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  • India - Million Death Study links and information.

    Global health: One million deaths
    What researchers are learning from an unprecedented survey of mortality in India.


    Erica Westly
    04 December 2013
    ...
    The Million Death Study (MDS) involves
    biannual
    in-person surveys of more than
    1 million households across India. The study
    covers the period from 1997 to the end of 2013,
    and will document roughly 1 million deaths. Jha
    and his colleagues have coded about 450,000
    so far, and have deciphered several compelling
    trends that are starting to lead to policy changes,
    such as stronger warning labels on tobacco.
    ...
    http://www.nature.com/polopoly_fs/1....df/504022a.pdf

    Centre for Global Health Research

    MILLION DEATH STUDY (MDS)

    Million Death Study
    The Million Death Study (MDS) is one of the largest studies of premature mortality in the world. The MDS is an ongoing study that is conducted in India, where, like most low- and middle-income countries, the majority of deaths occur at home and without medical attention. As a result, the majority of global deaths do not have a certified cause.

    In collaboration with the Registrar General of India, the MDS will monitor nearly 14 million people in 2.4 million nationally representative households in India between 1998-2014. Any deaths that occur in these households during this period will be assigned a probable cause, as determined by a method called verbal autopsy.

    The results for the leading causes of death in India will be provided to governments, research agencies, and media as they become available so that they can take action against preventable deaths.

    MDS Study Protocol
    MDS Collaborators
    MDS Publications
    ...
    http://www.cghr.org/index.php/projec...study-project/

    Diarrhea, Pneumonia, and Infectious Disease Mortality in
    Children Aged 5 to 14 Years in India

    Shaun K. Morris1,2*, Diego G. Bassani1, Shally Awasthi3, Rajesh Kumar4, Anita Shet5, Wilson Suraweera1,
    Prabhat Jha1 for the MDS Collaborators
    1 Centre for Global Health Research, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario,
    Canada, 2 Division of Infectious Diseases, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada, 3 Department of Pediatrics, King George’s Medical
    University, Lucknow, Uttar Pradesh, India, 4 School of Public Health, Post Graduate Institute of Medical Education, Chandigarh, India, 5 Department of Pediatrics, St. John’s
    National Academy of Health Sciences, Bangalore, India

    Abstract

    Background: Little is known about the causes of death in children in India after age five years. The objective of this study is
    to provide the first ever direct national and sub-national estimates of infectious disease mortality in Indian children aged 5
    to 14 years.

    Methods: A verbal autopsy based assessment of 3 855 deaths is children aged 5 to 14 years from a nationally representative
    survey of deaths occurring in 2001–03 in 1?1 million homes in India.

    Results: Infectious diseases accounted for 58% of all deaths among children aged 5 to 14 years. About 18% of deaths were
    due to diarrheal diseases, 10% due to pneumonia, 8% due to central nervous system infections, 4% due to measles, and
    12% due to other infectious diseases. Nationally, in 2005 about 59 000 and 34 000 children aged 5 to 14 years died from
    diarrheal diseases and pneumonia, corresponding to mortality of 24?1 and 13?9 per 100 000 respectively. Mortality was
    nearly 50% higher in girls than in boys for both diarrheal diseases and pneumonia.

    Conclusions: Approximately 60% of all deaths in this age group are due to infectious diseases and nearly half of these
    deaths are due to diarrheal diseases and pneumonia.
    Mortality in this age group from infectious diseases, and diarrhea in
    particular, is much higher than previously estimated.
    ...
    Morris SK, Bassani DG, Awasthi S, Kumar R, Shet A, et al. (2011) Diarrhea, Pneumonia, and Infectious Disease Mortality in Children Aged 5 to 14 Years in
    India. PLoS ONE 6(5): e20119. doi:10.1371/journal.pone.0020119
    http://cghr.org/wordpress/wp-content...idren-2011.pdf

    Causes of neonatal and child mortality in India: a nationally
    representative mortality survey

    The Million Death Study Collaborators*

    Summary

    Background More than 2·3 million children died in India in 2005; however, the major causes of death have not been
    measured in the country. We investigated the causes of neonatal and child mortality in India and their differences by
    sex and region.

