Background
Methods
Verbal autopsy
Behavioral risk factors
Demographic and socioeconomic factors
Data management and analysis
Ethical considerations
Results
Socioeconomic characteristics | Males n (%) | Females n (%) |
---|---|---|
Age
| ||
15-24 | 94 (5) | 123 (7) |
25-34 | 261 (14) | 270 (15) |
35-44 | 286 (15) | 241 (13) |
45-54 | 250 (13) | 237 (13) |
55-64 | 229 (12) | 234 (13) |
65-74 | 337 (18) | 262 (14) |
75-84 | 248 (13) | 221 (12) |
85+
| 159 (9) | 257 (14) |
Religion
| ||
Orthodox | 1649 (86) | 1629 (88) |
Muslim | 170 (9) | 166 (9) |
Others | 45 (2) | 50 (3) |
Ethnicity
| ||
Amhara | 933 (50) | 1001 (54) |
Oromo | 456 (25) | 453 (25) |
Guraghe | 248 (13) | 212 (12) |
Others | 227 (12) | 179 (10) |
Education status
| ||
No education | 484 (26) | 971 (53) |
Elementary School | 486 (26) | 405 (22) |
Secondary School | 465 (25) | 276 (15) |
College/University | 222 (12) | 74 (4) |
Others (church education) | 207 (11) | 119 (6) |
Occupation
| ||
Manual labor (skilled/unskilled) | 319 (17) | 216 (12) |
Employed (professional, technical, managerial, self-employed, sales and services) | 705 (38) | 248 (13) |
Unemployed | 200 (11) | 94 (5) |
Housewives | - | 1090 (59) |
Retired | 465 (25) | 79 (4) |
Others (Students, farmers) | 52 (3) | 46 (3) |
Unknown | 123 (7) | 72 (4) |
Marital status
| ||
Single | 515 (28) | 289 (16) |
Married | 1032 (55) | 446 (24) |
Separated | 48 (3) | 133 (7) |
divorce | 58 (3) | 139 (8) |
Widowed | 211 (11) | 838 (45) |
Prevalence of alcohol, tobacco and khatconsumption among the deceased adults
Health risk behaviors | Males (n = 1864) | Females (n = 1845) | Total (n = 3709) |
---|---|---|---|
n (%) | n (%) | n (%) | |
Alcohol use
| |||
Ever alcohol use | 869 (47)* | 188 (10) | 1055 (29) |
Frequently alcohol use | 411 (22)* | 43 (2) | 454 (12) |
Occasionally alcohol use | 424 (23)* | 131(7) | 555 (15) |
Getting drunk of alcohol use
| |||
Frequently get drunk | 247 (13)* | 22 (1) | 269 (7) |
Occasionally get drunk | 187 (10)* | 21 (1) | 208 (6) |
Tobacco use
| |||
Ever tobacco use | 337 (18)* | 15 (1) | 352 (10) |
Frequently tobacco use | 244 (13)* | 8 (0.4) | 252 (7) |
Occasionally tobacco use | 29 (2) | - | 29 (1) |
Duration of tobacco use
| |||
Tobacco used, ≤ 5years | 29 (2) | - | 29 (1) |
Tobacco used ,5 to10 years | 26 (1)* | 2 (0.1) | 28 (1) |
Tobacco used, 11 and above years | 228 (12)* | 9 (1) | 237 (6) |
Tobacco use till sick | 217 (12)* | 10 (1) | 227 (6) |
Stopped tobacco use before being sick | 100 (5)* | 2 (0.1) | 102 (3) |
Khat
Use
| |||
Ever khat use | 238 (13)* | 39 (2) | 277 (8) |
Frequently khat use | 145 (8)* | 14 (1) | 159 (4) |
Occasionally khat use | 77 (4)* | 19 (1) | 96 (3) |
Patterns of alcohol, tobacco and khatconsumption in relation to causes of death
