Mortality of neurological disorders in Tanzania: analysis of baseline data from sample vital registration with verbal autopsy (SAVVY)

Francis Levira; Charles R Newton; Honorati Masanja; Peter Odermatt

doi:10.1080/16549716.2019.1596378

Mortality of neurological disorders in Tanzania: analysis of baseline data from sample vital registration with verbal autopsy (SAVVY)

Glob Health Action. 2019;12(1):1596378. doi: 10.1080/16549716.2019.1596378.

Authors

Francis Levira^{1

2

3}, Charles R Newton^{4

5}, Honorati Masanja³, Peter Odermatt^{1

2}

Affiliations

¹ a Department of Epidemiology and Public Health , Swiss Tropical and Public Health Institute , Basel , Switzerland.
² b University of Basel , Basel , Switzerland.
³ c Health Systems, Impact Evaluation, and Policy , Ifakara Health Institute , Dar-es-Salaam , Tanzania.
⁴ d Kenya Medical Research Programme-Wellcome Trust Collaborative Programme , Kilifi , Kenya.
⁵ e Department of Psychiatry , University of Oxford , Oxford , UK.

Abstract

Background: Neurological disorders (ND) have a profound consequence on human productivity, quality of life and survival. There are limited data on the burden of ND in Tanzania due to insufficient coverage of civil and vital registration systems. Objectives: This study was conducted to estimate mortality of ND in all ages in Tanzania using data from the Sample Vital Registration with Verbal Autopsy (SAVVY) study. Methods: Multistage random sampling was employed to select 23 districts, 1397 census enumeration areas and 154,603 households. During the baseline survey conducted between 2011 and 2014, deaths which occurred 12 months prior to the baseline survey were documented followed by verbal autopsy interviews. Causes of death were certified using International Classification of Diseases. Results: The baseline survey enrolled a total of 650,864 residents. A total of 6645 deaths were reported to have occurred 12 months before the date of survey. Death certification was available for 5225 (79%) deaths. The leading causes of death were cerebrovascular diseases with a cause-specific mortality fraction (CSMF) of 1.64% (95% CI: 1.30-1.99) and 3.82% (95% CI: 2.92-4.72) in all ages and adults older than 50 years, respectively. Stroke accounted for 92% of all cerebrovascular deaths. Mortality of epilepsy was estimated with a CSMF of 0.94% (95% CI: 0.68-1.20); meningitis with a CSMF of 0.80% (95% CI: 0.56-1.04); cerebral palsy and other paralytic syndromes with a CSMF of 0.46% (95% CI: 0.27-0.65); and intrauterine hypoxia in neonates with a CSMF of 2.06% (95% CI: 1.12-3.01). Overall, mortality of ND was estimated with a CSMF of 4.99% (95% CI: 4.40-5.58). Conclusions: The SAVVY survey provides estimates of mortality burden of ND in Tanzania. The study provides a basis for monitoring trends of ND and contributes to advancing knowledge of the burden of diseases. Integrating morbidities measures into the SAVVY design will provide comprehensive measures of burden of ND taking into account lifetime disabilities created by ND.

Keywords: Cerebrovascular; cerebral palsy; epilepsy; intrauterine hypoxia; meningitis.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Autopsy / statistics & numerical data*
Cause of Death*
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Nervous System Diseases / epidemiology*
Nervous System Diseases / mortality*
Rural Population / statistics & numerical data
Surveys and Questionnaires
Tanzania / epidemiology
Urban Population / statistics & numerical data
Vital Statistics*
Young Adult

Grants and funding

The SAVVY work was funded by Center for Disease Control Prevention (CDC), Global Fund, and the Ifakara Health Institute core resources; with support from the governments of the UK; Switzerland; Norway; and Ireland. Training and data analysis funding were provided by City and Canton of Basel, Switzerland, and Training Unit of Ifakara Health Institute Tanzania.