Change search
ReferencesLink to record
Permanent link

Direct link
Two decades of mortality change in rural northeast South Africa
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Show others and affiliations
2014 (English)In: Global health action, ISSN 1654-9880, E-ISSN 1654-9880, Vol. 7, 25596- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The MRC/Wits University Agincourt research centre, part of the INDEPTH Network, has documented mortality in a defined population in the rural northeast of South Africa for 20 years (1992-2011) using long-term health and socio-demographic surveillance. Detail on the unfolding, at times unpredicted, mortality pattern has been published. This experience is reviewed here and updated using more recent data.

OBJECTIVE: To present a review and summary of mortality patterns across all age-sex groups in the Agincourt sub-district population for the period 1992-2011 as a comprehensive basis for public health action.

DESIGN: Vital events in the Agincourt population have been updated in annual surveys undertaken since 1992. All deaths have been rigorously recorded and followed by verbal autopsy interviews. Responses to questions from these interviews have been processed retrospectively using the WHO 2012 verbal autopsy standard and the InterVA-4 model for assigning causes of death in a standardised manner.

RESULTS: Between 1992 and 2011, a total of 12,209 deaths were registered over 1,436,195 person-years of follow-up, giving a crude mortality rate of 8.5 per 1,000 person-years. During the 20-year period, the population experienced a major HIV epidemic, which resulted in more than doubling of overall mortality for an extended period. Recent years show signs of declining mortality, but levels remain above the 1992 baseline recorded using the surveillance system.

CONCLUSIONS: The Agincourt population has experienced a major mortality shock over the past two decades from which it will take time to recover. The basic epidemic patterns are consistent with generalised mortality patterns observed in South Africa as a whole, but the detailed individual surveillance behind these analyses allows finer-grained analyses of specific causes, age-related risks, and trends over time. These demonstrate the complex, somewhat unpredicted course of mortality transition over the years since the dawn of South Africa's democratic era in 1994.

Place, publisher, year, edition, pages
2014. Vol. 7, 25596- p.
Keyword [en]
Africa, Agincourt, rural, mortality, HIV/AIDS, tuberculosis, INDEPTH Network, verbal autopsy, InterVA, non-communicable diseases
National Category
Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:umu:diva-97432DOI: 10.3402/gha.v7.25596PubMedID: 25377343OAI: diva2:772808
Wellcome trust, 058893/Z/99/AWellcome trust, 069683/Z/02/ZWellcome trust, 085477/Z/08/Z
Available from: 2014-12-17 Created: 2014-12-17 Last updated: 2015-04-29Bibliographically approved

Open Access in DiVA

fulltext(372 kB)57 downloads
File information
File name FULLTEXT01.pdfFile size 372 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Tollman, StephenMee, PaulKahn, KathleenByass, Peter
By organisation
Epidemiology and Global Health
In the same journal
Global health action
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar
Total: 57 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 51 hits
ReferencesLink to record
Permanent link

Direct link