Causes of death | Number | Frequent alcohol use | Occasional alcohol use | No alcohol use** |
---|---|---|---|---|
n | n(%) | n(%) | n(%) | |
I. Communicable diseases
| 1566 | 225 (14)* | 241 (16) | 1100 (70) |
HIV/AIDS | 707 | 111 (16)* | 90 (13) | 506 (72) |
Tuberculosis | 460 | 82 (18)* | 79 (17) | 299 (65) |
Respiratory infections | 102 | 10 (10) | 16 (16) | 76 (75) |
Diarrheal disease | 115 | 15 (13) | 21 (18) | 79 (69) |
Meningitis | 47 | 2 (4) | 6 (13) | 39 (83) |
II. Non communicable disease
| 1915 | 211 (11)* | 287 (15) | 1417 (74) |
A. Malignant neoplasm | 386 | 24 (6)* | 43 (11) | 319 (83) |
Stomach Cancer | 73 | 6 (8) | 10 (14) | 57 (78) |
Breast Cancer | 43 | 1 (2)* | 1 (2) | 41 (96) |
Uterine Cancer | 47 | 1 (2)* | 1 (2) | 45 (96) |
Liver Cancer | 37 | 4 (11) | 4 (11) | 29 (78) |
Cancer of cervix | 19 | 1 (5) | - | 18 (95) |
Colon and rectal cancer | 27 | 2 (7) | 5 (16) | 20 (74) |
Other neoplasm | 145 | 12 (8) | 20 (14) | 113 (78) |
B. Diabetes mellitus | 183 | 18 (10) | 29 (16) | 136 (74) |
C. Neuropsychiatry | 76 | 11 (15) | 15 (20) | 50 (66) |
D. Cardiovascular diseases | 885 | 81 (9)* | 141 (16) | 663 (75) |
Hypertensive disease | 426 | 35 (8)* | 71 (17) | 320 (75) |
Stroke | 404 | 40 (10) | 72 (18) | 292 (72) |
Congestive heart failure | 239 | 17 (7)* | 34 (14) | 188 (79) |
Myocardial infarction | 84 | 8 (10) | 14 (17) | 62 (74) |
E. Respiratory diseases | 93 | 8 (9) | 12 (13) | 73 (79) |
Asthma | 73 | 7 (10) | 10 (14) | 56 (77) |
F. Digestive diseases | 328 | 61 (19)* | 55 (17) | 212 (65) |
Chronic liver disease | 165 | 45 (27)* | 28 (17) | 92 (56) |
Peptic ulcer disease | 31 | 2 (7) | 5 (16) | 24 (77) |
G. Genitourinary disease | 137 | 12 (9) | 24 (18) | 101 (74) |
Chronic renal failure | 112 | 10 (9) | 19 (17) | 83 (74) |
III. Injuries
| 233 | 22 (9) | 37 (16) | 174 (75) |
A. Unintentional | 102 | 4 (4)* | 11 (11) | 87 (85) |
Road traffic accidents | 83 | 3 (4)* | 8 (10) | 72 (87) |
B. Intentional (Suicide…) | 79 | 7 (9) | 12 (15) | 60 (76) |
Poisoning | 28 | 12 (43)* | 4 (14) | 12 (43) |
Undetermined | 254 | 22 (9) | 34 (13) | 198 (78) |
Cause of death | Number | Frequent tobacco use | Occasional tobacco use | No tobacco use ** |
---|---|---|---|---|
n | n(%) | n(%) | n(%) | |
I. Communicable diseases
| 1566 | 135 (9)* | 15 (1) | 1416 (90) |
HIV/AIDS | 707 | 69 (10)* | 7 (1) | 631 (89) |
Tuberculosis | 460 | 57 (12)* | 8 (2) | 395 (86) |
Respiratory infections | 102 | 1 (1)* | 2 (2) | 99 (97) |
Diarrheal disease | 115 | 6 (5) | 1 (1) | 108 (94) |
Meningitis | 47 | 2 (4.3) | - | 45 (96) |
II. Non communicable disease
| 1915 | 108 (6)* | 11 (1) | 1796 (94) |
A. Malignant neoplasm | 386 | 15 (4)* | 1 (0.3) | 370 (96) |
