Causes of death in a rural hospital in South Africa

To determine the causes of death at Manguzi Hospital, in rural North Kwa-Zulu, over a three year period, July 1992 to June 1995.

A retrospective study using hospital records.

Rural hospital.

Of admissions, total deaths numbered 1,275 (703 males, 572 females), of which 143 were from accidents and trauma.

Deaths.

Of children under five years there were 430 deaths (34% of the total); 236 (55%) were from perinatal causes. Infections, chiefly gastro-enteritis, caused 124 (29%) of deaths. Of children five to 12 years, there were 39 deaths (3% of the total); 12 (44%) died from infections. Of adolescents and adults aged 13 to 59 years, there were 377 deaths (29% of the total); of these, accidents and trauma caused 88 (23%), and infectious diseases 82 (22%). In the elderly, 60 years and over, there were 429 deaths (34% of the total); infectious diseases predominated, 103 (24%). In this age group, there were 71 deaths (17%) from cerebrovascular disease; 63 (15%) from cardiac failure; 46 (11%) from cancer, but none from coronary heart disease. Of the 143 non-natural deaths, 30 (21%) were from assault, and 28 (20%) from motor vehicle and pedestrian accidents.

The high proportion of deaths from infections, as likewise reported from other rural hospitals, emphasizes the need for increased public health endeavours for furthering immunizations, health education, provision of water and sanitation, and tuberculosis control programmes.