Adult non-communicable disease mortality in Africa and Asia: Evidence from INDEPTH Health and Demographic Surveillance System sites

P. Kim Streatfield, Wasif A. Khan, Abbas Bhuiya, Syed M.A. Hanifi, Nurul Alam, Cheik H. Bagagnan, Ali Sié, Pascal Zabré, Bruno Lankoandé, Clementine Rossier, Abdramane B. Soura, Bassirou Bonfoh, Siaka Kone, Eliezer K. Ngoran, Juerg Utzinger, Fisaha Haile, Yohannes A. Melaku, Berhe Weldearegawi, Pierre Gomez, Momodou JassehPatrick Ansah, Cornelius Debpuur, Abraham Oduro, George Wak, Alexander Adjei, Margaret Gyapong, Doris Sarpong, Shashi Kant, Puneet Misra, Sanjay K. Rai, Sanjay Juvekar, Pallavi Lele, Evasius Bauni, George Mochamah, Carolyne Ndila, Thomas N. Williams, Kayla F. Laserson, Amek Nyaguara, Frank O. Odhiambo, Penelope Phillips-Howard, Alex Ezeh, Catherine Kyobutungi, Samuel Oti, Amelia Crampin, Moffat Nyirenda, Alison Price, Valérie Delaunay, Aldiouma Diallo, Laetitia Douillot, Cheikh Sokhna, F. Xavier Gómez-Olivé, Kathleen Kahn, Stephen M. Tollman, Kobus Herbst, Joël Mossong, Nguyen T.K. Chuc, Martin Bangha, Osman A. Sankoh, Peter Byass

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)


Background: Mortality from non-communicable diseases (NCDs) is a major global issue, as other categories of mortality have diminished and life expectancy has increased. TheWorld Health Organization's Member States have called for a 25% reduction in prematureNCDmortality by 2025,which can only be achieved by substantial reductions in risk factors and improvements in the management of chronic conditions. A high burden of NCD mortality among much older people, who have survived other hazards, is inevitable. The INDEPTH Network collects detailed individual data within defined Health and Demographic Surveillance sites. By registering deaths and carrying out verbal autopsies to determine cause of death across many such sites, using standardised methods, the Network seeks to generate population-based mortality statistics that are not otherwise available. Objective: To describe patterns of adult NCD mortality from INDEPTH Network sites across Africa and Asia, according to the WHO 2012 verbal autopsy (VA) cause categories, with separate consideration of premature (15-64 years) and older (65+ years) NCD mortality. Design: All adult deaths at INDEPTH sites are routinely registered and followed up with VA interviews. For this study, VA archives were transformed into the WHO 2012 VA standard format and processed using the InterVA-4 model to assign cause of death. Routine surveillance data also provide person-time denominators for mortality rates. Results: A total of 80,726 adult (over 15 years) deaths were documented over 7,423,497 person-years of observation. NCDs were attributed as the cause for 35.6% of these deaths. Slightly less than half of adult NCD deaths occurred in the 15-64 age group. Detailed results are presented by age and sex for leading causes ofNCD mortality. Per-site rates ofNCDmortalitywere significantly correlated with rates ofHIV/AIDS-relatedmortality. Conclusions: These findings present important evidence on the distribution of NCD mortality across a wide range of African and Asian settings. This comes against a background of global concern about the burden of NCD mortality, especially among adults aged under 70, and provides an important baseline for future work.

Original languageEnglish
Article number25365
JournalGlobal Health Action
Issue number1
Publication statusPublished or Issued - 2014


  • Adults
  • Africa
  • Asia
  • Indepth network
  • InterVA
  • Mortality
  • Non-communicable disease
  • Verbal autopsy

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this