Stomach cancer | 73 | 4 (6) | - | 69 (95) |
Breast cancer | 43 | - | - | 43 (100) |
Uterine cancer | 47 | - | - | 47 (100) |
Liver cancer | 37 | 1 (3) | - | 36 (97) |
Cancer of cervix | 19 | - | - | 19 (100) |
Colon and rectal cancer | 27 | 2 (7) | - | 25 (92) |
Other neoplasm | 145 | 8 (6) | 1 (1) | 136 (94) |
B. Diabetes mellitus | 183 | 12 (7) | 2 (1) | 169 (92) |
C. Neuropsychiatry | 76 | 5 (7) | 2 (3) | 69 (91) |
D. Cardiovascular diseases | 885 | 44 (5)* | 3 (0.3) | 838 (95) |
Hypertensive disease | 426 | 17 (4)* | 2 (1) | 407(96) |
Stroke | 404 | 18 (5) | 2 (1) | 384 (95) |
Congestive heart failure | 239 | 13 (5) | 1 (0.4) | 225 (94) |
Myocardial infarction | 84 | 10 (12) | - | 74 (88) |
E. Respiratory diseases | 93 | - | - | 93 (100) |
Asthma | 73 | - | - | 73 (100) |
F. Digestive diseases | 328 | 29 (9) | 3 (1) | 296 (90) |
Chronic liver disease | 165 | 17 (10) | 2 (1) | 146 (89) |
Peptic ulcer disease | 31 | 1 (3) | 1 (3) | 29 (94) |
G. Genitourinary disease | 137 | 6 (4) | - | 131 (96) |
Chronic renal failure | 112 | 5 (4.5) | - | 107 (96) |
II. Injuries
| 233 | 19 (8) | 3 (1) | 211 (91) |
A. Unintentional | 102 | 6 (6) | 1 (1) | 95 (93) |
Road traffic accidents | 83 | 4 (5) | 1 (1) | 78 (94) |
B. Intentional (Suicide…) | 79 | 9 (11) | - | 70 (89) |
Poisoning | 28 | 10 (36)* | - | 18 (64) |
Undetermined | 254 | 7 (3)* | 1(0.4) | 246 (97) |
Cause of death | Number | Frequent khatuse | Occasional khatuse | No khatuse ** |
---|---|---|---|---|
n | n (%) | n (%) | n (%) | |
I. Communicable diseases
| 1566 | 93 (6)* | 46 (3) | 1427 (91) |
HIV/AIDS | 707 | 60 (9)* | 29 (4) | 618 (87) |
Tuberculosis | 460 | 30 (7)* | 13 (3) | 417 (91) |
Respiratory infections | 102 | 2 (2) | - | 100 (98) |
Diarrheal disease | 115 | 4 (4) | 3 (3) | 108 (94) |
Meningitis | 47 | 1 (2) | 1 (2) | 45 (96) |
II. Non Communicable disease
| 1915 | 64 (3)* | 37(2) | 1814 (95) |
A. Malignant neoplasm | 386 | 7 (2)* | 9 (2) | 370 (96) |
Stomach cancer | 73 | 2 (3) | 1 (1) | 70 (96) |
Breast cancer | 43 | - | 1 (2) | 42 (98) |
Uterine cancer | 47 | - | 1 (2) | 46 (98) |
Liver cancer | 37 | - | - | 37 (100) |
Cancer of cervix | 19 | - | - | 19 (100) |
Colon and rectal cancer | 27 | 1 (4) | - | 26 (96) |
Other neoplasm | 145 | 3 (2) | 4 (3) | 138 (95) |
B. Diabetes mellitus | 183 | 6 (3) | 3 (2) | 174 (95) |
C. Neuropsychiatry | 76 | 4 (5) | 3 (4) | 69 (91) |
D. Cardiovascular diseases | 885 | 25 (3)* | 13 (2) | 847 (96) |
Hypertensive heart disease | 426 | 9 (2)* | 5 (1) | 412 (97) |
Cerebrovascular disease | 404 | 12 (3) | 8 (2) | 384 (95) |
Congestive heart failure | 239 | 9 (4) | 2 (1) | 228 (95) |
Myocardial infarction | 84 | 5 (6) | 1 (1) | 78 (93) |
E. Respiratory diseases | 93 | 1 (1) | 1 (1) | 91 (98) |
