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The epidemiological transition in Papua New Guinea: new evidence from verbal autopsy studies.

Abstract：

BACKGROUND:Recent economic growth in Papua New Guinea (PNG) would suggest that the country may be experiencing an epidemiological transition, characterized by a reduction in infectious diseases and a growing burden from non-communicable diseases (NCDs). However, data on cause-specific mortality in PNG are very sparse, and the extent of the transition within the country is poorly understood. METHODS:Mortality surveillance was established in four small populations across PNG: West Hiri in Central Province, Asaro Valley in Eastern Highlands Province, Hides in Hela Province and Karkar Island in Madang Province. Verbal autopsies (VAs) were conducted on all deaths identified, and causes of death were assigned by SmartVA and classified into five broad disease categories: endemic NCDs; emerging NCDs; endemic infections; emerging infections; and injuries. Results from previous PNG VA studies, using different VA methods and spanning the years 1970 to 2001, are also presented here. RESULTS:A total of 868 deaths among adolescents and adults were identified and assigned a cause of death. NCDs made up the majority of all deaths (40.4%), with the endemic NCD of chronic respiratory disease responsible for the largest proportion of deaths (10.5%), followed by the emerging NCD of diabetes (6.2%). Emerging infectious diseases outnumbered endemic infectious diseases (11.9% versus 9.5%). The distribution of causes of death differed across the four sites, with emerging NCDs and emerging infections highest at the site that is most socioeconomically developed, West Hiri. Comparing the 1970-2001 VA series with the present study suggests a large decrease in endemic infections. CONCLUSIONS:Our results indicate immediate priorities for health service planning and for strengthening of vital registration systems, to more usefully serve the needs of health priority setting.

journal_name

Int J Epidemiol

journal_title

International journal of epidemiology

authors

Gouda HN,Hazard RH,Maraga S,Flaxman AD,Stewart A,Joseph JC,Rarau P,Wangnapi R,Poka H,Serina P,Phuanukoonnon S,Pham BN,Vano M,Lupiwa S,Sie A,Kave H,Lehmann D,Siba P,Lopez AD,Riley ID

doi

10.1093/ije/dyz018

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

966-977

issue

eissn

0300-5771

issn

1464-3685

pii

5420303

journal_volume

pub_type

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The epidemiological transition in Papua New Guinea: new evidence from verbal autopsy studies.