| 1. |
- Berhane, Yemane, et al.
(författare)
-
A rural Ethiopian population undergoing epidemiological transition over a generation : Butajira from 1987 to 2004
- 2008
-
Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 36:4, s. 436-441
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: To describe the epidemiological development of a rural Ethiopian population from 1987 to 2004 in terms of mortality and associated sociodemographic factors. Methods: A rural population comprising 10 communities was defined in 1987 and has since been followed by means of regular household visits. After an initial census, births, deaths and migration events were recorded, together with key background factors, on an open cohort basis. Over 97,000 individuals were observed during a total of over 700,000 person years. Results: The initial population of 28,614 increased by an average of 3.64% annually to 54,426 from 1987 to 2004, and also grew older on average. Birth and mortality rates fell, but were still subject to short-term variation due to external factors. Overall mortality was 13.5 per 1000 person years. Increasing mortality in some adult age groups was consistent with increasing AIDS-related deaths, but a new local hospital in 2002 may have contributed to later falls in overall mortality. Sex, age group, time period, literacy, water source, house ownership and distance to town were all significantly associated with mortality differentials. Conclusions: This population has undergone a complex epidemiological transition during a generation. Detailed long-term surveillance of this kind is essential for describing such processes. Many factors that significantly affect mortality cannot be directly controlled by the health sector and will only improve with general development.
|
|
| 2. |
- Berhane, Yemane, et al.
(författare)
-
Gender, literacy, and survival among Ethiopian adults, 1987 - 96.
- 2002
-
Ingår i: Bulletin of the World Health Organization. - 0042-9686 .- 1564-0604. ; 80:9, s. 714-20
-
Tidskriftsartikel (refereegranskat)abstract
- Special attention should be given to raising literacy levels among rural women with a view to improving their survival.
|
|
| 3. |
- Byass, Peter, et al.
(författare)
-
DSS and DHS : longitudinal and cross-sectional viewpoints on child and adolescent mortality in Ethiopia
- 2007
-
Ingår i: Population Health Metrics. - : BioMed Central (BMC). - 1478-7954. ; 5:1, s. Article nr 12-
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In countries where routine vital registration data are scarce, Demographic Surveillance Sites (DSS: locally defined populations under longitudinal surveillance for vital events and other characteristics) and Demographic and Health Surveys (DHS: periodic national cluster samples responding to cross-sectional surveys) have become standard approaches for gathering at least some data. This paper aims to compare DSS and DHS approaches, seeing how they complement each other in the specific instance of child and adolescent mortality in Ethiopia.METHODS: Data from the Butajira DSS 1987-2004 and the Ethiopia DHS rounds for 2000 and 2005 formed the basis of comparative analyses of mortality rates among those aged under 20 years, using Poisson regression models for adjusted rate ratios.RESULTS: Patterns of mortality over time were broadly comparable using DSS and DHS approaches. DSS data were more susceptible to local epidemic variations, while DHS data tended to smooth out local variation, and be more subject to recall bias.CONCLUSION: Both DSS and DHS approaches to mortality surveillance gave similar overall results, but both showed method-dependent advantages and disadvantages. In many settings, this kind of joint-source data analysis could offer significant added value to results.
|
|
| 4. |
|
|
| 5. |
- Byass, Peter, et al.
(författare)
-
Refining a probabilistic model for interpreting verbal autopsy data.
- 2006
-
Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 34:1, s. 26-31
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To build on the previously reported development of a Bayesian probabilistic model for interpreting verbal autopsy (VA) data, attempting to improve the model's performance in determining cause of death and to reassess it. Design: An expert group of clinicians, coming from a wide range geographically and in terms of specialization, was convened. Over a four-day period the content of the previous probabilistic model was reviewed in detail and adjusted as necessary to reflect the group consensus. The revised model was tested with the same 189 VA cases from Vietnam, assessed by two local clinicians, that were used to test the preliminary model. Results: The revised model contained a total of 104 indicators that could be derived from VA data and 34 possible causes of death. When applied to the 189 Vietnamese cases, 142 (75.1%) achieved concordance between the model's output and the previous clinical consensus. The remaining 47 cases (24.9%) were presented to a further independent clinician for reassessment. As a result, consensus between clinical reassessment and the model's output was achieved in 28 cases (14.8%); clinical reassessment and the original clinical opinion agreed in 8 cases (4.2%), and in the remaining 11 cases (5.8%) clinical reassessment, the model, and the original clinical opinion all differed. Thus overall the model was considered to have performed well in 170 cases (89.9%). Conclusions: This approach to interpreting VA data continues to show promise. The next steps will be to evaluate it against other sources of VA data. The expert group approach to determining the required probability base seems to have been a productive one in improving the performance of the model.