Asthma | 73 | 1 (1) | 1 (1) | 71 (97) |
F. Digestive diseases | 328 | 20 (6) | 8 (2) | 300 (92) |
Chronic liver disease | 165 | 13 (8) | 4 (2) | 148 (90) |
Peptic ulcer disease | 31 | - | 2 (7) | 29 (94) |
G. Genitourinary disease | 137 | 6 (4) | 3 (2) | 128 (93) |
Chronic renal failure | 112 | 5 (5) | 2 (2) | 105 (94) |
III. Injuries
| 233 | 13 (6)* | 15 (6) | 205 (88) |
A. Unintentional | 102 | 2 (2) | 6 (6) | 94 (92) |
Road traffic accidents | 83 | 1 (1) | 5 (6) | 77 (93) |
B. Intentional (Suicide…) | 79 | 8 (10)* | 7 (9) | 64 (81) |
Poisoning | 28 | 2 (7)* | 3 (11) | 23 (82) |
Undetermined | 254 | 2 (1)* | 4 (2) | 248 (98) |
Association socioeconomic and behavioral risk factors with causes of death
Socioeconomic factors | HIV/AIDS | ||||
---|---|---|---|---|---|
n (%) | COR ( 95% CI) | P | AOR ( 95% CI)a
| P | |
Sex
| |||||
M | 314(9) | Ref. | NA | Ref. | NA |
F | 393(11) | 1.34 (1.13-1.58) | 0.001 | 1.96 (1.54-2.49) | <0.001 |
Age
| |||||
15-24 | 56 (2) | Ref | NA | Ref. | NA |
25-44 | 468(13) | 2.28 (1.64-3.16) | <0.001 | 2.32 (1.64-3.27) | <0.001 |
45-54 | 120(3) | 0.94 (0.65-1.36) | 0.742 | 0.88 (0.59-1.30) | 0.515 |
55-64 | 43 (1) | 0.29 (0.19-0.46) | <0.001 | 0.26 (0.16-0.42) | <0.001 |
≥65 | 20 (1) | 0.02 (0.01-0.04) | <0.001 | 0.07 (0.04-0.13) | <0.001 |
Education
| |||||
< High School | 439(12) | Ref | NA | Ref. | NA |
≥ Secondary School | 268(7) | 1.77 (1.49-211) | <0.001 | 0.61(0.50-0.76) | <0.001 |
Occupation
| |||||
Manual Labor | 535 (14) | Ref. | NA | Ref. | NA |
Employed | 953 (26) | 0.67 (0.53-0.84) | 0.001 | 0.99(0.75-1.29) | 0.910 |
Unemployed | 294 (8) | 0.54 (0.39-0.75) | <0.001 | 0.86(0.59-1.26) | 0.446 |
Housewives | 1098(30) | 0.24 (0.18-0.30) | <0.001 | 0.62(0.44-0.87) | 0.005 |
Retired | 544 (15) | 0.05 (0.03-0.09) | <0.001 | 0.58(0.31-1.10) | 0.094 |
Others | 98 (3) | 0.31 (0.17-0.57) | <0.001 | 0.30(0.16-0.57) | <0.001 |
Unknown | 187 (5) | 0.76 (0.53-1.10) | 0.142 | 1.01(0.67-1.53) | 0.952 |
Socioeconomic factors | Cardiovascular diseases | ||||
---|---|---|---|---|---|
No (%) | COR (95% CI) | P | AOR ( 95% CI)a
| P | |
Age
| |||||
15-24 | 19 (1) | Ref. | NA | Ref. | NA |
25-44 | 77 (2) | 0.82 (0.48-1.38) | 0.45 | 0.74 (0.42-1.28) | 0.276 |
45-54 | 95 (3) | 2.53 (1.49-4.25) | <0.001 | 2.17 (1.22-3.86) | 0.008 |
55-64 | 137 (4) | 4.38 (2.63-7.30) | <0.001 | 3.98 (2.22-7.13) | <0.001 |
65-74 | 231 (6) | 6.54 (3.97-10.77) | <0.001 | 5.97 (3.33-10.68) | <0.001 |
≥75 | 326 (9) | 6.08 (3.72-9.92) | <0.001 | 5.84 (3.26-10.48) | <0.001 |
Occupation
| |||||
Manual Labor | 535 (14) | Ref. | NA | Ref. | NA |
Employed | 953 (26) | 2.30 (1.68-3.16) | <0.001 | 1.92(1.37-2.71) | <0.001 |
Unemployed | 294 (8) | 1.80 (1.19-2.70) | 0.005 | 1.36 (0.88-2.11) | 0.171 |
