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  • Title: Female mortality in reproductive ages in Dar es Salaam, Tanzania.
    Author: Urassa E, Massawe S, Mgaya H, Lindmark G, Nyström L.
    Journal: East Afr Med J; 1994 Apr; 71(4):226-31. PubMed ID: 8062768.
    Abstract:
    An audit of all cases of female mortality in the reproductive age groups has been performed in Dar es Salaam during 1991-93. Multiple sources of information was used to collect information on deaths. None of the sources of information on death was alone adequate. 73% of the interviews was done at home. The mother or another close relative was interviewed in more than 70% of the cases. A total of 645 deaths were identified and 18% of these were related to pregnancy. Fever, shortness of breath and weight loss were the most common symptoms before death followed by pallor and vomiting. Almost 90% visited a health facility before death. AIDS (27%), tuberculosis (13%) and malaria (12%) were the most common causes of death. Diagnosis could not be made from audit data in 22 cases, and the relatives attributed 7.6% of all deaths to witchcraft or just God's will. AIDS and related diseases are now a major cause of death in the female reproductive age group. There is need to identify preventive measures of this disease as well as prevention of malaria and tuberculosis. In order to study maternal mortality in Ilala District, Dar es Salaam, Tanzania, all female deaths in the 12-44 year age group were registered from February 1991 to January 1993. After a follow-up, a relative of the deceased was interviewed to classify the death as associated with pregnancy or not. Eight data collectors were employed to collect information. The team visited each of the 72 areas at least once in 2 weeks. The team also visited mortuaries, grave yards, and religious premises to get information on deaths. All hospitals in the district were regularly visited. A detailed history was taken from a relative of the deceased woman according to a structured questionnaire. 645 female deaths were identified and 117 (18%) were maternal deaths. Most of the interviews (73%) were made at home. In 32% of the cases the interviewee was the mother, in 26% the sister, and in 4-9% the husband, aunt, uncle, father or daughter. Only 10% of the deceased women did not seek any medical treatment prior to death. Three out of 4 women had had fever before death. The second most common symptom was shortness of breath (56%) with a median duration of 6 days. About half of the women had lost weight, complained of abdominal pain, or had been pale or vomiting. Medical records were available in only 44% of the cases. According to the physicians, in 22 (3.5%) women the cause of death was not possible to determine. AIDS (27%), tuberculosis (13%), and malaria (12%) were the most common causes of death. God's will and witchcraft were mentioned as the cause of death for 48 (7.6%) cases. AIDS is a major cause of death in women of reproductive age, therefore AIDS preventive measures must be employed along with more aggressive treatment of malaria and tuberculosis.
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