nawi Ng Hoang Van Minh Francesc Xavier Gómez-Olivé Stephen Tollman Kathleen Kahn |
| author_sort | Chodziwadziwa Whiteson Kabudula |
| collection | DOAJ |
| description | Background Mortality burden in South Africa since the mid-1990s has been characterized by a quadruple disease burden: HIV/AIDS and tuberculosis (TB); other communicable diseases (excluding HIV/AIDS and TB), maternal causes, perinatal conditions and nutritional deficiencies; non-communicable diseases (NCDs); and injuries. Causes from these broad groupings have persistently constituted the top 10 causes of death. However, proportions and rankings have varied over time, alongside overall mortality levels. Objective To provide evidence on the contributions of age and cause-of-death to changes in mortality levels in a rural South African population over a quarter century (1993–2018). Methods Using mortality and cause-of-death data from the Agincourt Health and Socio-Demographic Surveillance System (HDSS), we derive estimates of the distribution of deaths by cause, and hazards of death by age, sex, and time period, 1993–2018. We derive estimates of life expectancies at birth and years of life expectancy gained at age 15 if most common causes of death were deleted. We compare mortality indicators and cause-of-death trends from the Agincourt HDSS with South African national indicators generated from publicly available datasets. Results Mortality and cause-of-death transition reveals that overall mortality levels have returned to pre-HIV epidemic levels. In recent years, the concentration of mortality has shifted towards older ages, and the mortality burden from cardiovascular diseases and other chronic NCDs are more prominent as people living with HIV/AIDS access ART and live longer. Changes in life expectancy at birth, distribution of deaths by age, and major cause-of-death categories in the Agincourt population follow a similar pattern to the South African population. Conclusion The Agincourt HDSS provides critical information about general mortality, cause-of-death, and age patterns in rural South Africa. Realigning and strengthening the South African public health and healthcare systems is needed to concurrently cater for the prevention, control, and treatment of multiple disease conditions. |
| first_indexed | 2024-12-12T19:21:58Z |
| format | Article |
| id | doaj.art-ac1da46389b04477b4570fc23c11ee85 |
| institution | Directory Open Access Journal |
| issn | 1654-9880 |
| language | English |
| last_indexed | 2024-12-12T19:21:58Z |
| publishDate | 2021-10-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj.art-ac1da46389b04477b4570fc23c11ee852022-12-22T00:14:35ZengTaylor & Francis GroupGlobal Health Action1654-98802021-10-0114S110.1080/16549716.2021.19905071990507Mortality transition over a quarter century in rural South Africa: findings from population surveillance in Agincourt 1993-2018Chodziwadziwa Whiteson Kabudula0Brian Houle1Daniel Ohene-Kwofie2Daniel Mahlangu3Nawi Ng4Hoang Van Minh5Francesc Xavier Gómez-Olivé6Stephen Tollman7Kathleen Kahn8University of the WitwatersrandUniversity of the WitwatersrandUniversity of the WitwatersrandUniversity of the WitwatersrandUmeå UniversityHanoi University of Public HealthUniversity of the WitwatersrandUniversity of the WitwatersrandUniversity of the WitwatersrandBackground Mortality burden in South Africa since the mid-1990s has been characterized by a quadruple disease burden: HIV/AIDS and tuberculosis (TB); other communicable diseases (excluding HIV/AIDS and TB), maternal causes, perinatal conditions and nutritional deficiencies; non-communicable diseases (NCDs); and injuries. Causes from these broad groupings have persistently constituted the top 10 causes of death. However, proportions and rankings have varied over time, alongside overall mortality levels. Objective To provide evidence on the contributions of age and cause-of-death to changes in mortality levels in a rural South African population over a quarter century (1993–2018). Methods Using mortality and cause-of-death data from the Agincourt Health and Socio-Demographic Surveillance System (HDSS), we derive estimates of the