scholarly journals Excess mortality in Wuhan city and other parts of China during the three months of the covid-19 outbreak: findings from nationwide mortality registries

BMJ ◽  
2021 ◽  
pp. n415
Author(s):  
Jiangmei Liu ◽  
Lan Zhang ◽  
Yaqiong Yan ◽  
Yuchang Zhou ◽  
Peng Yin ◽  
...  

Abstract Objective To assess excess all cause and cause specific mortality during the three months (1 January to 31 March 2020) of the coronavirus disease 2019 (covid-19) outbreak in Wuhan city and other parts of China. Design Nationwide mortality registries. Setting 605 urban districts and rural counties in China’s nationally representative Disease Surveillance Point (DSP) system. Participants More than 300 million people of all ages. Main outcome measures Observed overall and weekly mortality rates from all cause and cause specific diseases for three months (1 January to 31 March 2020) of the covid-19 outbreak compared with the predicted (or mean rates for 2015-19) in different areas to yield rate ratio. Results The DSP system recorded 580 819 deaths from January to March 2020. In Wuhan DSP districts (n=3), the observed total mortality rate was 56% (rate ratio 1.56, 95% confidence interval 1.33 to 1.87) higher than the predicted rate (1147 v 735 per 100 000), chiefly as a result of an eightfold increase in deaths from pneumonia (n=1682; 275 v 33 per 100 000; 8.32, 5.19 to 17.02), mainly covid-19 related, but a more modest increase in deaths from certain other diseases, including cardiovascular disease (n=2347; 408 v 316 per 100 000; 1.29, 1.05 to 1.65) and diabetes (n=262; 46 v 25 per 100 000; 1.83, 1.08 to 4.37). In Wuhan city (n=13 districts), 5954 additional (4573 pneumonia) deaths occurred in 2020 compared with 2019, with excess risks greater in central than in suburban districts (50% v 15%). In other parts of Hubei province (n=19 DSP areas), the observed mortality rates from pneumonia and chronic respiratory diseases were non-significantly 28% and 23% lower than the predicted rates, despite excess deaths from covid-19 related pneumonia. Outside Hubei (n=583 DSP areas), the observed total mortality rate was non-significantly lower than the predicted rate (675 v 715 per 100 000), with significantly lower death rates from pneumonia (0.53, 0.46 to 0.63), chronic respiratory diseases (0.82, 0.71 to 0.96), and road traffic incidents (0.77, 0.68 to 0.88). Conclusions Except in Wuhan, no increase in overall mortality was found during the three months of the covid-19 outbreak in other parts of China. The lower death rates from certain non-covid-19 related diseases might be attributable to the associated behaviour changes during lockdown.

2020 ◽  
Vol 41 (2) ◽  
pp. 119-123 ◽  
Author(s):  
T. J. Ellapen ◽  
M. Barnard ◽  
G. L. Strydom ◽  
K. M. Masime ◽  
Y. Paul

Researchers have identified cancer, diabetes mellitus, cardiovascular, and respiratory diseases as being the principal pathologies of increased aged standardized death rates (ASDRs) among noncommunicable diseases (NCDs). The objective of this study was to compare the change in the ASDR of these principal NCDs between the years 2010 and 2016 in Botswana, Mozambique, Namibia, South Africa, and Zimbabwe. ASDR data were collected from the 2016 Global Health Estimate. Among the selected Southern African countries for both 2010 and 2016, the order of prevalence of NCDs linked to increased ASDR was cardiovascular diseases (both cardiac and stroke), cancer, diabetes mellitus, and chronic respiratory diseases. The percentage of the total number of NCDs linked to increased ASDR in relation to total deaths increased from 43.8% (in 2010) to 51.0% (in 2016) from ( p < .0001). The percentage of principal NCDs in relation to total ASDR increased from 33.0% (in 2010) to 38.2% (in 2016; p < .0001).


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Katherine E Kurgansky ◽  
David Gagnon ◽  
Kelly Cho ◽  
J M Gaziano ◽  
Jacob Joseph ◽  
...  

