The Epidemiologic Transition for three decades in the Butajira community, South-Central Ethiopia: using Butajira HDSS database

Abstract

AbstractBackground: Health and Demographic Surveillance System sites are the primary source of community-based death and cause of death data, providing essential policy inputs. Currently, many African countries, including Ethiopia, have undergone different stages of epidemiological transition.Objective: To assess the epidemiologic transition in the Butajira community in south-central Ethiopia.Methods: All deaths registered in the Butajira Health and Demographic Surveillance System databases were included. The trend in the overall mortality rate and the change in the proportion of major causes of death were evaluated, and significant trends were checked using the Mann-Kendall statistical test with significance set at P< 0.05.Results: The overall mortality rate per 1000 population declined from 9.8 in 1987 to 2.8 in 2016. The decline was significant (tau, the measure of the strength and direction of association,= -0.76, p-value <0.05). During this study period, 2610 deaths were registered in the Health and Demographic Surveillance System database, of which 1,625 were adults. The proportion of yearly deaths attributed to communicable diseases, maternal and perinatal conditions, and nutritional deficiencies showed a significant decline (tau = -0.727, p < 0.05), while there was a significant increase in non-communicable diseases (tau = 0.469, p < 0.05), and a rise in external causes (tau = 0.0953, p > 0.05). Furthermore, there were notable changes in the death proportion in the top five leading causes of death, showing a transition in the epidemiology of major causes of death, especially in the age group 15+.Conclusion: The decline in mortality and burden shift implies the existence of an epidemiological transition. This transition necessitates policymakers to design a responsive health system that cater to the population undergoing this epidemiological transition. [Ethiop. J. Health Dev. 2023; 37(3) 000-000] Keywords: Cause of death; Epidemiological transition; Mortality, Trend