Housewives | 1098 (30) | 3.74 (2.76-5.07) | <0.001 | 1.55 (1.07-2.26) | 0.021 |
Retired | 544 (15) | 4.86 (3.50-6.74) | <0.001 | 1.69 (1.17-2.42) | 0.005 |
Others | 98 (3) | 1.31 (0.69-2.50) | 0.415 | 2.31 (1.13-4.74) | 0.022 |
Unknown | 187 (5) | 1.77 (1.10-2.83) | 0.018 | 1.56 (0.95-2.61) | 0.08 |
Malignancy
| |||||
Sex
| |||||
Male | 153 (4) | Ref | NA | Ref. | NA |
Female | 233 (6) | 1.62 (1.30-2.00) | <0.001 | 1.89 (1.37-2.60) | <0.001 |
Age
| |||||
15-24 | 21 (1) | Ref | NA | Ref | NA |
25-44 | 73 (2) | 0.69 (0.42-1.15) | 0.115 | 0.75 (0.43-1.30) | 0.304 |
45-54 | 68 (2) | 1.54 (0.92-2.58) | 0.101 | 1.80 (1.01-3.26) | 0.051 |
55-64 | 79 (2) | 1.92 (1.15-3.20) | 0.012 | 2.36 (1.28-4.35) | 0.006 |
65-74 | 79 (2) | 1.42 (0.85-2.24) | 0.178 | 1.80 (0.96-3.37) | 0.066 |
≥75 | 65 (1) | 0.74 (0.44-1.24) | 0.253 | 0.96 (0.50-1.83) | 0.902 |
Education
| |||||
< High School | 270 (7) | Ref | NA | Ref | NA |
≥ Secondary School | 116 (3) | 1.12(0.89-1.41) | 0.333 | 1.49 (1.12-1.99) | 0.006 |
Occupation
| |||||
Manual labor | 535 (14) | Ref. | NA | Ref. | NA |
Employed | 953 (26) | 1.51 (1.01-2.26) | 0.047 | 1.34 (0.88-2.04) | 0.179 |
Unemployed | 294 (8) | 0.82 (0.45-1.51) | 0.530 | 0.86 (0.46-1.60) | 0.639 |
Housewives | 1098 (30) | 2.26 (1.54-3.32) | <0.001 | 1.72 (1.10-2.69) | 0.018 |
Retired | 544 (15) | 1.77 (1.15-2.74) | 0.010 | 1.81(1.11-2.94) | 0.017 |
Others | 98 (3) | 1.99 (1.00-3.99) | 0.052 | 2.32 (1.16-4.83) | 0.024 |
Unknown | 187 (5) | 1.90 (1.09-3.34) | 0.025 | 1.56 (0.87-2.78) | 0.135 |
Health risk behaviours | HIV/AIDS | ||||
---|---|---|---|---|---|
No (%) | COR (95% CI) | P | AOR ( 95% CI)a
| P | |
Alcohol use
| |||||
Non alcohol use | 506 (14) | Ref. | NA | Ref | NA |
Frequent alcohol use | 111 (3) | 1.40 (1.12-1.78) | 0.005 | 2.14 (1.52-3.00) | <0.001 |
Occasional alcohol use | 90 (2.4) | 0.84 (0.66-1.07) | 0.162 | 1.21 (0.89-1.66) | 0.231 |
Tuberculosis
| |||||
Alcohol use
| |||||
Non alcohol use | 299 (8) | Ref. | NA | Ref | NA |
Frequent alcohol use | 82 (2.2) | 1.77 (1.35-2.31) | <0.001 | 1.61 (1.15-2.24) | 0.005 |
Occasional alcohol use | 79 (2.1) | 1.33 (1.02-1.74) | 0.035 | 1.35 (1.00-1.82) | 0.056 |
Tobacco use
| |||||
Non tobacco use | 395 (11) | Ref. | NA | Ref | NA |
Frequent tobacco use | 57 (2) | 2.24 (1.64-3.07) | <0.001 | 1.67 (1.13-2.47) | 0.010 |
Occasional tobacco use | 8 (0.2) | 2.93 (1.29-6.65) | 0.010 | 2.41 (1.01-5.74) | 0.047 |
Chronic liver diseases
| |||||
Alcohol use
| |||||
Non alcohol use | 92 (3) | Ref. | NA | Ref | NA |
Frequent alcohol use | 45 (1.2) | 3.12 (2.15-4.52) | <0.001 | 3.09 (1.95-4.89) | <0.001 |
Occasional alcohol use | 28 (1) | 1.51 (1.00-2.32) | 0.064 | 1.51 (0.94-2.42) | 0.088 |