LEADING CAUSES OF DEATH AND MORTALITY...

THE CARIBBEAN EPIDEMIOLOGY CENTRE (CAREC) PAHO/WHOEPIDEMIOLOGY DIVISION

STATISTICS UNIT

LEADING CAUSES OF DEATH AND MORTALITY RATES(COUNTS AND RATES)

IN

CARIBBEAN EPIDEMIOLOGY CENTRE MEMBER COUNTRIES (CMCS)

1985 1990 1995 2000

Leading Causes of Death And Mortality Rates (Counts and Rates)in Caribbean Epidemiology Centre Member Countries (CMCs):

1985 1990 1995 2000

ISBN 976-8114-24-4

The Caribbean Epidemiology Centre (CAREC) welcomes requests for permission to reproduce or translate its publications, in part or in full. Applications and enquiries should be addressed to CAREC, which will be glad to provide the latest information on any changes made on the text, plans for new editions, reprints and translations already available.

First Edition 2005

Caribbean Epidemiology Centre (CAREC) – 2005

Pan American Health Organization/World Health Organization (PAHO/WHO)

Publications of the Caribbean Epidemiology Centre (CAREC) enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights are reserved.

The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the CAREC concerning the legal status of any country, territory, city or area of its authorities, or concerning the delimitation of its frontiers or boundaries.

ACKNOWLEDGEMENTS

CAREC MEMBER COUNTRIES

Anguilla Ms. Ezra Connor Grenada Ms. Angella Joseph, Dr. Allister Antoine

Antigua and Barbuda Mr. Statchel Edwards Guyana Ms. Cheryl Peters, Dr. Navindra Persaud

Aruba Ms. Maribelle Tromp Jamaica Dr. Affette McCaw-Binns, Dr. Deanna Ashley

Bahamas Ms. Kathleen Wilson Montserrat Ms. Grethlyn West

Barbados Ms. Ingrid Layne Saint Lucia Ms. Milva Edmunds-Jerome, Dr. Alina Jamie

Belize Mr. Engelbert Emmanuel St. Vincent & the Grenadines Ms. Sandra Grant, Ms. Marjorie Browne

Bermuda Ms. Brenda Vanderpool St. Kitts & Nevis Ms. Sandra Cotton, Ms. Gail Cranstoun

British Virgin Islands Ms. Adeline Vanterpool Suriname Dr. Widya Punwasi

Cayman Islands Dr. Alla Kumar Trinidad & Tobago Ms. Cheryl Rickson-Pinder

Curaçao and the Netherlands Antilles Ms. Norediz Lourents, Dr. Izzy Gerstenbluth Turks and Caicos Islands Medical Records Department, Ministry of Health

Dominica Ms. Lidy Warrington

CARIBBEAN EPIDEMIOLOGY CENTRE (CAREC)

Dr. Eldonna Boisson, Manager

Dr. George Legall, Senior Biostatistician

Ms. Marsha Ivey, Biostatistician

Mrs. Angela Hinds, Computer Systems Analyst/Programmer

Ms. Esther Bissessarsingh, Statistical Information Officer

Ms. Stacey Grant, Statistical Information Officer

Mr. Nigel Grant, Statistical Information Officer

Mr. Michael Dolabaille, Office/Printing Assistant

CONTENTS

Foreword i

List of Abbreviations ii

Notes to Tables iii

Table 1. Selected Mortality Rates: CAREC Member Countries – 1985 1990 1995 2000 1

Table 2. Age-specific Crude Mortality Rates by Gender: CAREC Member Countries – 1985 1990 1995 2000 1

Table 3a. Ten Leading Causes of Death: All Genders – CAREC Member Countries – 1985 1990 1995 2000 2

Table 3b. Ten Leading Causes of Death: Males – CAREC Member Countries – 1985 1990 1995 2000 3

Table 3c. Ten Leading Causes of Death: Females – CAREC Member Countries – 1985 1990 1995 2000 4

Table 4a. Ten Leading Causes of Death by Age Group: CAREC Member Countries – 1985 5

Table 4b. Ten Leading Causes of Death by Age Group: CAREC Member Countries – 1990 6

Table 4c. Ten Leading Causes of Death by Age Group: CAREC Member Countries – 1995 7

Table 4d. Ten Leading Causes of Death by Age Group: CAREC Member Countries – 2000 8

Table 5. Deaths and Crude Mortality Rates (Per 100,000 Population) by Age Group and Gender for Selected Diseases: CAREC Member Countries – 1985 1990 1995 2000 9

Table 6. Potential Years of Life Lost (PYLL) and PYLL Rate (Per 100,000) by Age Group and Gender for Selected Diseases: CAREC Member Countries – 1985 1990 1995 2000 12

Table 7a. Causes of Death Due to Communicable Diseases: CAREC Member Countries – 1985 1990 1995 2000 16

Table 7b. Causes of Death Due to Neoplasms: CAREC Member Countries – 1985 1990 1995 2000 17

Table 7bi. Causes of Death Due to Neoplasms – Males: CAREC Member Countries – 1985 1990 1995 2000 18

