Global Health Action (Dec 2024)

Causes of death among older children and adolescents (5–19 years) in the Magu Health and Demographic Surveillance Study, Tanzania, 1995–2022

  • Sophia Kagoye,
  • Milly Marston,
  • Yasson Abha,
  • Eveline T. Konje,
  • Mark Urassa,
  • Jim Todd,
  • Ties Boerma

DOI
https://doi.org/10.1080/16549716.2024.2425470
Journal volume & issue
Vol. 17, no. 1

Abstract

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Background Population data on mortality and causes of death among 5–19-year-olds are limited. Objectives To assess levels, trends, and risk factors of cause-specific mortality and place at death among 5–19-year-olds in Tanzania (1995–2022). Methods Using longitudinal data from the Magu Health and Demographic Surveillance System in northwest Tanzania, we identified leading causes of death among 5–19-year-olds from verbal autopsy interviews, using physician review and a Bayesian probabilistic model (InSilicoVA). We analyzed trends in cause and place of death using three periods: 1995–2004, 2005–2014 and 2015–2022, and assessed risk factors in a Cox-proportional hazards model. We compared the results with children aged 1–4 years and global estimates for Tanzania. Results Between 1995 and 2022, communicable disease mortality decreased by 73%, similar to the 76% decline among 1–4-year-olds. This decline in communicable disease mortality drove all-cause mortality declines of 43% and 48% among 5–14- and 15–19-year-olds, respectively. Non-communicable diseases and injuries gained importance, with their relative share of all deaths increasing from 15% in 1995–2004 to 58% in 2015–2022. Mortality risks were significantly higher among boys (particularly for injuries), those residing in rural areas (for non-communicable diseases), and those from the poorest households (for communicable diseases). By 2015–2022, 48% of 5–14 and 42% of 15–19-year-olds died in health facilities, up from 25% in 1995–2002. Conclusions Since 1995, the decline in communicable disease mortality drove a major all-cause mortality reduction among 5–19-year-olds. Further progress will depend on continued reduction in communicable disease mortality, particularly among the poorest, and effectively addressing non-communicable and injury mortality.

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