Causes of death in Africa: a review.

The paper summarizes studies of causes of death in sub-Saharan Africa. Studies included those that reported cause of death methodology the age groups the place of the study and the time period. Only one study was selected when multiple studies of the same data set were available. The study sample began with 73 research reports that came from 23 countries in sub-Saharan Africa. 20 studies were eliminated because the age groups did not correspond to 0-4 5-14 15+ and 15-49 years. All studies from South Africa were excluded. The final sample included 48 studies from about 16 countries and 62 data sets. Findings grouped by major causes of death indicate that 35% were based on hospital records alone 35% were based on verbal autopsy reports and 10% were based on both methods. 42% of studies were on maternal mortality and 38% focused on childhood mortality. The fewest studies were conducted in Central Africa 35 studies pertained to West Africa and 24 studies pertained to East Africa. About 16-17% of births resulted in childhood mortality (under 5 years). The leading cause of death was respiratory infections (14% of deaths in all studies) followed closely by diarrhea (13%) and malnutrition and anemia (12%). Diarrhea was the leading cause of death in verbal autopsy studies. Malnutrition was the leading cause in vital statistics reports. Infectious diseases were the leading cause regardless of data collection method. The UN estimated 12% of children aged 5-14 years died during 1990-95 in Africa. Infectious disease was the main general cause and malaria (12%) was the leading specific cause followed by diarrhea (10%) malnutrition (9%) and accidents and violence (9%). AIDS (25) was the leading cause of death among adults followed by malaria (8%) and tuberculosis (7.3%). The major cause of maternal deaths (based mostly on hospital records) was hemorrhage (19%) followed by infection (13%) hypertension (7.8%) and ruptured uterus (7%). Africa has the highest risk of maternal death.