|
|
| 6. |
- Byass, Peter, et al.
(författare)
-
Spatio-temporal clustering of mortality in Butajira HDSS, Ethiopia, from 1987 to 2008
- 2010
-
Ingår i: Global Health Action. - : CoAction Publishing. - 1654-9716 .- 1654-9880. ; 3, s. 26-31
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Mortality in a population may be clustered in space and time for a variety of reasons, including geography, socio-economics, environment and demographics. Analysing mortality clusters can therefore reveal important insights into patterns and risks of mortality in a particular setting. Objective and design: To investigate the extent of spatio-temporal clustering of mortality in the Butajira District, Ethiopia, from 1987 to 2008. The Health and Demographic Surveillance System (HDSS) dataset recorded 10,696 deaths among 951,842 person-years of observation, with each death located by household, in which population time at risk was also recorded. The surveyed population increased from 28,614 in 1987 to 62,322 in 2008, in an area approximately 25 km in diameter. Spatio-temporal clustering analyses were conducted for overall mortality and by specific age groups, grouping the population into a 0.01° latitude-longitude grid. Results: A number of significantly high- and low-mortality clusters were identified at various times and places. Butajira town was characterised by significantly low mortality throughout the period. A previously documented major mortality crisis in 1998-1999, largely resulting from malaria and diarrhoea, dominated the clustering analysis. Other local high-mortality clusters, appreciably attributable to meningitis, malaria and diarrhoea, occurred in the earlier part of the period. In the later years, a more homogeneous distribution of mortality at lower rates was observed. Conclusions: Mortality was by no means randomly distributed in this community during the period of observation. The clustering analyses revealed a clear epidemiological transition, away from localised infectious epidemics, over a generation.
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
- Emmelin, Anders, et al.
(författare)
-
Vulnerability to episodes of extreme weather : Butajira, Ethiopia, 1998-1999
- 2009
-
Ingår i: Global Health Action. - Järfälla, Sweden : CoAction Publishing. - 1654-9716 .- 1654-9880. ; 2, s. 140-148
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: During 1999-2000, great parts of Ethiopia experienced a period of famine which was recognised internationally. The aim of this paper is to characterise the epidemiology of mortality of the period, making use of individual, longitudinal population-based data from the Butajira demographic surveillance site and rainfall data from a local site.METHODS: Vital statistics and household data were routinely collected in a cluster sample of 10 sub-communities in the Butajira district in central Ethiopia. These were supplemented by rainfall and agricultural data from the national reporting systems.RESULTS: Rainfall was high in 1998 and well below average in 1999 and 2000. In 1998, heavy rains continued from April into October, in 1999 the small rains failed and the big rains lasted into the harvesting period. For the years 1998-1999, the mortality rate was 24.5 per 1,000 person-years, compared with 10.2 in the remainder of the period 1997-2001. Mortality peaks reflect epidemics of malaria and diarrhoeal disease. During these peaks, mortality was significantly higher among the poorer.CONCLUSIONS: The analyses reveal a serious humanitarian crisis with the Butajira population during 1998-1999, which met the CDC guideline crisis definition of more than one death per 10,000 per day. No substantial humanitarian relief efforts were triggered, though from the results it seems likely that the poorest in the farming communities are as vulnerable as the pastoralists in the North and East of Ethiopia. Food insecurity and reliance on subsistence agriculture continue to be major issues in this and similar rural communities. Epidemics of traditional infectious diseases can still be devastating, given opportunities in nutritionally challenged populations with little access to health care.
|
|
| 10. |
|
|
