Burden of disease analysis in rural Ethiopia

We describe the design and results of a study conducted to determine the magnitude and healthy years of life lost due to morbidity and mortality for major causes in rural Ethiopia. The design included a cross-sectional household survey to determine the magnitude and causes of morbidity and a retrospective longitudinal study to determine the magnitude and causes of mortality. The study was conducted between June 1 and July 12, 1998, within the Butajira Rural Health Project (BRHP) setting. The source population were all people residing in the district and the study population were the sample of households for the BRHP which are the inhabitants of nine rural and one urban Kebeles (villages) in Butajira area, which is located about 130 Kms south of Addis Ababa. The sample was previously selected randomly using probabilities proportional to size, constituting 10% of the total district population (approximately 32,000) and has been under continuous demographic surveillance since 1987. All individuals who were sick two weeks preceding the survey and all those who deceased in the two years prior to the survey were included in the present analysis. The Disability-Adjusted Life Years (DALYs) lost was used as a measure of the burden of disease from the analyzed data. According to the results, prevalence of morbidity within the preceding two weeks was 13.8% (95% CI = 12.8-14.8). In addition, there were 875 deaths during the preceding two years making an annual mortality rate of 13.5 per 1,000 populations (95% CI = 13.13-13.87). The total burden of disease in terms of DALYs lost calculated from these data was 59,125 per 100,000 populations (95% CI = 58,591-59,659). Communicable, maternal, perinatal and nutritional problems contributed to 72% of the total DALYs lost; non-communicable diseases contributed to 24% of the DALYs lost while the proportion of DALYs lost due to injuries was only 4%. The results were similar to previous estimates for countries in Sub-Saharan Africa.