Causes of death in the Taabo health and demographic surveillance system, Côte d'Ivoire, from 2009 to 2011

Siaka Koné, Thomas Fürst, Fabienne N Jaeger, Emmanuel L J C Esso, Nahoua Baïkoro, Kouamé A Kouadio, Lukas G Adiossan, Fabien Zouzou, Louis I Boti, Marcel Tanner, Jürg Utzinger, Bassirou Bonfoh, Daouda Dao, Eliézer K N'Goran, Siaka Koné, Thomas Fürst, Fabienne N Jaeger, Emmanuel L J C Esso, Nahoua Baïkoro, Kouamé A Kouadio, Lukas G Adiossan, Fabien Zouzou, Louis I Boti, Marcel Tanner, Jürg Utzinger, Bassirou Bonfoh, Daouda Dao, Eliézer K N'Goran

Abstract

Background: Current vital statistics from governmental institutions in Côte d'Ivoire are incomplete. This problem is particularly notable for remote rural areas that have limited access to the health system.

Objective: To record all deaths from 2009 to 2011 and to identify the leading causes of death in the Taabo health and demographic surveillance system (HDSS) in south-central Côte d'Ivoire.

Design: Deaths recorded in the first 3 years of operation of the Taabo HDSS were investigated by verbal autopsy (VA), using the InterVA-4 model. InterVA-4 is based on the World Health Organization 2012 VA tool in terms of input indicators and categories of causes of death.

Results: Overall, 948 deaths were recorded, of which 236 (24.9%) had incomplete VA data. Among the 712 deaths analyzed, communicable diseases represented the leading causes (58.9%), with most deaths attributed to malaria (n=129), acute respiratory tract infections (n=110), HIV/AIDS (n=80), and pulmonary tuberculosis (n=46). Non-communicable diseases accounted for 18.9% of the deaths and included mainly acute abdomen (n=38), unspecified cardiac diseases (n=15), and digestive neoplasms (n=13). Maternal and neonatal conditions accounted for 8.3% of deaths, primarily pneumonia (n=19) and birth asphyxia (n=16) in newborns. Among the 3.8% of deaths linked to trauma and injury, the main causes were assault (n=6), accidental drowning (n=4), contact with venomous plants/animals (n=4), and traffic-related accidents (n=4). No clear causes were determined in 10.0% of the analyzed deaths.

Conclusions: Communicable diseases remain the predominant cause of death in rural Côte d'Ivoire. Based on these findings, measures are now being implemented in the Taabo HDSS. It will be interesting to monitor patterns of mortality and causes of death in the face of rapid demographic and epidemiological transitions in this part of West Africa.

Keywords: Côte d'Ivoire; InterVA-4; cause of death; health and demographic surveillance system; mortality; verbal autopsy.

Figures

Fig. 1
Fig. 1
Flow chart detailing the operational result of verbal autopsies in the Taabo HDSS, 2009–2011. The total number of deaths recorded, reasons for exclusion from the present analysis, and the final study sample with complete verbal autopsy data are highlighted.

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Source: PubMed

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