    Methods The Registrar General of India surveyed all deaths occurring in 2001–03 in 1·1 million nationally
    representative homes. Field staff interviewed household members and completed standard questions about events
    that preceded the death. Two of 130 physicians then independently assigned a cause to each death. Cause-specific
    mortality rates for 2005 were calculated nationally and for the six regions by combining the recorded proportions for
    each cause in the neonatal deaths and deaths at ages 1–59 months in the study with population and death totals from
    the United Nations.

    Findings There were 10 892 deaths in neonates and 12 260 in children aged 1–59 months in the study. When these
    details were projected nationally, three causes accounted for 78% (0·79 million of 1·01 million) of all neonatal deaths:
    prematurity and low birthweight (0·33 million, 99% CI 0·31 million to 0·35 million), neonatal infections
    (0·27 million, 0·25 million to 0·29 million), and birth asphyxia and birth trauma (0·19 million, 0·18 million to
    0·21 million). Two causes accounted for 50% (0·67 million of 1·34 million) of all deaths at 1–59 months: pneumonia
    (0·37 million, 0·35 million to 0·39 million) and diarrhoeal diseases (0·30 million, 0·28 million to 0·32 million)
    . In
    children aged 1–59 months, girls in central India had a fi ve-times higher mortality rate (per 1000 livebirths) from
    pneumonia (20·9, 19·4–22·6) than did boys in south India (4·1, 3·0–5·6) and four-times higher mortality rate from
    diarrhoeal disease (17·7, 16·2–19·3) than did boys in west India (4·1, 3·0–5·5).

    Interpretation Five avoidable causes accounted for nearly 1·5 million child deaths in India in 2005, with substantial
    differences between regions and sexes.
    Expanded neonatal and intrapartum care, case management of diarrhoea and
    pneumonia, and addition of new vaccines to immunisation programmes could substantially reduce child deaths in India.

    Funding US National Institutes of Health, International Development Research Centre, Canadian Institutes of Health
    Research, Li Ka Shing Knowledge Institute, and US Fund for UNICEF.
    ...
    http://cghr.org/wordpress/wp-content...India-2010.pdf

    Health Datasets from the Government of India;
    http://data.gov.in/catalogs/?filter=...rt=title%20asc

    Adult and child malaria mortality in India: a nationally
    representative mortality survey

    Neeraj Dhingra, Prabhat Jha, Vinod P Sharma, Alan A Cohen, Raju M Jotkar, Peter S Rodriguez, Diego G Bassani, Wilson Suraweera,
    Ramanan Laxminarayan, Richard Peto, for the Million Death Study Collaborators*

    Summary
    Background National malaria death rates are difficult to assess because reliably diagnosed malaria is likely to be cured,
    and deaths in the community from undiagnosed malaria could be misattributed in retrospective enquiries to other
    febrile causes of death, or vice-versa. We aimed to estimate plausible ranges of malaria mortality in India, the most
    populous country where the disease remains common.

    Methods Full-time non-medical field workers interviewed families or other respondents about each of 122 000 deaths
    during 2001–03 in 6671 randomly selected areas of India, obtaining a half-page narrative plus answers to specific
    questions about the severity and course of any fevers. Each field report was sent to two of 130 trained physicians, who
    independently coded underlying causes, with discrepancies resolved either via anonymous reconciliation or
    adjudication.

    Findings Of all coded deaths at ages 1 month to 70 years, 2681 (3·6%) of 75 342 were attributed to malaria. Of these,
    2419 (90%) were in rural areas and 2311 (86%) were not in any health-care facility.
    Death rates attributed to malaria
    correlated geographically with local malaria transmission rates derived independently from the Indian malaria control
    programme. The adjudicated results show 205 000 malaria deaths per year in India before age 70 years (55 000 in early
    childhood, 30 000 at ages 5–14 years, 120 000 at ages 15–69 years); 1·8% cumulative probability of death from malaria
    before age 70 years.
    Plausible lower and upper bounds (on the basis of only the initial coding) were 125 000–277 000.
    Malaria accounted for a substantial minority of about 1·3 million unattended rural fever deaths attributed to infectious
    diseases in people younger than 70 years.


