Adult deaths and the future: A cause specific analysis of adult deaths from a longitudinal study in rural Tanzania, 2003 – 2007

Objective To determine patterns and risk factors for cause-specific adult mortality in rural southern Tanzania. Method The study was a longitudinal open cohort and focused on adults aged 15–59 yrs from 2003 to 2007. Causes of deaths were ascertained by VA. Cox proportion hazards regression model was used to determine factors associated with cause-specific mortality over the 5-year. Results 1352 of 65548 adults died, representing a crude AMR of 7.3 per 1000PYO. HIV⁄AIDS [231(20.4%)] was the leading cause of death followed by malaria [150(13.2%)]. AMR for CD causes was 2.49 per 1000PYO, 1.21 per 1000PYO for NCD and 0.53 per 1000PYO for accidents⁄injury causes. NCD deaths increased from 16% in 2003 to 24% in 2007. High level of education was associated with a reduction in the risk of dying from NCDs. Those with primary education (HR=0.67, 95% CI:0.49, 0.92) and with education beyond primary school (HR=0.11, 95% CI:0.02, 0.40) had lower mortality than those who had no education. Compared with local residents, in-migrants were 1.7(95% CI:1.37, 2.11) times more likely to die from CD causes. Conclusion NCDs are increasing as a result of demographic and epidemiological transitions taking place in most African countries including Tanzania and require attention to prevent increased triple disease burden of CD, NCD and accident ⁄ injuries.