Table 7bii. Causes of Death Due to Neoplasms – Females: CAREC Member Countries – 1985 1990 1995 2000 19

Table 7c. Causes of Death Due to Diseases of The Circulatory System: CAREC Member Countries – 1985 1990 1995 2000 20

Table 7d. Causes of Death Due to Conditions Originating In The Perinatal Period: CAREC Member Countries – 1985 1990 1995 2000 21

Table 7e. Causes of Death Due to External Conditions: CAREC Member Countries – 1985 1990 1995 2000 22

Page i

Table 7f. Causes of Death Due to All Other Diseases: CAREC Member Countries – 1985 1990 1995 2000 23

Table 8a. Potential Years of Lost Life (PYLL) and PYLL Rate by Age Group: Communicable Diseases; Neoplasms; Circulatory Disorders: CAREC Member Countries – 1985 1990 1995 2000 25

Table 8b. Potential Years of Lost Life (PYLL) and PYLL Rate by Age Group: Perinatal Conditions; External Causes; Other Diseases: CAREC Member Countries – 1985 1990 1995 2000 26

Table 9a. Standardised Mortality Rates by Age Group: CAREC Member Countries – 1985 27

Table 9b. Standardised Mortality Rates by Age Group: CAREC Member Countries – 1990 30

Table 9c. Standardised Mortality Rates by Age Group: CAREC Member Countries – 1995 33

Table 9d. Standardised Mortality Rates by Age Group: CAREC Member Countries – 2000 36

Figure 1. Crude Mortality Rates for Select Diseases by Year: CAREC Member Countries 39

Figure 2. Potential Years of Life Lost by Six Major Cause of Death Groups: CAREC Member Countries – 1985 1990 1995 2000 40

Figure 3. Potential Years of Life Lost by Six Major Cause of Death Groups for Selected Diseases: CAREC Member Countries – 2000 41

Appendix A Population Distribution by Age Group and Gender: CAREC Member Countries – 1985 1990 1995 2000 42

Appendix B Formulas Used 43

Appendix C CAREC Ranking List 44

Appendix D Mortality Tabulation ICD9/ICD10 Merger Listing 45

Page i

FOREWORD

Most CAREC member countries (CMCs) have experienced a health transition, with fertility and mortality rates decreasing and disease patterns changing, such that the greatest morbidity and mortality burdens are due to chronic non-communicable diseases (NCDs), AIDS and injuries, paralleled and sometimes driven by social and behavioural changes that affect health. In the Caribbean, CMCs have also been experiencing another phase of the health transition described as a re-emergence of ‘old’ communicable diseases (e.g. tuberculosis) and the emergence of new communicable diseases (e.g. AIDS), together with the increasing prominence of NCDs (e.g. heart disease, cancers and diabetes).

A descriptive study of mortality data from all CMCs was conducted for four point years; 1985, 1990, 1995 and 2000. This publication provides the summary, as well as age and sex specific tables for the leading causes of death for these four years. Analyses showed that during 1985-2000, there was an overall 5% decrease in age-adjusted mortality rates in the CMCs and male mortality exceeded female mortality. Overall, as well as among males and females, heart disease was the leading cause of death, with cancers, cerebrovascular diseases, diabetes mellitus and hypertensive disease also in the top five causes in most years. Among cancers, prostate cancer was the leading cause of death among men and among women cancer of the uterus and breast. HIV disease (AIDS) featured in the ten leading causes of death for the first time in 1990 and was the 5th leading cause in 2000. In 2000, AIDS was the largest contributor to premature death (contributing 14% of the total person years of life lost that year); followed by heart disease (7% PYLL), assault/homicide (6% PYLL), diabetes (4% PYLL), cerebrovascular diseases (3% PYLL) and hypertensive disease (2% PYLL).

During the period 1985-2000, CMCs observed an increase in mortality due to NCDs diseases, AIDS and assaults (homicides), the latter two causes occurring particularly in the 15-44 year age group. Member states of the Caribbean Community participate in the Caribbean Cooperation in Health, an initiative aimed at improving and sustaining the health of the people of the Caribbean. Phase II of this initiative includes NCDs and AIDS as priority areas, but not intentional injures and violence. The latter two areas must also be considered as priority areas in phase III of this initiative. Non-communicable diseases, AIDS, injuries and violence are often considered to be a manifestation of lifestyle choices, though it must be recognized that choices are greatly affected by social, cultural and economic factors. The determinants of these conditions are influenced by many sectors other than health. Thus, a multi-sectoral, long-term approach is necessary to reverse the increasing mortality due to these conditions.

This publication will be useful for public health and medical practitioners, policy makers and researchers, both regionally and internationally. I thank the many persons in our 21 CMCs who have contributed to collecting data for this publication – medical and public health practitioners, mortality data coders, statisticians, epidemiologists, researchers, etc. I also thank the CAREC staff and collaborating partners who have produced this publication.