distribution of deaths by cause, and hazards of death by age, sex, and time period, 1993–2018. We derive estimates of life expectancies at birth and years of life expectancy gained at age 15 if most common causes of death were deleted. We compare mortality indicators and cause-of-death trends from the Agincourt HDSS with South African national indicators generated from publicly available datasets. Results Mortality and cause-of-death transition reveals that overall mortality levels have returned to pre-HIV epidemic levels. In recent years, the concentration of mortality has shifted towards older ages, and the mortality burden from cardiovascular diseases and other chronic NCDs are more prominent as people living with HIV/AIDS access ART and live longer. Changes in life expectancy at birth, distribution of deaths by age, and major cause-of-death categories in the Agincourt population follow a similar pattern to the South African population. Conclusion The Agincourt HDSS provides critical information about general mortality, cause-of-death, and age patterns in rural South Africa. Realigning and strengthening the South African public health and healthcare systems is needed to concurrently cater for the prevention, control, and treatment of multiple disease conditions.http://dx.doi.org/10.1080/16549716.2021.1990507south africamortalityverbal autopsynon- communicable diseases (ncds)health and socio-demographic surveillance system (hdss) |
| spellingShingle | Chodziwadziwa Whiteson Kabudula Brian Houle Daniel Ohene-Kwofie Daniel Mahlangu Nawi Ng Hoang Van Minh Francesc Xavier Gómez-Olivé Stephen Tollman Kathleen Kahn Mortality transition over a quarter century in rural South Africa: findings from population surveillance in Agincourt 1993-2018 Global Health Action south africa mortality verbal autopsy non- communicable diseases (ncds) health and socio-demographic surveillance system (hdss) |
| title | Mortality transition over a quarter century in rural South Africa: findings from population surveillance in Agincourt 1993-2018 |
| title_full | Mortality transition over a quarter century in rural South Africa: findings from population surveillance in Agincourt 1993-2018 |
| title_fullStr | Mortality transition over a quarter century in rural South Africa: findings from population surveillance in Agincourt 1993-2018 |
| title_full_unstemmed | Mortality transition over a quarter century in rural South Africa: findings from population surveillance in Agincourt 1993-2018 |
| title_short | Mortality transition over a quarter century in rural South Africa: findings from population surveillance in Agincourt 1993-2018 |
| title_sort | mortality transition over a quarter century in rural south africa findings from population surveillance in agincourt 1993 2018 |
| topic | south africa mortality verbal autopsy non- communicable diseases (ncds) health and socio-demographic surveillance system (hdss) |
| url | http://dx.doi.org/10.1080/16549716.2021.1990507 |
| work_keys_str_mv | AT chodziwadziwawhitesonkabudula mortalitytransitionoveraquartercenturyinruralsouthafricafindingsfrompopulationsurveillanceinagincourt19932018 AT brianhoule mortalitytransitionoveraquartercenturyinruralsouthafricafindingsfrompopulationsurveillanceinagincourt19932018 AT danielohenekwofie mortalitytransitionoveraquartercenturyinruralsouthafricafindingsfrompopulationsurveillanceinagincourt19932018 AT danielmahlangu mortalitytransitionoveraquartercenturyinruralsouthafricafindingsfrompopulationsurveillanceinagincourt19932018 AT nawing mortalitytransitionoveraquartercenturyinruralsouthafricafindingsfrompopulationsurveillanceinagincourt19932018 AT hoangvanminh mortalitytransitionoveraquartercenturyinruralsouthafricafindingsfrompopulationsurveillanceinagincourt19932018 AT francescxaviergomezolive mortalitytransitionoveraquartercenturyinruralsouthafricafindingsfrompopulationsurveillanceinagincourt19932018 AT stephentollman mortalitytransitionoveraquartercenturyinruralsouthafricafindingsfrompopulationsurveillanceinagincourt19932018 AT kathleenkahn mortalitytransitionoveraquartercenturyinruralsouthafricafindingsfrompopulationsurveillanceinagincourt19932018 |