Excess mortality during COVID-19 and prediction of mortality in Bangladesh: an analysis based on death records in urban graveyards.

IF 4.5 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Global Health Pub Date : 2025-02-28 DOI:10.7189/jogh.15.04050

Ema Akter, Aniqa Tasnim Hossain, Bibek Ahamed, Md Hafizur Rahman, Tanvir Hossain Akm, Uchchash Barua, Md Shahidul Islam, Ridwana Maher Manna, Md Alamgir Hossain, Tasnu Ara, Nasimul Ghani Usmani, Pradip Chandra, Shafiqul Ameen, Sabrina Jabeen, Anisuddin Ahmed, Taufiq Zahidur Rahman, Mohammad Mamun-Ul-Hassan, Atiqul Islam, Beth Tippett Barr, Qazi Sadeq-Ur Rahman, Shams El Arifeen, Ahmed Ehsanur Rahman

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引用次数: 0

Abstract

Background: The COVID-19 pandemic significantly impacted global mortality, underscoring the need for reliable data to guide public health policy. In low- and middle-income countries, graveyard-based death records can offer valuable insights into COVID-19-related mortality, yet they remain limited. Additionally, data on mortality beyond the pandemic remains scarce as we approach the 2030 Sustainable Development Goals. We addressed this gap by using graveyard-based data to assess excess mortality during the pandemic (2020-23) and predict mortality trends through 2030.

Methods: We analysed 70 585 deaths from six graveyards in Dhaka, Bangladesh, from January 2001 to December 2023. The data was divided into pre-COVID-19 (2001-19), peak-COVID-19 (2020-21), and end-of-COVID-19 (2022-23) phases. We assessed the excess mortality using the P-score and Bayesian approach. We estimated excess mortality with a log-linear Bayesian model and predicted death trends for 2024-30, reporting incidence rate ratio (IRR) with 95% credible intervals (CrI).

Results: Overall, excess mortality was 69% greater in 2020 and 31% in 2023 compared to the 2018-19 average. The IRR for deaths during peak-COVID-19 was 1.66 times higher than pre-COVID-19 (95% CrI = 1.35-2.04). Neonates had significantly higher IRRs during both the peak (IRR = 1.45; 95% CrI = 1.02-2.05) and end-of-COVID-19 (IRR = 1.67; 95% CrI = 1.02-2.71). Individuals aged >40 years showed a significantly higher IRR during peak-COVID-19 (IRR = 1.79; 95% CrI = 1.46-2.18). Predictions using data between 2001-23 indicate rising mortality, with the number of adult deaths increasing from 3318 in 2023 to 5089 (95% CrI = 3871-6267) by 2030.

Conclusions: We revealed a significant rise in mortality during the pandemic, with elevated death rates persisting at the end of the pandemic. Predictions indicate continued mortality increases through 2030, underscoring the pandemic's long-term health impacts. While further research is needed, these findings highlight the value of graveyard-based death registration data for tracking mortality trends and informing public health strategies.

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孟加拉国2019冠状病毒病期间的超额死亡率和死亡率预测：基于城市墓地死亡记录的分析

背景：2019冠状病毒病大流行严重影响了全球死亡率，强调需要可靠的数据来指导公共卫生政策。在低收入和中等收入国家，基于墓地的死亡记录可以提供有关covid -19相关死亡率的宝贵见解，但它们仍然有限。此外，在我们接近2030年可持续发展目标之际，疫情之外的死亡率数据仍然很少。我们利用基于墓地的数据来评估大流行期间（2020-23年）的超额死亡率，并预测到2030年的死亡率趋势，从而弥补了这一差距。方法：我们分析了2001年1月至2023年12月期间孟加拉国达卡6个墓地的70585例死亡病例。数据分为covid -19前期（2001-19年）、covid -19高峰期（2020-21年）和covid -19末期（2022-23年）阶段。我们使用P-score和贝叶斯方法评估超额死亡率。我们使用对数线性贝叶斯模型估计了超额死亡率，并预测了2024-30年的死亡趋势，报告了95%可信区间（CrI）的发病率比（IRR）。结果：总体而言，与2018-19年的平均水平相比，2020年和2023年的超额死亡率分别高出69%和31%。covid -19高峰期间死亡的IRR是covid -19前的1.66倍（95% CrI = 1.35-2.04）。在两个峰值时，新生儿的IRR均显著升高(IRR = 1.45；CrI = 1.02 - -2.05)和95% end-of-COVID-19 (IRR = 1.67;95% CrI = 1.02-2.71)。年龄在bb0 ~ 40岁的个体在covid -19高峰期间的IRR显著较高(IRR = 1.79；95% CrI = 1.46 ~ 2.18)。使用2001-23年数据进行的预测表明死亡率上升，成人死亡人数从2023年的3318人增加到2030年的5089人（95% CrI = 3871-6267）。结论：我们发现大流行期间死亡率显著上升，并且在大流行结束时死亡率持续升高。预测显示，到2030年，死亡率将继续上升，凸显了这一大流行病对健康的长期影响。虽然需要进一步的研究，但这些发现突出了基于墓地的死亡登记数据在跟踪死亡率趋势和为公共卫生战略提供信息方面的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -

CiteScore

6.10

自引率

2.80%

发文量

240

审稿时长

6 weeks

期刊介绍： Journal of Global Health is a peer-reviewed journal published by the Edinburgh University Global Health Society, a not-for-profit organization registered in the UK. We publish editorials, news, viewpoints, original research and review articles in two issues per year.