Introduction: Heart failure with preserved ejection fraction (HFpEF) affects about 5% of people 65 or older, with a higher prevalence in women. Previous studies suggest that women with HFpEF may live longer than men. Further understanding of mortality outcomes by gender could be useful in implementing gender-specific treatment strategies to improve outcomes in HFpEF patients. Hypothesis: We assessed the hypothesis that women have a lower rate of total mortality than males in a US Veteran HFpEF cohort. Methods: We used a validated algorithm to curate a HFpEF cohort using ICD9 codes, laboratory values, medications, and ejection fraction values from the national Veterans Affairs database. This algorithm had 88% sensitivity and 96% specificity. We examined crude and adjusted mortality rates by gender, beginning at the time of heart failure diagnosis with follow-up through 2016. The adjusted mortality rate was directly standardized to the population of veterans with heart failure (n= 626,179) according to distribution of age, race, cardiovascular disease (CVD), and chronic kidney disease (CKD). Crude and standardized rate ratios were calculated from the mortality rates. Results: Our HFpEF cohort (n= 74,937) included 72,267 men and 2,670 women. Mean age was 72.5 (11.2) in men and 69.1 (14.3) in women at the time of heart failure diagnosis. Males were 85.2% white, 33.7% had CVD, and 27.1% had CKD, whereas females were 82.5% white, 28.7% had CVD, and 20.5% had CKD. During a mean follow up of 4.8 (3.7) years, 52,703 deaths occurred in men and 1,614 deaths occurred in women.The crude mortality rate was significantly lower for females (109.7/1000 person-years) compared to males (153.5/1000 person-years). Corresponding crude incidence rate ratio (95% CI) for total mortality comparing females to males was 0.71 (0.69-0.74; p<.0001). However, after standardizing, there was no significant difference in total mortality rates between men (170.0/1000 person-years) and women (173.4/1000 person-years). The standardized mortality rate ratio was 1.02 (95% CI: 0.84-1.23; p=0.8397). Conclusions: In conclusion, our data do not show any difference in total mortality rate between men and women following the diagnosis of HFpEF.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emerson Augusto Baptista ◽  
Sudeshna Dey ◽  
Soumya Pal

Abstract Background Chronic Respiratory Diseases (CRDs) in Asian countries are a growing concern in terms of morbidity and mortality. However, a systematic understanding of the increasing age-adjusted mortality rate of chronic respiratory disease (CRD) and its associated factors is not readily available for many Asian countries. We aimed to determine country-level factors affecting CRD mortality using a panel error correction model. Methods Based on data from the Global Burden of Disease Study 2017, we estimated the trends and distribution of CRD mortality for selected Asian countries from 2010 to 2017. Furthermore, we evaluated the relationship between CRD mortality and Gross Domestic Product (GDP) per capita, average years of schooling, urbanization, and pollutant emission (PM2.5 concentration) using a fixed-effect model. We corrected the estimates for heteroscedasticity and autocorrelation through Prais-Winsten adjustment along with robust standard error. Results Between 2010 and 2017, approximately 21.4 million people died from chronic respiratory diseases in the countries studied. Age-standardized crude mortality rate from CRDs in the period had minimum and maximum values of 8.19 (Singapore in 2016) and 155.42 (North Korea in 2010) per 100,000 population, respectively. The coefficients corrected for autocorrelation and heteroskedasticity based on the final model of our study (Prais-Winsten), showed that all explanatory variables were statistically significant (p < 0.001). The model shows that the 1% increase in GDP per capita results in a 20% increase (0.203) in the CRD mortality rate and that a higher concentration of air pollution is also positively associated with the CRD deaths (0.00869). However, an extra year of schooling reduces the mortality rate by 4.79% (− 0.0479). Further, rate of urbanization is negatively associated with the CRD death rate (− 0.0252). Conclusions Our results indicate that both socioeconomic and environmental factors impact CRD mortality rates. Mortality due to CRD increases with rising GDP per capita and decreases with the percentage of the total population residing in urban areas. Further, mortality increases with greater exposure to PM2.5. Also, higher years of schooling mitigate rising CRD mortality rates, showing that education can act as a safety net against CRD mortality. These results are an outcome of sequential adjustments in the final model specification to correct for heteroscedasticity and autocorrelation.


