Mortality from external causes 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, Eric Diboulo, Louis Niamba, Ali Sié, Bruno Lankoandé, Roch Millogo, Abdramane B. Soura, Bassirou Bonfoh, Siaka Kone, Eliezer K. Ngoran, Juerg Utzinger, Yemane Ashebir, Yohannes A. Melaku, Berhe Weldearegawi, Pierre Gomez, Momodou JassehDaniel Azongo, Abraham Oduro, George Wak, Peter Wontuo, Mary Attaa-Pomaa, Margaret Gyapong, Alfred K. Manyeh, Shashi Kant, Puneet Misra, Sanjay K. Rai, Sanjay Juvekar, Rutuja Patil, Abdul Samik Wahab, Siswanto Wilopo, Evasius Bauni, George Mochamah, Carolyne Ndila, Thomas N. Williams, Christine Khaggayi, Amek Nyaguara, David Obor, Frank O. Odhiambo, Alex Ezeh, Samuel Oti, Marylene Wamukoya, Menard Chihana, Amelia Crampin, Mark A. Collinson, Chodziwadziwa W. Kabudula, Ryan Wagner, Kobus Herbst, Joël Mossong, Jacques B.O. Emina, Osman A. Sankoh, Peter Byass

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)


Background: Mortality from external causes, of all kinds, is an important component of overall mortality on a global basis. However, these deaths, like others in Africa and Asia, are often not counted or documented on an individual basis. Overviews of the state of external cause mortality in Africa and Asia are therefore based on uncertain information. The INDEPTH Network maintains longitudinal surveillance, including cause of death, at population sites across Africa and Asia, which offers important opportunities to document external cause mortality at the population level across a range of settings. Objective: To describe patterns of mortality from external causes at INDEPTH Network sites across Africa and Asia, according to the WHO 2012 verbal autopsy (VA) cause categories. Design: All 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 5,884 deaths due to external causes were documented over 11,828,253 person-years. Approximately one-quarter of those deaths were to children younger than 15 years. Causes of death were dominated by childhood drowning in Bangladesh, and by transport-related deaths and intentional injuries elsewhere. Detailed mortality rates are presented by cause of death, age group, and sex. Conclusions: The patterns of external cause mortality found here generally corresponded with expectations and other sources of information, but they fill some important gaps in population-based mortality data. They provide an important source of information to inform potentially preventive intervention designs.

Original languageEnglish
Article number25366
JournalGlobal Health Action
Issue number1
Publication statusPublished or Issued - 2014
Externally publishedYes


  • Accidents
  • Africa
  • Asia
  • Assault
  • Drowning
  • External causes
  • INDEPTH network
  • Inter VA
  • Mortality
  • Suicide
  • Transport
  • Verbal autopsy

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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