Casablanca Morocco 1923 March 2018 Dr Eman Aly MD PhD 1 Introduction Mortality data are the most relevant medical data to describe trend of diseases in the community Accurate and complete causes of death registration are required to represent the true burden of diseases ID: 931823
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Slide1
EMR
burden of Diseases
Operation of Civil Registration, Vital Statistics and Identity Management Systems and the Production of Vital Statistics Reports, EMRO countries,
Casablanca, Morocco
19-23 March 2018
Dr. Eman Aly MD PhD
1
Slide2Introduction:
Mortality data are the most relevant medical data to describe trend of diseases in the community
Accurate and complete causes of death registration are required to represent the true burden of diseasesCRVS – program in EMRO, is focusing on improving death/cause of death registration coverage and accurate identification of underlying cause of death, through; building capacity, close monitoring and evaluation of death registration systems at MS and provide technical support to overcome system issues
Dr. Eman Aly MD PhD2
Slide3Objective:
Provide examples of cause specific mortality data analysis, including the Global burden of disease list, using the actual national resisted data
Introduce output analysis of one of cause of death and data quality analysis software (ANACONDA)Identify the main data quality parameters (completeness and accuracy) Dr. Eman Aly MD PhD
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Slide4Methodology:
Calculation of proportion of causes of death using, the most recent mortality data available at, WHO global mortality data base, where data are cleaned in consultation with MS and uploaded
The plan of analysis followed the classification of Global burden of disease list (20 causes), Analysis is done using STATA – 13 ANACONDA “Analysis of Cause of Death and data quality check tool”, is used to visualize the proportion of deaths and death rate per 100,000 by age group and sex
Dr. Eman Aly MD PhD4
Slide5GBD Cause category
Freq.
%
Diabetes mellitus
47417.59Malignant neoplasms27910.36Ill-defined diseases2659.84Unintentional injuries160
5.94
Endocrine disorders
93
3.45
Perinatal conditions
77
2.86
Congenital anomalies
65
2.41
Infectious and parasitic diseases
62
2.3
Neuropsychiatric conditions
622.3Genitourinary diseases562.08Respiratory diseases542Digestive diseases531.97Ill-defined injuries/accident341.26Respiratory infections291.08Intentional injuries160.59Musculoskeletal diseases140.52Other neoplasms130.48Skin diseases130.48Nutritional deficiencies90.33Maternal conditions20.07Total2,694
Bahrain 2014Completeness =83%
Dr. Eman Aly MD PhD
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Slide6Bahrain
2014
Dr. Eman Aly MD PhD
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Slide7GBD Cause category
Freq.
%
Cardiovascular diseases
253,15247.66Digestive diseases58,46011.01Malignant neoplasms32,8646.19Ill-defined diseases
30,736
5.79
Respiratory diseases
23,295
4.39
Genitourinary diseases
20,681
3.89
Diabetes mellitus
19,838
3.74
Unintentional injuries
19,515
3.67
Infectious and parasitic diseases19,2493.62Respiratory infections17,3753.27Endocrine disorders9,3351.76Congenital anomalies8,6541.63Neuropsychiatric conditions6,2401.17Perinatal conditions4,8330.91Other neoplasms2,4710.47Nutritional deficiencies1,2580.24Ill-defined injuries/accident1,2520.24Intentional injuries6080.11Maternal conditions5010.09Skin diseases
4090.08Musculoskeletal diseases314
0.06
Sense organ diseases
45
0.01
Oral conditions
30
0.01
Total531,115
Egypt 2014Completeness =95%
Dr. Eman Aly MD PhD
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Slide8Egypt 2014
Completeness
=95%
8
Slide9Iran
2014
Completeness =90%
GBD Cause category
Freq.%Cardiovascular diseases114,01341.99Malignant neoplasms35,88213.21Unintentional injuries24,710
9.1
Ill-defined diseases
18,505
6.82
Respiratory diseases
10,317
3.8
Perinatal conditions
10,198
3.76
Diabetes mellitus
9,989
3.68
Neuropsychiatric conditions
6,7312.48Digestive diseases6,6222.44Respiratory infections5,5722.05Congenital anomalies5,1481.9Genitourinary diseases5,1151.88Infectious and parasitic diseases4,9731.83Intentional injuries4,8221.78Other neoplasms2,4500.9Ill-defined injuries/accident2,4020.88Endocrine disorders2,0460.75Musculoskeletal diseases8070.3Skin diseases5810.21Nutritional deficiencies3730.14
Sense organ diseases1460.05