    Interpretation Despite uncertainty as to which unattended febrile deaths are from malaria, even the lower bound greatly
    exceeds the WHO estimate of only 15 000 malaria deaths per year in India (5000 early childhood, 10 000 thereafter). This
    low estimate should be reconsidered, as should the low WHO estimate of adult malaria deaths worldwide.

    Funding US National Institutes of Health, Canadian Institute of Health Research, Li Ka Shing Knowledge Institute.
    ...
    http://cghr.org/wordpress/wp-content...India-2010.pdf

    Official number of cases & deaths due to Acute Diarrhoeal Diseases, Acute Respiratory Infection, Deaths, Japanese Encephalitis, Malaria & Viral Hepatitis 2000 - 2011
    http://data.gov.in/dataset/number-ca...s-due-diseases

    FluTrackers Threads:
    India malaria deaths hugely underestimated, says report
    20,000 rabies deaths per annum in India - Maybe not
    Twitter: @RonanKelly13
    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

  • #2
    Re: India - Million Death Study links and information.

    ht @Crof

    12 July 2014 Last updated at 15:54 ET

    The mystery of India's unrecorded deaths
    By Cathy Edwards and Suhail Haleem
    BBC Health Check

    There are estimated to be around 56m deaths per year according to the World Health Organisation - and it's thought half are not registered - so there is a lot of missing information about what people die of. The Million Deaths Study aims to change that by investigating one million deaths in India - and there have been some surprising discoveries.
    ...
    Knowing what is killing people is vital - it helps save lives by ensuring public health money is spent on the right things.
    ...
    It's a mammoth task - 60,000 homes per year have been visited over the course of 14 years and they are set to reach the millionth death later this year.
    ...
    By number crunching the data they found the average male cigarette smoker is losing a decade of life in India.

    Prof Jha says their findings helped prompt India's health minister Harsh Vardhan to recommend a 200% tax hike on cigarettes for the new government's budget.

    In the budget which was announced this week, taxes on cigarettes were raised between 11 and 72%, but the researchers estimate that even this more modest hike could save nearly one million lives.
    ...
    http://www.bbc.com/news/health-28228...medium=twitter

    MDS Publications;


    JOURNAL PUBLICATIONS

    Comparison of physician-certified verbal autopsy with computer-coded verbal autopsy for cause of death assignment in hospitalized patients in low- and middle-income countries: systematic review
    Leitao J, Desai N, Aleksandrowicz L, Miasnikof P, Tollman S, Alam D, Lu Y, Rathi S, Singh A, Suraweera W, Ram F, Jha P
    BMC Medicine 2014, 12:22

    Performance criteria for verbal autopsy-based
    systems to estimate national causes of death: development and application to the Indian Million Death Study

    Aleksandrowicz L, Malhotra V, Dikshit R, Gupta P, Kumar R, Sheth J, Rathi S, Suraweera W, Miasnikof P, Jotkar R, Sinha D, Awasthi S, Bhatia P, Jha P
    BMC Medicine 2014, 12:21

    Performance of four computer-coded verbal autopsy methods for cause of death assignment compared with physician coding on 24,000 deaths in low- and middle-income countries
    Desai N, Aleksandrowicz L, Miasnikof P, Lu Y, Leitao J, Byass P, Tollman S, Mee P, Alam D, Rathi S, Singh A, Kumar R, Ram F, Jha P
    BMC Medicine 2014, 12:20

    Reliable direct measurement of causes of death in low- and middle-income countries
    Jha P
    BMC Medicine 2014, 12:19

    Road traffic injury mortality and its mechanisms in India: nationally representative mortality survey of 1.1 million homes
    Hsiao M, Malhotra A, Thakur JS, Sheth JK, Nathens AB, Dhingra N, Jha P, for the Million Death Study Collaborators.
    BMJ Open. 2013; 3:e002621

    Measles mortality in high and low burden districts of India: Estimates from a nationally representative study of over 12,000 child deaths
    Morris SK, Awasthi S, Kumar R, Shet A, Khera A, Nakhaee F, Ram U, Brandao JR, Jha P, on behalf of the Million Death Study Collaborators.

