Cause of Death in a Tertiary Referral Hospital in Maputo, Mozambique: A One-year Autopsy Study in an Adult Population (original) (raw)

2020, Biomedical Journal of Scientific & Technical Research

Background: Information on causes of death (CoD) is very poor in sub-Saharan Africa, although it provides vital information for planning health strategies. We aimed to analyze the CoD in a large series of autopsies conducted in Mozambique during one-year period. Methods: All adult autopsies conducted at the Maputo Central Hospital (Mozambique) from January,1st to December 31st 2013 (12 month-long period) were analyzed, according to HIV status. Maternal and traumatic deaths were excluded from the study. Results: Four hundred and forty-nine adult autopsies were performed (52% males, median age 42 years, range 15-93). HIV-positive patients comprised 37% (166), 19% (87) were HIV-negative, and in 44% (196) information on HIV status was unavailable. Infectious diseases were the leading CoD (249; 55%), followed by malignancies (76; 17%), cardiovascular (75;17%), other non-infectious diseases (46;10%), and nonconclusive CoD (3;1%). Infectious diseases were responsible for 64%, 51% and 50% of HIV-positive,-negative and-unknown patients, respectively. Tuberculosis was the leading infectious CoD, regardless of HIV status. Other common infections included pyogenic meningitis (42; 17%) and pneumonia (37;15%). Non-infectious cardiovascular diseases and malignancies comprised 33% of all CoD in HIV-negative, and 15% in HIV-positive patients. Conclusion: The burden of infectious diseases, particularly of tuberculosis, remains high in Mozambique, even in HIV-negative patients. Apart from tuberculosis, pyogenic infections of the central nervous system and respiratory tract are also frequent and thus require introduction of new point-of-care tests and improvement of treatment strategies. Non-communicable conditions, mainly cardiovascular and oncologic diseases are becoming prevalent in Mozambique.