Maternal conditions
104
0.04
Oral conditions
26
Total
271,532
No data in age >75y
Dr. Eman Aly MD PhD9
Slide10Iran
2014
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Slide11Iraq
2008
Completeness =75%
GBD Cause category
Freq.%Cardiovascular diseases43,13040.59Unintentional injuries11,02010.37Malignant neoplasms7,9077.44
Infectious and parasitic diseases
6,833
6.43
Ill-defined diseases
6,353
5.98
Perinatal conditions
5,651
5.32
Genitourinary diseases
5,197
4.89
Ill-defined injuries/accident
4,246
4Diabetes mellitus3,4743.27Intentional injuries3,0932.91Respiratory infections2,0621.94Respiratory diseases1,8661.76Congenital anomalies1,7541.65Neuropsychiatric conditions1,4601.37Digestive diseases1,2141.14Nutritional deficiencies3710.35Endocrine disorders3230.3Other neoplasms1140.11Maternal conditions630.06Sense organ diseases480.05Musculoskeletal diseases
470.04Skin diseases
27
0.03
Oral conditions
3
0
Total
106,256
No data in age >75yDr. Eman Aly MD PhD
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Slide12Iraq
2008
Dr. Eman Aly MD PhD
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Slide13Jordan
2012
Completeness =65%
GBD Cause category
Freq.%Cardiovascular diseases6,43437.13Malignant neoplasms2,49014.37Diabetes mellitus1,272
7.34
Unintentional injuries
1,042
6.01
Perinatal conditions
958
5.53
Congenital anomalies
747
4.31
Genitourinary diseases
544
3.14
Respiratory infections
5353.09Ill-defined diseases5122.95Digestive diseases4992.88Respiratory diseases4942.85Ill-defined injuries/accident4562.63Infectious and parasitic diseases4102.37Neuropsychiatric conditions3031.75Other neoplasms1941.12Endocrine disorders1851.07Intentional injuries1470.85Musculoskeletal diseases490.28Maternal conditions440.25Nutritional deficiencies70.04
Skin diseases70.04Total
17,329
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Slide14Jordan
2012
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Slide15Kuwait
2014
Completeness =65%
GBD Cause category
Freq.%Cardiovascular diseases2,27338.32Unintentional injuries75512.73Malignant neoplasms74312.53
Respiratory infections
497
8.38
Infectious and parasitic diseases
383
6.46
Perinatal conditions
235
3.96
Congenital anomalies
221
3.73
Diabetes mellitus
127
2.14Digestive diseases1071.8Intentional injuries1031.74Genitourinary diseases931.57Respiratory diseases761.28Ill-defined diseases731.23Neuropsychiatric conditions631.06Endocrine disorders560.94Ill-defined injuries/accident560.94Other neoplasms500.84Musculoskeletal diseases100.17Maternal conditions70.12Skin diseases30.05Nutritional deficiencies
10.02Total5,932
Dr. Eman Aly MD PhD
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Slide16Kuwait
2014
Completeness =65%
Dr. Eman Aly MD PhD16
Slide17Morocco
2012
Completeness =22%
GBD Cause category
Freq.%Ill-defined diseases14,22830.44Cardiovascular diseases9,10319.47Malignant neoplasms4,0418.64
Perinatal conditions
3,796
8.12
Diabetes mellitus
2,558
5.47
Ill-defined injuries/accident
2,062
4.41
Infectious and parasitic diseases
1,849
3.96
Unintentional injuries
1,609
3.44Respiratory diseases1,4093.01Genitourinary diseases1,1762.52Digestive diseases1,1462.45Neuropsychiatric conditions1,0322.21Respiratory infections9211.97Congenital anomalies5511.18Endocrine disorders3660.78Intentional injuries2700.58Other neoplasms2130.46Nutritional deficiencies1990.43Maternal conditions920.2Musculoskeletal diseases770.16Skin diseases420.09Oral conditions
40.01Total46,744
Available Pop. data = 0-4
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Slide18Morocco
2012
Dr. Eman Aly MD PhD
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Slide19OPT 2014
GBD Cause category
Freq.
%
Cardiovascular diseases2,73640.86Malignant neoplasms95414.25Diabetes mellitus5998.95Perinatal conditions
346
5.17
Ill-defined diseases
306
4.57
Genitourinary diseases
264
3.94
Infectious and parasitic diseases
233
3.48
Respiratory diseases
221
3.3
Congenital anomalies2002.99Digestive diseases1662.48Unintentional injuries1572.34Respiratory infections1402.09Neuropsychiatric conditions1231.84Ill-defined injuries/accident1001.49Intentional injuries791.18Endocrine disorders620.93Maternal conditions50.07Musculoskeletal diseases20.03Nutritional deficiencies20.03Other neoplasms10.01Total6,696
Dr. Eman Aly MD PhD19
Slide20OPT 2014
Dr. Eman Aly MD PhD
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Slide21Oman
2012
Completeness=81%
GBD Cause category Freq.