    Vaccine. 2013; 31(41):4655-61

    Deaths from symptomatically identifiable furious rabies in India: a nationally representative mortality survey
    Suraweera W, Morris SK, Kumar R, Warrell DA, Warrell MJ, Jha P for the Million Death Study Collaborators.
    PLoS Negl Trop Dis. 2012; 6(10): e1847.

    Rotavirus mortality in India: estimates based on a nationally representative survey of diarrhoeal deaths
    Morris SK, Awasthi S, Khera A, Bassani DG, Kang G, Parashar UD, Kumar R, Shet A, Glass RI, Jha P for the Million Death Study Collaborators.
    Bull World Health Organ. 2012; BLT.12.101873

    Unintentional injury mortality in India, 2005: Nationally representative mortality survey of 1.1 million homes
    Jagnoor J, Suraweera W, Keay L, Ivers RQ, Thakur JS, Jha P.
    BMC Public Health. 2012; 12(487).

    Suicide mortality in India: a nationally representative survey
    Patel V, Ramasundarahettige C, Vijayakumar L, Thakur JS, Gajalakshmi V, Gururaj G, Suraweera W, Jha P for the Million Death Study Collaborators.
    Lancet. 2012; 379: 2343-51.

    Cancer mortality in India: a nationally representative survey
    Dikshit R, Gupta PC, Ramasundarahettige C, Gajalakshmi V, Aleksandrowicz L, Badwe R, Kumar R, Roy S, Suraweera W, Bray F, Mallath M, Singh PK, Sinha DN, Shet AS, Gelband H, Jha P for the Million Death Study Collaborators.
    Lancet. 2012; 379: 1807-16.

    Factors associated with physician agreement and coding choices of cause of death using verbal autopsies for 1130 maternal deaths in India.
    Montgomery AL, Morris SK, Bassani DG, Kumar R, Jotkar R, Jha P.
    PLoS One. 2012; 7(3): e33075.

    Factors associated with physician agreement on verbal autopsy of over 11500 injury deaths in India.
    Hsiao M, Morris SK, Bassani DG, Montgomery AL, Thakur JS, Jha P.
    PLoS One. 2012; 7(1): e30336.

    Geospatial assessment of the relationship between altitude and mortality in India.
    Hsiao C, Jha P.
    4th International Conference on HealthGIS 2011. August 5-6th, 2011, New Delhi, India.

    Childhood and adult mortality from unintentional falls in India.
    Jagnoor J, Suraweera W, Keay L, Ivers RQ, Thakur JS, Gururajd G, Jha P for the Million Death Study Collaborators.
    Bull World Health Organ. 2011 August 3; BLT.11.086306.

    Male use of female sex work in India: a nationally representative behavioural survey.
    Gaffey MF, Venkatesh S, Dhingra N, Khera A, Kumar R, Arora P, Nagelkerke N, Jha P.
    Plos One. 2011; 6(7): e22704.

    Trends in selective abortions of girls in India: analysis of nationally representative birth histories from 1990 to 2005 and census data from 1991 to 2011.
    Jha P, Kesler MA, Kumar R, Ram F, Ram U, Aleksandrowicz L, Bassani DG, Chandra S, Banthia JK.
    Lancet. 2011;377:1921-1928. DOI: 1016/S0140-6736(11)60649-1.

    Diarrhea, pneumonia, and infectious disease mortality in children aged 5-14 years in India.
    Morris SK, Bassani DB, Awashti S, Kumar R, Shet A, Suraweera W, Jha P, for the MDS Collaborators.
    PLoS ONE 2011 May; 6(5): e20119 [Epub].

    Unintentional injury deaths among children younger than five years of age in India: a nationally representative mortality survey of 1.1 million homes.
    Jagnoor J, Keay L, Ivers R, Suraweera W, Jha P.
    Injury Prevention. 2011 April 14. [Epub]. doi: 10.1136/ip.2010.029934.

