Reducing ignorance about causes of death: can we, and why should we?

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Professor Alan Lopez

This is a guest post by Professor Alan Lopez, Director of the Global Burden of Disease Group at the University of Melbourne. He takes a look at why we need to know more about causes of death in populations, and how verbal autopsy provides a viable solution.

We need to know more about causes of death

Each year, over 50 million people die worldwide, many of them prematurely, but for only about one-third of them  do we know with some confidence what they died of. In some regions of the world this fraction is much higher at  90% or more; in others, like sub-Saharan Africa, it is less than 10% Yet politicians, policy makers and public health professionals are expected to …

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Verbal autopsy: To be counted is to become visible

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PB lowres

 

This is a guest blog by Peter Byass, Director of the WHO Collaborating Centre for Verbal Autopsy at Umeå University, Sweden. Peter has a regular global health blog and is on Twitter, @UCGHR.

 

“Nothing is certain except death and taxes” – Benjamin Franklin, 1789

Unfortunately, Franklin was correct in excluding cause of death from the realm of certainty. Whatever method is used to determine the cause of a particular death, there is some degree of uncertainty. Even if a body is put in front of several pathologists, there can well be multiple opinions about cause of death. But for more than half of the world’s deaths today, no expert opinion is even sought or recorded around cause of …

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More countries need to count their dead

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Recording information

This is a guest post by Professor Prabhat Jha and Lukasz Aleksandrowicz of Centre for Global Health Research.

Reliable cause of death (COD) statistics have transformed public health in the last century. These basic data have uncovered links between diseases and risk factors (such as smoking), and are essential to smart allocations of spending and planning of health programs. Whereas high-income countries have near universal robust death certification and medically-certified COD, these systems are uncommon in low and middle-income income countries.

Most deaths worldwide occur outside of the medical system, and consequently, are invisible in vital statistics. As we point out in this series, global indirect estimates of the causes of death have to rely on roughly 850 guesses for one actual …

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What is verbal autopsy?

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Verbal autopsy

This post is the first of  a series about verbal autopsy, the subject of a selection of articles just published in BMC Medicine’s Medicine for Global Health collection.

Determining causes of death is vitally important to public health. It helps to determine what health problems are afflicting a population, which in turn affects policies and strategies to improve health and reduce the number of deaths from certain causes.

One of the first examples we have of a research method to determine causes of death in a population is from 17th Century London, where ‘death searchers’ recorded deaths in the population by weekly household visits, mainly to estimate mortality from the plague.

These days, in developed countries, the process has become …

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Helping the 15 million babies born too soon every year

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A small baby held on one arm

Posted on behalf of Natasha Salaria

This Sunday is World Prematurity Day 2013, a global effort to raise awareness about premature birth and its prevention.

Published last year, Born Too Soon is a global action report which involved collaboration from more than 50 organisations and provides the first-ever national, regional and global estimates of preterm birth. The major findings of the report have now been expanded upon in six new review papers, which are published today in a supplement for the journal Reproductive Health. The articles have been jointly funded by the charities Save the Children and March of Dimes and are published in collaboration with the Partnership for Maternal, Newborn and Child Health and …

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RTS,S; the world’s first malaria vaccine?

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According to the World Health Organisation, each year malaria causes an estimated 660,000 deaths worldwide, mostly in Africa, where one child dies of malaria each minute. At present, there is no available vaccine, only preventative measures such as mosquito nets and insecticides which have limited use. In a considerable step forward towards the fight against malaria, British drug firm GlaxoSmithKline (GSK) made headline news earlier this month with the announcement that they are seeking regulatory approval for the world’s first malaria vaccine; RTS,S. Whilst there are some other malaria vaccines in development, RTS,S is the most advanced vaccine targeting Plasmodium falciparum, the most deadly malaria parasite. Understandably, this news generated substantial excitement worldwide, however critics have raised concerns about the efficacy of …

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Global health issues: millennium development goals, evidence-based medicine and open access

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Written by Lin Lee, Senior Editor at BioMed Central

Deaths of women and children in low and middle income countries account for over 95% of all maternal and child deaths. This startling figure comes as we approach the deadline to the 2015 Millennium Development Goals (MDGs). These eight goals aim to release people from poverty and associated health inequities. Although some goals will be met, it seems that MDGs 4 and 5 which relate to child survival and maternal health respectively, will not.

Childbirth, for instance, has one of the highest mortality rates for both the mother and the new born –  complications during labor and delivery account for half the maternal deaths, one third of stillbirths and a …

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Madagascar – an island swarming with problems

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With problems ranging from locust plagues to forest destruction, Madagascar may appear to be a beautiful & diverse paradise, but looks can be deceiving…

 

Recently it was announced that Madagascar is facing its worst locust plague since the 1950s. Already one quarter of the island’s crops have been depleted, and 60% of the population’s livelihood is now under threat. The country must race to find appropriate interventions, as infestation may engulf over two-thirds of the land by September, according to the Food and Agriculture Organizations (FAO). Fighting back locusts is not a cheap endeavour –  launching this campaign requires 41.5 million USD. Yet funding is vital to ensure food …

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The war against malnutrition

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Food insecurity is one of the main causes of undernutrition in the developing world. We tend to assume that as a result of poverty many are left hungry, however suffering is often caused through malnutrition where many disorders can arise depending on what nutrients are under or over-abundant in the diet. In many cases across the globe, most being in children under five,  undernutrition is a result of insufficient calories, vitamins and protein with extreme undernourishment resulting in starvation.

Despite undernutrition causing almost half of deaths in children (3.1 children per year) and approximately 1 in 3 suffering from stunted growth, it has been agreed that this is one of the most neglected issues in …

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This week in BMC Medicine: Tuberculosis, HIV and global health

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Written by Lin Lee, Senior Editor, BMC Medicine

In China, tuberculosis (TB) is a major public health problem; it has the second largest burden in the world, and TB is the number one cause of deaths due to a single infectious agent. Here,  1.4 million people per year develop the active form of the disease, and just 20 years ago, it was attributable to the deaths of 360, 000 individuals per year. However, it is known that when intervention strategies are in place, they are effective. For instance, China was able to halve the deaths attributed to TB following a large scale program initiated in 1992.

Early diagnosis followed by prompt treatment are the core objectives of an …

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