%Ill-defined diseases2,64237.98Cardiovascular diseases1,39820.1Unintentional injuries4376.28
Infectious and parasitic diseases
386
5.55
Malignant neoplasms
313
4.5
Ill-defined injuries/accident
228
3.28
Respiratory diseases
217
3.12
Perinatal conditions
208
2.99Diabetes mellitus1962.82Respiratory infections1772.54Congenital anomalies1552.23Digestive diseases1542.21Genitourinary diseases1522.19Neuropsychiatric conditions951.37Endocrine disorders941.35Other neoplasms260.37Musculoskeletal diseases210.3Intentional injuries190.27Nutritional deficiencies160.23Skin diseases130.19Maternal conditions6
0.09Sense organ diseases3
0.04
Total
6,956
Dr. Eman Aly MD PhD
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Slide22Oman
2012
Dr. Eman Aly MD PhD
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Slide23Qatar 2014
Completeness=67%
GBD Cause category
Freq.
PercentIll-defined diseases66628.18Unintentional injuries39016.5Cardiovascular diseases37215.74
Malignant neoplasms
250
10.58
Diabetes mellitus
135
5.71
Respiratory infections
75
3.17
Congenital anomalies
67
2.84
Intentional injuries
67
2.84Genitourinary diseases652.75Digestive diseases602.54Perinatal conditions522.2Infectious and parasitic diseases471.99Respiratory diseases371.57Endocrine disorders321.35Neuropsychiatric conditions271.14Ill-defined injuries/accident110.47Other neoplasms40.17Nutritional deficiencies30.13Skin diseases20.08Maternal conditions10.04Total
2,363
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Slide24Qatar
2014
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Slide25Saudi Arabia 2012
Completeness=36%
GBD Cause category
Freq.%Ill-defined diseases13,68129.99*******************************Cardiovascular diseases8,21618.01*******************
Ill-defined injuries/accident
5,609
12.3
*************
Perinatal conditions
3,622
7.94
********
Unintentional injuries
3,175
6.96
*******
Malignant neoplasms
2,026
4.44*****Genitourinary diseases1,5583.42****Infectious and parasitic diseases1,4883.26***Congenital anomalies1,2442.73***Respiratory infections1,0742.35**Diabetes mellitus9502.08**Digestive diseases8421.85**Respiratory diseases8331.83**Neuropsychiatric conditions4520.99*Endocrine disorders4290.94*Skin diseases179
0.39Nutritional deficiencies
88
0.19
Intentional injuries
76
0.17
Maternal conditions
45
0.1Musculoskeletal diseases
240.05Other neoplasms
4
0.01
Sense organ diseases
2
0
Total
45,617
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Slide26Syria 2010
GBD Cause category
Freq.
Percent
GBD Cause category Cardiovascular diseases33,78050.4*******************************Respiratory infections9,18513.7********
Malignant neoplasms
4,036
6.02
****
Respiratory diseases
3,008
4.49
***
Ill-defined diseases
2,828
4.22
***
Perinatal conditions
2,560
3.82**Unintentional injuries2,0493.06**Congenital anomalies1,9472.9**Digestive diseases1,8112.7**Infectious and parasitic diseases1,7772.65**Genitourinary diseases9821.47*Ill-defined injuries/accident8081.21*Diabetes mellitus7511.12*Neuropsychiatric conditions5080.76Endocrine disorders
4890.73
Intentional injuries
245
0.37
Other neoplasms
132
0.2
Nutritional deficiencies
91
0.14Maternal conditions23
0.03
Skin diseases
11
0.02
Musculoskeletal diseases
6
0.01
Total
67,027
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Slide27Tunisia 2013
Completeness=28%
GBD Cause category
Freq.
%Cardiovascular diseases5,67026.46Ill-defined diseases3,82217.83Malignant neoplasms3,109
14.51
Diabetes mellitus
1,705
7.96
Perinatal conditions
1,171
5.46
Respiratory diseases
858
4
Ill-defined injuries/accident
769
3.59
Infectious and parasitic diseases
6913.22Digestive diseases5942.77Neuropsychiatric conditions5552.59Congenital anomalies5192.42Genitourinary diseases4672.18Respiratory infections4522.11Unintentional injuries4071.9Endocrine disorders3331.55Other neoplasms1450.68Musculoskeletal diseases500.23Nutritional deficiencies450.21Maternal conditions280.13
Intentional injuries210.1
Skin diseases
20
0.09
Sense organ diseases
1
0
Total
21,432Dr. Eman Aly MD PhD
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Slide28Tunisia 2013
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Slide29Key Findings!
Using standardized data distribution for age group and the use of accurate ICD codes, reflect the actual burden of diseases and their epidemiological trends
Cardiovascular disease comes on the top of the list, reflect the true epidemiologic evolution of NCDs and, also due the use of non specific diagnosis heart diseases (heart failure, cardiac arrest …etc)Ill-defined cause of death, which is representing the use of chapter IIIVX in ICD 10, also comes on the top of the list, indicating limited data quality and underlying cause of death identification
Limited death and cause of death registration coverage, lower the confidence of the data analysis results Dr. Eman Aly MD PhD29