Chronic diseases now a leading cause of death in rural India - Mortality data from the Andhra Pradesh Rural Health Initiative

Rohina Joshi, Magnolia Cardona, Srinivas Iyengar, A. Sukumar, C. Ravi Raju, K. Rama Raju, Krishnam Raju, K. Srinath Reddy, Alan Lopez, Bruce Neal

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195 Citations (Scopus)

Abstract

Introduction: India is undergoing rapid epidemiological transition as a consequence of economic and social change. The pattern of mortality is a key indicator of the consequent health effects but up-to-date, precise, and reliable statistics are few, particularly in rural areas. Methods: Deaths occurring in 45 villages (population 180 162) were documented during a 12-month period in 2003-04 by multipurpose primary healthcare workers trained in the use of a verbal autopsy tool. Algorithms were used to define causes of death according to a limited list derived from the international classification of disease version 10. Causes were assigned by two independent physicians with disagreements resolved by a third. Results: A total of 1354 deaths were recorded with verbal autopsies completed for 98%. A specific underlying cause of death was assigned for 82% of all verbal autopsies done. The crude death rate was 7.5/1000 (95% confidence interval, 7.1-7.9). Diseases of the circulatory system were the leading causes of mortality (32%), with similar proportions of deaths attributable to ischaemic heart disease and stroke. Second was injury and external causes of mortality (13%) with one-third of these deaths attributable to deliberate self harm. Third were infectious and parasitic diseases (12%). Tuberculosis and intestinal conditions each caused one-third of deaths within this category. HIV was assigned as the cause for 2% of all deaths. The fourth and fifth leading causes of death were neoplasms (7%) and diseases of the respiratory system (5%). Conclusion: Non-communicable and chronic diseases are the leading causes of death in this part of rural India. The observed pattern of death is unlikely to be unique to these villages and provides new insight into the rapid progression of epidemiological transition in rural India.

Original languageEnglish
Pages (from-to)1522-1529
Number of pages8
JournalInternational Journal of Epidemiology
Volume35
Issue number6
DOIs
Publication statusPublished - 1 Dec 2006
Externally publishedYes

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Rural Health
India
Cause of Death
Chronic Disease
Mortality
Autopsy
Self-Injurious Behavior
Parasitic Diseases
International Classification of Diseases
Cardiovascular System
Social Change
Respiratory System
Myocardial Ischemia
Communicable Diseases
Primary Health Care
Tuberculosis
Stroke
Economics
HIV
Confidence Intervals

Cite this

Joshi, Rohina ; Cardona, Magnolia ; Iyengar, Srinivas ; Sukumar, A. ; Raju, C. Ravi ; Raju, K. Rama ; Raju, Krishnam ; Reddy, K. Srinath ; Lopez, Alan ; Neal, Bruce. / Chronic diseases now a leading cause of death in rural India - Mortality data from the Andhra Pradesh Rural Health Initiative. In: International Journal of Epidemiology. 2006 ; Vol. 35, No. 6. pp. 1522-1529.
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abstract = "Introduction: India is undergoing rapid epidemiological transition as a consequence of economic and social change. The pattern of mortality is a key indicator of the consequent health effects but up-to-date, precise, and reliable statistics are few, particularly in rural areas. Methods: Deaths occurring in 45 villages (population 180 162) were documented during a 12-month period in 2003-04 by multipurpose primary healthcare workers trained in the use of a verbal autopsy tool. Algorithms were used to define causes of death according to a limited list derived from the international classification of disease version 10. Causes were assigned by two independent physicians with disagreements resolved by a third. Results: A total of 1354 deaths were recorded with verbal autopsies completed for 98{\%}. A specific underlying cause of death was assigned for 82{\%} of all verbal autopsies done. The crude death rate was 7.5/1000 (95{\%} confidence interval, 7.1-7.9). Diseases of the circulatory system were the leading causes of mortality (32{\%}), with similar proportions of deaths attributable to ischaemic heart disease and stroke. Second was injury and external causes of mortality (13{\%}) with one-third of these deaths attributable to deliberate self harm. Third were infectious and parasitic diseases (12{\%}). Tuberculosis and intestinal conditions each caused one-third of deaths within this category. HIV was assigned as the cause for 2{\%} of all deaths. The fourth and fifth leading causes of death were neoplasms (7{\%}) and diseases of the respiratory system (5{\%}). Conclusion: Non-communicable and chronic diseases are the leading causes of death in this part of rural India. The observed pattern of death is unlikely to be unique to these villages and provides new insight into the rapid progression of epidemiological transition in rural India.",
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Chronic diseases now a leading cause of death in rural India - Mortality data from the Andhra Pradesh Rural Health Initiative. / Joshi, Rohina; Cardona, Magnolia; Iyengar, Srinivas; Sukumar, A.; Raju, C. Ravi; Raju, K. Rama; Raju, Krishnam; Reddy, K. Srinath; Lopez, Alan; Neal, Bruce.