    Snakebite mortality in India: a nationally representative mortality survey.
    Mohapatra B, Warrell DA, Suraweera W, Bhatia P, Dhingra N, Jotkar R, Mony P, Whitaker R, Jha P.
    PLoS NTD. 2011 Apr 12; 5(4): e1018 [Epub].

    Capturing the context of maternal deaths from verbal autopsies: a reliability study of the Maternal Data Extraction Tool (M-DET).
    Montgomery AL, Morris SK, Kumar R, Jotkar R, Money P, Bassani DG, Jha P.
    PLoS One. 2011 February 7. [Epub].

    Causes of child and neonatal mortality in India: nationally-representative mortality survey.
    Bassani DG, Kumar R, Morris SK, Jha P et al, for the Million Death Study Collaborators.
    Lancet. 2010; 376: 1853-6.

    Adult and child malaria mortality in India.
    Dhingra N, Jha P, Sharma VP, Cohen AA, Jotkar RM, Rodriguez PS, Bassani DG, Suraweera W, Laxminarayan R, Peto R.
    Lancet. 2010; 376: 1768-7.

    Factors associated with physician agreement on verbal autopsy of over 27000 childhood deaths in India.
    Morris SK, Bassani DG, Kumar R, Awasthi S, Paul VK, Jha P.
    PLoS One. 2010; 5(3): e9583.

    HIV mortality and infection in India: estimates from nationally representative mortality survey of 1.1 million homes.
    Jha P, Kumar R, Khera A, Bhattachary M, Arora P, Gajakshmi V, Bhatia P, Kam D, Bassani DG, Sullivan A, Suraweera W, McLaughlin C, Dhingra N, Nagelkerke N on behalf of Million Death Study Collaborators.
    BMJ. 2010; 340: c621.

    A nationally representative case-control study of smoking and death in India.
    Jha P, Jacob B, Gajalakshmi V, et al.
    N Engl J Med. 2008 February 13. [Epub].

    Low male-to-female sex ratio of children born in India: national survey of 1.1 million households.
    Jha P, Kumar R, Vasa P et al.
    Lancet. 2006; 367: 211-218.

    Prospective study of one million deaths in India: rationale, design and validation results.
    Jha P, Gajalakshimi V, Gupta PC, et al for the RGI-CGHR Prospective Study Collaborators.
    PLoS Medicine. 2006; 3: 191-200.

    Sample registration of vital events with verbal autopsy: A renewed commitment to measuring and monitoring vital statistics.
    Setel P, Sankoh O, Rao C, Velkoff VA, Mathers C, Gonhuan Y, Jha P, Sethi RC, Hemed Y, Lopez AD.
    Bull World Health Organ. 2005; 83(8): 611-617.



    REPORTS

    Choosing Health: An Entitlement for All Indians.
    Jha P, Laxminarayan R.
    CGHR, University of Toronto, Toronto and New Delhi 2009.

    Causes of Death in India: Results from the Million Death Study.
    RGI/CGHR. New Delhi: Registrar General; 2009

    Maternal Mortality in India, 1997–2003: Levels, Trends and Risk Factors.
    RGI/CGHR. New Delhi: Registrar General, 2006.

    Special Fertility & Mortality Survey, 1998. A Report of 1.1 Million Indian Households.
    RGI/CGHR. New Delhi: Registrar General, 2005.

    http://www.cghr.org/index.php/public...n-death-study/
    Twitter: @RonanKelly13
    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

    Comment


    • #3
      Re: India - Million Death Study links and information.

      Lessons From the Dead
      Why ďverbal autopsiesĒ are changing public health.

      By Linda Geddes

      This article originally appeared in New Scientist.

      Relatives of the recently deceased are helping to pin down the causes of deaths in India and boost public health, says Prabhat Jha, professor of epidemiology and public health at the University of Toronto in Canada. He is also founder of the Centre for Global Health Research at St Michaelís Hospital in Toronto, through which he leads the ongoing Million Death Study in India.
      ...
      What are your most important findings so far?
      As well as finding a far higher death toll than expected linked to smoking in India, we estimated that there were 200,000 malaria deaths in Indians younger than 70 during 2005. For that year, the World Health Organization had estimated about 15,000 malaria deaths in India. The WHOís numbers are based on properly diagnosed patients, but because you can cure most malaria, anyone you diagnose is very unlikely to die. Meanwhile, many acute fever deaths were and are going undiagnosed.