2016 ◽  
Vol 5 (4) ◽  
pp. 65-70
Author(s):  
Natalya Vitalievna Tochilkina

The article examines the impact of air pollution on the demographic characteristics of the residents of Saratov. It describes the main air pollutants that have a significant impact on the incidence of non-communicable diseases and child mortality. The author discusses the impact of complex index of air pollution and its components on overall mortality rates, mortality from cancer, respiratory diseases and the mortality rate of children under one year. The research has shown that there is a strong direct relationship between the complex index of air pollution and mortality from respiratory diseases and infant mortality rates. The author also reveals that the total mortality rate is closely associated with the increased content in the air of nitrogen oxide, the mortality rate from cancer with the increased content of nitrogen oxide and phenol, the mortality rate from respiratory diseases with excess of formaldehyde, the mortality rate of children under one year - with excess of formaldehyde and phenol. Despite the importance and relevance of such studies the author notes that it is difficult to access the information about morbidity by classes of diseases, by age and sex of the inhabitants of various administrative areas of the city. It does not enable a full analysis of the current situation and retrospective studies for its prediction.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Anne Abio ◽  
Pascal Bovet ◽  
Joachim Didon ◽  
Till Bärnighausen ◽  
Masood Ali Shaikh ◽  
...  

AbstractData on injury-related mortality are scarce in the African region. Mortality from external causes in the Seychelles was assessed, where all deaths are medically certified and the population is regularly enumerated. The four fields for underlying causes of death recorded were reviewed in the national vital statistics register. The age-standardised mortality rates were estimated (per 100,000 person-years) from external causes in 1989–1998, 1999–2008, and 2009–2018. Mortality rates per 100,000 person-years from external causes were 4–5 times higher among males than females, and decreased among males over the three 10-year periods (127.5, 101.4, 97.1) but not among females (26.9, 23.1, 26.9). The contribution of external causes to total mortality did not change markedly over time (males 11.6%, females 4.3% in 1989–2018). Apart from external deaths from undetermined causes (males 14.6, females 2.4) and “other unintentional injuries” (males 14.1, females 8.0), the leading external causes of death in 2009–2018 were drowning (25.9), road traffic injuries (18.0) and suicide (10.4) among males; and road traffic injuries (4.6), drowning (3.4) and poisoning (2.6) among females. Mortality from broad categories of external causes did not change consistently over time but rates of road traffic injuries increased among males. External causes contributed approximately 1 in 10 deaths among males and 1 in 20 among females, with no marked change in cause-specific rates over time, except for road traffic injuries. These findings emphasise the need for programs and policies in various sectors to address this large, but mostly avoidable health burden.


2021 ◽  
Vol 21 (4) ◽  
pp. 1-10
Author(s):  
V. Gomathy ◽  
K. Janarthanan ◽  
Fadi Al-Turjman ◽  
R. Sitharthan ◽  
M. Rajesh ◽  
...  

Coronavirus Disease 19 (COVID-19) is a highly infectious viral disease affecting millions of people worldwide in 2020. Several studies have shown that COVID-19 results in a severe acute respiratory syndrome and may lead to death. In past research, a greater number of respiratory diseases has been caused by exposure to air pollution for long periods of time. This article investigates the spread of COVID-19 as a result of air pollution by applying linear regression in machine learning method based edge computing. The analysis in this investigation have been based on the death rates caused by COVID-19 as well as the region of death rates based on hazardous air pollution using data retrieved from the Copernicus Sentinel-5P satellite. The results obtained in the investigation prove that the mortality rate due to the spread of COVID-19 is 77% higher in areas with polluted air. This investigation also proves that COVID-19 severely affected 68% of the individuals who had been exposed to polluted air.


