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Non-communicable diseases are the leading cause of mortality in rural Birbhum, West Bengal, India: a sex-stratified analysis of verbal autopsies from a prospective cohort, 2012-2017.

ABSTRACT: OBJECTIVES:There is a dearth of data on causes of death in rural India, which impedes identification of public health priorities to guide health interventions. This study aims to offer insights from verbal autopsies, to understand the pattern and distribution of causes of death in a rural area of Birbhum District, West Bengal, India. DESIGN:Causes of death data were retrieved from a prospective vital event surveillance system. SETTING:The Birbhum Population Project, a Health and Demographic Surveillance System, West Bengal, India. PARTICIPANTS:Between January 2012 and December 2017, all deaths were recorded. MAIN OUTCOME MEASURES:Trained Surveyors tracked all deaths prospectively and used a previously validated verbal autopsy (VA) tool to record causes of death. Experienced physicians reviewed completed VA forms, and assigned cause of death using the 10th version of International Classification of Diseases. In addition to cause-specific mortality fraction, cause-specific crude death rate (CDR) among males and females were estimated. RESULTS:A total of 2320 deaths (1348 males and 972 females) were recorded. An estimated CDR was 708/100?000. Over half of all deaths (1176 deaths, 50.7%) were attributed to non-communicable diseases (NCDs), with nearly 30% of all deaths attributed to circulatory system disorders; whereas 24.2% and 3.9% deaths were due to cerebrovascular diseases and ischaemic heart disease, respectively. Equal percent (13%) of males died from external causes and from infectious and parasitic diseases, and 11% died from respiratory system-related diseases. Among females, 12% died from infectious and parasitic diseases. Among children aged 0-4 years, 50% of all male deaths and 45% of all female deaths were attributed to conditions in the perinatal period. CONCLUSIONS:NCDs are the leading cause of death among adults in a select population of rural Birbhum, India. Health programmes for rural India should prioritise plans to mitigate deaths due to NCDs.

SUBMITTER: Rai RK

PROVIDER: S-EPMC7590361 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Non-communicable diseases are the leading cause of mortality in rural Birbhum, West Bengal, India: a sex-stratified analysis of verbal autopsies from a prospective cohort, 2012-2017.

Rai Rajesh Kumar RK Barik Anamitra A Mazumdar Saibal S Chatterjee Kajal K Kalkonde Yogeshwar V YV Mathur Prashant P Chowdhury Abhijit A Fawzi Wafaie W WW

BMJ open 20201023 10

<h4>Objectives</h4>There is a dearth of data on causes of death in rural India, which impedes identification of public health priorities to guide health interventions. This study aims to offer insights from verbal autopsies, to understand the pattern and distribution of causes of death in a rural area of Birbhum District, West Bengal, India.<h4>Design</h4>Causes of death data were retrieved from a prospective vital event surveillance system.<h4>Setting</h4>The Birbhum Population Project, a Healt ...[more]

PMID: 33099492

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Project description:BackgroundFollowing data access and storage concerns, Government of India transferred the management of its Sample Registration System (SRS) based mortality surveillance (formerly known as the Million Death Study) to an Indian agency. This paper introduces the new system, challenges it faced and its vision for future.MethodsThe All India Institute of Medical Sciences (AIIMS), New Delhi, the new nodal agency, established the "Mortality in India Established through Verbal Autopsy" (MINErVA) platform with state level partners across India in November 2017. The network in its first three years has undertaken capacity building of supervisors conducting verbal autopsy under the SRS, established a panel of trained physician reviewers and developed three IT-based platforms for training, quality control and coding. Coding of VA forms started from January 2015 onwards, and the cause specific mortality fractions (CSMF) of the first 14 185 adult verbal autopsy (VA) records for 2015 were compared with earlier published data for 2010-2013 to check for continuity of system performance.ResultsThe network consists of 25 institutions and a panel of 676 trained physician reviewers. 916 supervisors have been trained in conducting verbal autopsies. More than 75 000 VA forms have been coded to date. The median time taken for finalizing cause of death on the coding platform is 37 days. The level of physician agreement (67%) and proportion of VA forms requiring adjudication (12%) are consistent with published literature. Preliminary CSMF estimates for 2015 were comparable with those for 2010-2013 and identified same top ten causes of death. In addition to the delay, two major challenges identified for coding were language proficiency of physician reviewers vis-à-vis language of narratives and quality of verbal autopsies. While an initial strategic decision was made to consolidate the system to ensure continuity, future vision of the network is to move towards technology-based solutions including electronic data capture of VAs and its analysis and improving the use of mortality data in decision making.ConclusionMINErVA network is now fully functional and is moving towards achieving global standards. It provides valuable lessons for other developing countries to establish their own mortality surveillance systems.

Project description:Hybrid rice requires adequate nitrogen (N) management in order to achieve good yields from its vegetative and reproductive development. With this backdrop, a field experiment was conducted at Regional Research Station (Coastal Saline Zone), Bidhan Chandra Krishi Viswavidyalaya, Kakdwip, West Bengal (India) to record growth and yield performance of hybrid rice (cv. PAN 2423) under varied N-fertilizer doses. A modelling approach was adopted for the first time in hybrid rice production system under coastal ecosystem of West Bengal (India). In the present study, the Agricultural Production Systems Simulator (APSIM) model was calibrated and validated for simulating a hybrid rice production system with different N rates. The APSIM based crop simulation model was found to capture the physiological changes of hybrid rice under varied N rates effectively. While studying the relationship between simulated and observed yield data, we observed that the equations developed by APSIM were significant with higher R2 values (≥0.812). However, APSIM caused an over-estimation for calibrate data but it was rectified for validated data. The RMSE of models for all the cases was less than respective SD values and the normalized RMSE values were ≤20%. Hence, it was proved to be a good rationalized modelling and the performance of APSIM was robust. On the contrary, APSIM underestimated the calibrated amount of N (kg ha−1) in storage organ of hybrid rice, which was later rectified in case of validated data. A strong correlation existed between the observed and APSIM-simulated amounts of N in storage organ of hybrid rice (R2 = 0.94** and 0.96** for the calibration and validation data sets, respectively), which indicates the robustness of the APSIM simulation study. Scenario analysis also suggests that the optimal N rate will increase from 160 to 200 kg N ha−1 for the greatest hybrid rice production in coming years under elevated CO2 levels in the atmosphere. The APSIM-Oryza crop model had successfully predicted the variation in aboveground biomass and grain yield of hybrid rice under different climatic conditions.

Dataset Information

Non-communicable diseases are the leading cause of mortality in rural Birbhum, West Bengal, India: a sex-stratified analysis of verbal autopsies from a prospective cohort, 2012-2017.

Publications

Non-communicable diseases are the leading cause of mortality in rural Birbhum, West Bengal, India: a sex-stratified analysis of verbal autopsies from a prospective cohort, 2012-2017.

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