In: International Journal of Epidemiology, Vol. 35, No. 6, 01.12.2006, p. 1522-1529.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Chronic diseases now a leading cause of death in rural India - Mortality data from the Andhra Pradesh Rural Health Initiative

AU - Joshi, Rohina

AU - Cardona, Magnolia

AU - Iyengar, Srinivas

AU - Sukumar, A.

AU - Raju, C. Ravi

AU - Raju, K. Rama

AU - Raju, Krishnam

AU - Reddy, K. Srinath

AU - Lopez, Alan

AU - Neal, Bruce

PY - 2006/12/1

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N2 - Introduction: India is undergoing rapid epidemiological transition as a consequence of economic and social change. The pattern of mortality is a key indicator of the consequent health effects but up-to-date, precise, and reliable statistics are few, particularly in rural areas. Methods: Deaths occurring in 45 villages (population 180 162) were documented during a 12-month period in 2003-04 by multipurpose primary healthcare workers trained in the use of a verbal autopsy tool. Algorithms were used to define causes of death according to a limited list derived from the international classification of disease version 10. Causes were assigned by two independent physicians with disagreements resolved by a third. Results: A total of 1354 deaths were recorded with verbal autopsies completed for 98%. A specific underlying cause of death was assigned for 82% of all verbal autopsies done. The crude death rate was 7.5/1000 (95% confidence interval, 7.1-7.9). Diseases of the circulatory system were the leading causes of mortality (32%), with similar proportions of deaths attributable to ischaemic heart disease and stroke. Second was injury and external causes of mortality (13%) with one-third of these deaths attributable to deliberate self harm. Third were infectious and parasitic diseases (12%). Tuberculosis and intestinal conditions each caused one-third of deaths within this category. HIV was assigned as the cause for 2% of all deaths. The fourth and fifth leading causes of death were neoplasms (7%) and diseases of the respiratory system (5%). Conclusion: Non-communicable and chronic diseases are the leading causes of death in this part of rural India. The observed pattern of death is unlikely to be unique to these villages and provides new insight into the rapid progression of epidemiological transition in rural India.

AB - Introduction: India is undergoing rapid epidemiological transition as a consequence of economic and social change. The pattern of mortality is a key indicator of the consequent health effects but up-to-date, precise, and reliable statistics are few, particularly in rural areas. Methods: Deaths occurring in 45 villages (population 180 162) were documented during a 12-month period in 2003-04 by multipurpose primary healthcare workers trained in the use of a verbal autopsy tool. Algorithms were used to define causes of death according to a limited list derived from the international classification of disease version 10. Causes were assigned by two independent physicians with disagreements resolved by a third. Results: A total of 1354 deaths were recorded with verbal autopsies completed for 98%. A specific underlying cause of death was assigned for 82% of all verbal autopsies done. The crude death rate was 7.5/1000 (95% confidence interval, 7.1-7.9). Diseases of the circulatory system were the leading causes of mortality (32%), with similar proportions of deaths attributable to ischaemic heart disease and stroke. Second was injury and external causes of mortality (13%) with one-third of these deaths attributable to deliberate self harm. Third were infectious and parasitic diseases (12%). Tuberculosis and intestinal conditions each caused one-third of deaths within this category. HIV was assigned as the cause for 2% of all deaths. The fourth and fifth leading causes of death were neoplasms (7%) and diseases of the respiratory system (5%). Conclusion: Non-communicable and chronic diseases are the leading causes of death in this part of rural India. The observed pattern of death is unlikely to be unique to these villages and provides new insight into the rapid progression of epidemiological transition in rural India.

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U2 - 10.1093/ije/dyl168

DO - 10.1093/ije/dyl168

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SN - 0300-5771

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