Author(s):  
Dan Kibuuka ◽  
Charles Mpofu ◽  
Penny Neave ◽  
Samuel Manda

Background: South Africa, with an estimated annual tuberculosis (TB) incidence of 360,000 cases in 2019, remains one of the countries with the largest burden of TB in the world. The identification of highly burdened TB areas could support public health policy planners to optimally target resources and TB control and prevention interventions. Objective: To investigate the spatial epidemiology and distribution of TB mortality in South Africa in 2010 and its association with area-level poverty and HIV burden. Methods: The study analysed a total of 776,176 TB deaths for the period 2005–2015. Local and global and spatial clustering of TB death rates were investigated by Global and Local Moran’s Indices methods (Moran’s I). The spatial regression analysis was employed to assess the effect of poverty and HIV on TB mortality rates. Results: There was a significant decrease in TB mortality rate, from 179 per 100,000 population in 2005 to 60 per 100,000 population in 2015. The annual TB mortality rate was higher among males (161.5 per 100,000 male population; (95% confidence interval (CI) 132.9, 190.0) than among females (123.2 per 100,000 female population; (95% CI 95.6, 150.8)). The 35–44 age group experienced higher TB mortality rates, regardless of gender and time. Hot spot clusters of TB mortality were found in the South-Eastern parts of the country, whereas cold spot clusters were largely in the north-eastern parts. Tuberculosis death rates were positively associated with poverty, as measured by the South African Multidimension Poverty Index (SAMPI) as well TB death rates in the neighbouring districts. Conclusion: The findings of this study revealed a statistically significant decrease in TB deaths and a disproportionate distribution of TB deaths among certain areas and population groups in South Africa. The existence of the identified inequalities in the burden of TB deaths calls for targeted public health interventions, policies, and resources to be directed towards the most vulnerable populations in South Africa.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mehran Shams ◽  
Farnam Mohebi ◽  
Kimiya Gohari ◽  
Masoud Masinaei ◽  
Bahram Mohajer ◽  
...  

Abstract Background Road-Traffic-Injuries (RTIs) are predicted to rise up to the fifth leading cause of worldwide death by 2030 and Iran has the third highest RTIs mortality among higher-middle income countries. Although the high mortality of RTI in Iran is a warning, it provides the opportunity to indirectly assess the implemented RTI-related regulations’ effectiveness via high-resolution relevant statistics and, hence, Iran could serve as a guide for countries with similar context. In order to do so, we utilized this study to report the time and spatial trends of RTIs-related mortality in different age and sex groups and road user classes in Iran. Methods Based on the national death-registration-system (DRS), cemeteries data, and the demographic characteristics, and after addressing incompleteness, we estimated mortality rates using spatiotemporal and Gaussian process regression models. We assessed Pearson seatbelt and helmet use and RTIs-attributable Age-Standardized-Morality-Rate (ASMR) associations. We also predicted RTIs-death-numbers, 2012–2020, by fitting a Generalized Additive Model to assess the status of achieving relevant sustainable development goal (SDG), namely reducing the number of RTIs-related deaths by half. Results Overall RTIs-attributable death and ASMR at the national level increased from 12.64 [95% UI, 9.52–16.86] to 29.1 [22.76–37.14] per 100,000 people in the time period of 1990–2015. The trend consisted of an increasing segment in 1990–2003 followed by a decreasing part till 2015. The highest percentage of death belonged to the three-or-more-wheels motorized vehicles. Pedestrian injuries percentage increased significantly and the highest mortality rate occurred in 85 years and older individuals. Low prevalence of seatbelt and helmet use were observed in provinces with higher than the median ASMR due to the relevant cause of each. RTIs-attributable death number is expected to reduce by 15.99% till 2020 which is lower than the established SDG goal. Conclusions Despite the observed substantial moderation in the RTI-ASMR, Iran is till among the leading countries in terms of the highest mortality rates in the world. The enforced regulations including speed limitations (particularly for elder pedestrians) and mandatory use of seatbelt and helmet (for young adult and male drivers) had a considerable effect on ASMR, nevertheless, the RTI burden reduction needs to be sustained and enhanced.


