The World Health Organisation recently updated its death statistics, which now reflect 2015 data. When Africa Check last reviewed the continent’s leading causes of death, the terrifying Ebola virus was making international headlines, despite the crisis contributing a relatively small portion of total African deaths.
By the time the West African pandemic ended in 2016, 11,300 people had died from Ebola. But the new WHO data shows it is the ailments we may consider more commonplace that actually claim the most lives in Africa.
9.2 million deaths from all causes in 2015
To shed more light on the continent’s leading causes of death, it is necessary to place these large figures into context. The UN estimated the region’s 2015 population at close to 1 billion and in that year, some 9.2 million deaths were registered. (Note: WHO’s Africa region consists of 47 of 54 countries on the continent.)
The agency classifies deaths into three broad groups. Group I are communicable, maternal, newborn and nutritional conditions; Group II are noncommunicable – or chronic – diseases and Group III are caused by injuries.
|How the World Health Organization collects death data
The World Health Organization’s estimates are based on the latest available national information on deaths by place, time and cause. These are collected from national civil registration systems of deaths, with the underlying cause of death captured by the national authority.
Where these figures are lacking the WHO relied on data collection and modelling based on their own work and a network of partner organisations.
Data sources and methodology are available on the organisation’s Global Health Estimates webpage.
In 2015, group I conditions accounted for 5.2 million of deaths (56.4%), down from 5.7 million deaths in 2010 (61.4%). Notable causes of death in this category were:
- lower respiratory tract infections (1 million),
- HIV/AIDS (760,000),
- diarrhoeal diseases (643,000),
- tuberculosis (434,000) and
- malaria (403,000).
Noncommunicable, or group II, diseases are those traditionally associated with urbanisation and higher standards of living. They accounted for 3.1 million deaths (33.5% of all deaths), rising from 29.4% in 2010.
The major killers in this category were:
- stroke (451,000 deaths),
- ischaemic heart disease (caused by decreased blood flow and thus oxygen/nutrient supply to the heart) at 441,000, and
- cirrhosis of the liver (replacement of normal liver with scar tissue) with 174,095 deaths.
Since 2010, stroke and ischaemic heart disease have replaced tuberculosis and malaria in the top 5 primary causes of death in Africa.
Group III deaths, or those caused by injury, were at 930,000 of the total (10.1%), rising from 9.1% in 2010. These included:
- 269,000 deaths from road injuries,
- 102,000 from interpersonal violence (including assaults by strangers and within relationships) and
- 87,000 deaths due to self-harm.
As nations develop, become increasingly urbanised and able to tackle poverty, mortality patterns tend to shift. In 2015, only 7% of deaths were from group I causes in what could be considered high-income countries. Instead, the overwhelming share of deaths (88%) was from non-communicable diseases, which include those commonly known as “lifestyle diseases”.
In Africa, the burden of deaths in 2015, as in 2012, still remained largely due to preventable causes. A notable change since 2012 is that malaria has dropped off the top 5 list, allowing ischaemic heart disease to move into this list.
We look closer at the leading killers on the continent.
Africa’s top 5 causes of death
Lower respiratory tract infections
The leading cause of death in Africa, lower respiratory tract infections target your airways and lungs. Diverse in origin, they stem from many viruses and bacteria and occasionally fungi or parasites.
The most common illnesses are bronchitis or pneumonia. Pneumonia is single-handedly responsible for 16% of global deaths of children younger than five, with a significantly greater share in Africa.
The notable exclusion from this category is tuberculosis as the disease can infect virtually anywhere in the body even if initially limited to the lungs.
The Human Immunodeficiency Virus targets the immune system, restricting someone’s ability to mount a defence against infections and cancers as it progresses. The most severe phase of the disease is known as AIDS, or acquired immunodeficiency syndrome, and can take between 2 to 15 years to develop depending on the person infected.
Antiretroviral drugs suppress the replication of the virus in the body while also allowing the immune system to strengthen.
In 2015, there were an estimated 760,000 deaths from HIV/AIDS and related complications in Africa, compared to 1 million in 2010. This 24% decrease is due to better diagnosis and treatment and more information on the condition. The near-halving in HIV/AIDS mortality is a trend seen over the last decade – 1.5 million people died of HIV/AIDS in 2005.
Of special mention is tuberculosis. People who are HIV+ find themselves at particular risk of an active TB infection. In contrast, TB often takes on a latent form when someone’s immune system is healthy.
The World Health Organisation classifies deaths in cases of patients with both TB and HIV as the result of a complication of HIV. For HIV- patients, their deaths are classified as being caused by tuberculosis but this is entirely dependent on accurate diagnosis. In places with fewer resources, the HIV status of an infected person may not be known, compromising data accuracy.
Diarrhoea is defined as the passage of three or more loose or liquid stools per day or more than is normal for a person. It is often a symptom of either a viral, bacterial or parasitic infection. According to the Centers for Disease Control and Prevention, 88% of deaths in this category worldwide are due to unsafe water, poor sanitation and insufficient hygiene.
It is the second leading cause of death of children younger than five worldwide. Compounded by malnutrition, death is caused by dehydration, poor absorption of nutrients or infectious complications, such as damage to the intestinal wall.
Since 2010, deaths due to diarrhoeal illnesses have decreased from 725,000, or 8% of the region’s deaths, to 643,000 (or 7%) in 2015.
A stroke happens when blood flow to a region of the brain is interrupted by either a clot or bleeding, depriving the body of oxygen and nutrients. Often, the person dies or suffers permanent damage.
Stroke deaths increased over the past five years from 406,595 (4.4% of deaths) to 451,000 deaths (4.9%) in 2015.
Ischaemic heart disease
Ischaemic heart disease refers to the narrowing of the arteries of the heart due to the buildup of plaques. This causes less oxygen to reach portions of the heart lying beyond the obstruction. Death occurs when an artery suddenly becomes fully blocked, causing severe damage to the heart. More commonly this is known as a heart attack.
During 2015, an estimated 441,000 deaths (or 4.8% of the total) were due to ischaemic heart disease. In 2010, this category had a significantly smaller number of deaths at 389,785 (or 4.2% of total deaths).
Changeable risk factors for conditions that affect blood vessels – such as stroke and heart attack – include high blood pressure, smoking, diabetes, being overweight, high cholesterol levels, an unhealthy diet, stress and lack of exercise.
Shifting trend expected to continue
After these top five killers, the next leading causes of death in the region were tuberculosis (456,000 or 4.7% of total), malaria (403,000, or 4.4%), preterm birth complications (344,000 or 3.7%), birth asphyxia or trauma (321,000 or 3.5%) and road injury (269,000 or 2.9%).
The shifting trend towards causes of death more traditionally associated with developed world countries is expected to continue with increased urbanisation and better access to medical care.
|CORRECTION: A previous version of this factsheet stated that diarrhoeal diseases were the second leading cause of death for children younger than five in Africa. That is the case worldwide. In Africa, it is the fifth leading cause of death. We have corrected the piece and apologise for the error.|
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