      How have people reacted to such findings?
      The malaria numbers were very controversial. The main criticism was that we donít know whether it was the malaria or some other infection that killed the person. And thatís absolutely true, because we didnít have microbiological confirmation. Weíre starting to work with mortuaries to do that now.

      But the presence of acute fever deaths was unambiguous. We were consistently finding a person who was otherwise well, then suddenly had an acute fever and died. The number of diseases that can kill in this way is reasonably limited, and these fever deaths also correlated with the known geographical distribution for malaria. Itís still controversial, but the numbers are just too big to be explained by some of the criticisms that were thrown at it.
      ...
      http://www.slate.com/articles/health...ic_health.html
      Twitter: @RonanKelly13
      The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

      Comment


      • #4
        National Burden Estimates of healthy life lost in India, 2017: an analysis using direct mortality data and indirect disability data

        Geetha R Menon, Lucky Singh, Palak Sharma, Priyanka Yadav, Shweta Sharma, Shrikant Kalaskar, Harpreet Singh, Srividya Adinarayanan, Vasna Joshua, Vaitheeswaran Kulothungan, Jeetendra Yadav, Leah K Watson, Shaza A Fadel, Wilson Suraweera, M Vishnu Vardhana Rao, R S Dhaliwal, Rehana Begum, Prabha Sati, Dean T Jamison, Prabhat Jha
        Summary

        Background Many countries, including India, seek locally constructed disease burden estimates comprising mortality and loss of health to aid priority setting for the prevention and treatment of diseases. We created the National Burden Estimates (NBE) to provide transparent and understandable disease burdens at the national and subnational levels, and to identify gaps in knowledge.

        Methods To calculate the NBE for India, we combined 2017 UN death totals with national and subnational mortality rates for 2010–17 and causes of death from 211 166 verbal autopsy interviews in the Indian Million Death Study for 2010–14. We calculated years of life lost (YLLs) and years lived with disability (YLDs) for 2017 using published YLD–YLL ratios from WHO Global Health Estimates. We grouped causes of death into 45 groups, including illdefined deaths, and summed YLLs and YLDs to calculate disability-adjusted life-years (DALYs) for these causes in eight age groups covering rural and urban areas and 21 major states of India.

        Findings In 2017, there were about 9∑7 million deaths and 486 million DALYs in India. About three quarters of deaths and DALYs occurred in rural areas. More than a third of national DALYs arose from communicable, maternal, perinatal, and nutritional disorders. DALY rates in rural areas were at least twice those of urban areas for perinatal and nutritional conditions, chronic respiratory diseases, diarrhoea, and fever of unknown origin. DALY rates for ischaemic heart disease were greater in urban areas. Injuries caused 11∑4% of DALYs nationally. The top 15 conditions that accounted for the most DALYs were mostly those causing mortality (ischaemic heart disease, perinatal conditions, chronic respiratory diseases, diarrhoea, respiratory infections, cancer, stroke, road traffic accidents, tuberculosis, and liver and alcohol-related conditions), with disability mostly due to a few conditions (nutritional deficiencies, neuropsychiatric conditions, vision and other sensory loss, musculoskeletal disorders, and genitourinary diseases). Every condition that was common in one part of India was uncommon elsewhere, suggesting state-specific priorities for disease control.


        Interpretation The NBE method quantifies disease burden using transparent, intuitive, and reproducible methods. It provides a simple, locally operable tool to aid policy makers in priority setting in India and other low-income and middle-income countries. The NBE underlines the need for many more countries to collect nationally representative cause of death data, paired with focused surveys of disability.

        Funding Ministry of Health and Family Welfare, Government of India.

        Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
        ...
        https://www.thelancet.com/pdfs/journ...19)30451-6.pdf
        Twitter: @RonanKelly13
        The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

        Comment

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