2008 ◽  
Vol 52 (No. 6) ◽  
pp. 262-266 ◽  
Author(s):  
E. Voslarova ◽  
B. Janackova B ◽  
F. Vitula ◽  
A. Kozak ◽  
V. Vecerek

Poor welfare is the cause of high mortality among hens and roosters transported to poultry processing plants. In the Czech Republic, death rates among hens and roosters in transport to poultry slaughter plants were monitored between 1997 and 2004, and their total mortality rate was in the 0.925% &plusmn; 0.479% range. Death rates among hens and roosters were influenced by the transport distance to poultry processing plants. The percentage of dead birds increased from 0.592% &plusmn; 0.575% at transport distances up to 50 km to 1.638% &plusmn; 0.952% at transport distances up to 300 km. The bird mortality was also influenced by the season of the year. Higher mortality rates were ascertained during the cold months of the year, specifically in October through to April.


BMJ ◽  
2020 ◽  
pp. m234 ◽  
Author(s):  
Xiaochen Li ◽  
Xiaopei Cao ◽  
Mingzhou Guo ◽  
Min Xie ◽  
Xiansheng Liu

AbstractObjectiveTo describe the temporal and spatial trends of mortality and disability adjusted life years (DALYs) due to chronic respiratory diseases, by age and sex, across the world during 1990-2017 using data from the Global Burden of Disease Study 2017.DesignSystematic analysis.Data sourceThe Global Burden of Diseases, Injuries, and Risk Factors Study 2017.MethodsMortality and DALYs from chronic respiratory diseases were estimated from the Global Burden of Disease Study 2017 using DisMod-MR 2.1, a Bayesian meta-regression tool. The estimated annual percentage change of the age standardised mortality rate was calculated using a generalised linear model with a Gaussian distribution. Mortality and DALYs were stratified according to the Socio-demographic index. The strength and direction of the association between the Socio-demographic index and mortality rate were measured using the Spearman rank order correlation. Risk factors for chronic respiratory diseases were analysed from exposure data.ResultsBetween 1990 and 2017, the total number of deaths due to chronic respiratorydiseases increased by 18.0%, from 3.32 (95% uncertainty interval 3.01 to 3.43) million in 1990 to 3.91 (3.79 to 4.04) million in 2017. The age standardised mortality rate of chronic respiratory diseases decreased by an average of 2.41% (2.28% to 2.55%) annually. During the 27 years, the annual decline in mortality rates of chronic obstructive pulmonary disease (COPD; 2.36%, uncertainty interval 2.21% to 2.50%) and pneumoconiosis (2.56%, 2.44% to 2.68%) has been slow, whereas the mortality rate for interstitial lung disease and pulmonary sarcoidosis (0.97%, 0.92% to 1.03%) has increased. Reductions in DALYs for asthma and pneumoconiosis have been seen, but DALYs due to COPD, and interstitial lung disease and pulmonary sarcoidosis have increased. Mortality and the annual change in mortality rate due to chronic respiratory diseases varied considerably across 195 countries. Assessment of the factors responsible for regional variations in mortality and DALYs and the unequal distribution of improvements during the 27 years showed negative correlations between the Socio-demographic index and the mortality rates of COPD, pneumoconiosis, and asthma. Regions with a low Socio-demographic index had the highest mortality and DALYs. Smoking remained the major risk factor for mortality due to COPD and asthma. Pollution from particulate matter was the major contributor to deaths from COPD in regions with a low Socio-demographic index. Since 2013, a high body mass index has become the principal risk factor for asthma.ConclusionsRegions with a low Socio-demographic index had the greatest burden of disease. The estimated contribution of risk factors (such as smoking, environmental pollution, and a high body mass index) to mortality and DALYs supports the need for urgent efforts to reduce exposure to them.


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