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|Title: ||Trends in causes of death by autopsy at the Komfo Anokye Teaching Hospital|
|Authors: ||Appiah, Anita|
|Issue Date: ||4-Nov-2015|
|Abstract: ||Background: Autopsy remains the most reliable tool for the determination of the actual cause of death. In Ghana, mortality data play an important role in the formulation of health policies. However autopsy data and procedures alone are not audited and analysed for the trends in disease causation. This does not allow for adequate and evidence-based health planning. The available cause of death, which is almost invariably under reported is used in health planning. We therefore set out to determine the trends in causes of death at Ghana’s second largest teaching hospital in Kumasi.
Methods: A retrospective cross-sectional study involving the review of secondary data from the Department of Pathology at the Komfo-Anokye Teaching Hospital was carried out from July 15th 2014 to November 15th 2014. A total of 6632 reported deaths that occurred during the period under review and for which autopsies were performed were included in the study. The outcome was then compared with the national health data on top ten (10) causes of death. We also determined the cause of death by trend and socio demographic characteristics and the public health priorities of the ageing population by comparing findings of our study to findings from SAGE. These data were taken from a five-year period between 2009 and 2013.
Results: The rate in autopsy performance showed a declining trend from 41% in 2009 to 21% in 2013.
The top 10 causes of death by autopsy varied from the national top 10; injuries consistently remained as the highest cause of death in all the years, whereas the second and third positions were shared by hypertension and pneumonia respectively.
Two main indications for autopsy made at the Department of Pathology at KATH were statistical and medico legal. The rate of statistical autopsies (67%) was generally high compared with that of medico legal.
Majority of autopsies was carried out in the 25-44 age group (34%). Of all cases sent for autopsies in the department, there were more males than females who died within the period under review (62.5%). Age was significantly associated with injuries [p value<0.001; 95% CI (235.42–236.70)], hypertension [p value=0.003; 95% CI (55.38–57.08)] and cancers [p value<0.001; 95% CI (142.99–147.79)]. Injury constituted the majority cause of death and was significantly associated with gender [p value< 0.001; 95% CI (55.27–57.09)].
The odds of having severe disability increased with the number of diseases or health conditions an adult had. The age-adjusted odds ratio was three times more in an adult with three diseases (3.23) compared with that of an adult without any.
Conclusion: There is a progressive decline in the rate of autopsy at KATH during the period under review. Additionally, top ten cause of mortality clearly varied from that of the national statistics data. Reasons for decline and variation between the causes of death from the clinical point of view and that of pathological viewpoint would make an interesting future study. Health planning should make use of such mortality data for future planning.|
|Description: ||A thesis submitted to the Department of Health Policy, Management and Economics, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, in partial fulfilment of the requirements for the Degree of Master of Public Health (Health Services Planning and Management), 2015|
|Appears in Collections:||College of Health Sciences|
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