Semaw Ferede Abera|Alemseged Aregay Gebru|Hans Konrad Biesalski|Gebisa Ejeta|Andreas Wienke|Veronika Scherbaum|Eva Johanna Kantelhardt
Social determinants of adult mortality from non-communicable diseases in northern Ethiopia, 2009-2015: Evidence from health and demographic surveillance site
Mekelle University|University of Hohenheim|Mekelle University|University of Hohenheim|Purdue University West Lafayette|Martin Luther University Halle-Wittenberg|University of Hohenheim|Martin Luther University Halle-Wittenberg
developing countries mortality disability noncommunicable diseases ncds rising considerably effect social determinants ncdsattributed mortality context developing countries poorly understood study examines burden socioeconomic determinants adult mortality attributed ncds eastern tigray ethiopiawe followed 45982 adults implementing community based dynamic cohort design recording mortality events september 2009 april 2015 physician review based verbal autopsy used identify probable causes death multivariable cox proportional hazards regression performed identify social determinants ncd mortalityacross 1937587 personyears recorded 1091 adult deaths compared communicable diseases ncds accounted slightly higher proportion adult deaths 33 vs 345 respectively incidence density rate idr ncd attributed mortality 1941 deaths idr 1941 95 ci 1754 2147 per 100000 personyears one hundred fiftyseven 418 68 181 34 9 376 ncd deaths due cardiovascular disease cancer renal failure respectively multivariable analysis age per 5year increase hr 135 95 ci 130 141 extended family nonfamily household members hr 286 95 ci 205 398 compared household heads associated significantly increased hazard ncd mortality although difference statistically significant compared poor adults wealthy 15 hr 085 95 ci 065 111 lower hazard mortality ncds hand literate adults hr 035 95 ci 013 09 significantly decreased hazard ncd attributed mortality compared adults unable read write effect literacy modified age effect reduced 18 every 5year increase age among literate adultsin summary study indicates double mortality burden ncds communicable diseases evident northern rural ethiopia public health intervention measures prioritise disadvantaged ncd patients unable read write elders extended family nonfamily household coresidents could significantly reduce ncd mortality among adult population