Dr. C. James HospedalesDirector, CAREC

Page ii Page iii

LIST OF ABBREVIATIONS

AIDS Acquired Immunodeficiency Syndrome

CAREC Caribbean Epidemiology Centre

CCHD Caribbean Commission on Health and Development

CDC Centre For Disease Control and Prevention

CMCs CAREC Member Countries

CTC CAREC Assigned Tabulation Code

HIV Human Immunodeficiency Virus

NCD Non-Communicable Diseases

PAHO Pan American Health Organization

PYLL Potential Years of Life Lost

WYLL Working Years of Life Lost

ICD International Classification of Disease

Page ii Page iii

NOTES TO TABLES

1. Data Source: Data submitted to CAREC by Government institutions from the following 21 CAREC member countries:Anguilla; Antigua and Barbuda; Aruba; Bahamas; Barbados; Belize; Bermuda; British Virgin Islands; Cayman islands; Dominica; Grenada; Guyana; Jamaica; Montserrat; Netherland Antilles (Curaçao); St Kitts and Nevis; St Lucia; St Vincent and the Grenadines; Suriname; Trinidad and Tobago; Turks and Caicos Islands

2. Tables 3A-4D, 7A-7F and 9A-9D are a mixture of ICD 9 and ICD 10 PAHO Mortality Tabulation Listing. Please refer to Appendix C and/or Appendix D for guidance when interpreting.

3. Tables 3A-4D were ranked using the CAREC Ranking List in Appendix C.

4. Table 9A - 9D are ordered using the CAREC Assigned Tabulation Code (CTC) in Appendix D

5. Rates calculated using population figures for CMCs and expressed per 100,000 (see Appendix A and Appendix B)

6. The ‘Total’ columns and/or rows for the ‘All Genders’ tables are inclusive of ‘unknown’ categories and as such, may not agree with the sum ‘Total’ columns for the Age and Gender specific tables.

7. Mortality data are not included for the following countries: Aruba for 1985, Bahamas for 1990, Curaçao for 1995 and 2000, Montserrat for 1985 and Grenada for 1995 and 2000.

8. Mortality data substitutions were made for the following countries: Bermuda - 1994 for 1995; Curaçao - 1987 for 1985; Jamaica - 1996 for 1995 and 1998 for 2000.

9. Population substitutions were made for following countries: Belize - 1986 for 1985; Grenada 1984 for 1985; and Guyana 1984 for 1985.

CAREC/PAHO/WHO Epidemiology Division – Statistics UnitLeading Causes of Death and Mortality Rates

Page 1


Page 1

TABLE 1. SELECTED MORTALITY RATES: CAREC MEMBER COUNTRIES1985 1990 1995 2000

1985 1990 1995 2000

Crude Death Rate per 100,000 634.9 625.2 683.6 652.0

Under 5 Mortality Rate per 100,000 559.8 469.2 488.7 425.9

Potential Years of Life Lost – <65 years [rate per 100,000] 511,235 [89.9] 446,035 [79.1] 531,000 [89.9] 522,775 [84.9]

Working Years of Life Lost – 15-65 years [rate per 100,000] 223,730 [63.1] 216,990 [60.1] 305,005 [78.6] 321,770 [77.3]

TABLE 2. AGE-SPECIFIC CRUDE MORTALITY RATES BY GENDER: CAREC MEMBER COUNTRIES1985 1990 1995 2000

AGE GROUP

1985 1990 1995 2000

Male Female BothSexes




0-4 603.7 514.9 559.8 513.1 424.2 469.2 518.2 428.3 488.7 451.9 387.0 425.9

5-14 47.8 39.1 43.5 46.3 37.6 42.0 44.2 29.8 37.1 43.3 33.2 38.3

15-24 120.8 62.9 91.7 113.1 61.1 87.2 169.2 80.4 124.9 150.5 73.3 112.1

25-44 262.5 147.8 204.1 247.9 142.9 194.5 365.7 191.9 277.2 365.5 207.6 284.9

45-64 1251.1 889.6 1064.0 1164.8 819.0 988.0 1189.3 826.0 1005.2 1115.5 789.9 950.5

65+ 6052.2 5173.0 5571.5 5695.2 5058.5 5348.7 6145.9 5181.1 5616.4 5745.2 4656.8 5146.8

Overall 682.4 588.4 634.9 664.0 587.0 625.2 750.1 614.9 683.6 719.6 583.9 652.0


Page 2 CAREC/PAHO/WHO Epidemiology Division – Statistics UnitLeading Causes of Death and Mortality Rates

Page 3

TABLE 3A. TEN LEADING CAUSES OF DEATH: ALL GENDERS – CAREC MEMBER COUNTRIES

1985 1990 1995 2000

Rank

1985 1990 1995 2000

Cause of Death n % Rate Cause of Death n % Rate Cause of Death n % Rate Cause of Death n % Rate

1 Heart Disease 6504 16.9 107.2 Heart Disease 6629 17.5 109.5 Heart Disease 7206 16.7 114.0 Heart Disease 6764 15.7 102.5

2 Cerebrovascular diseases 4997 13.0 82.3 Cancers 4943 13.1 81.6 Cerebrovascular diseases 6056 14.0 95.8 Cancers 6301 14.6 95.5

3 Cancers 4924 12.8 81.1 Cerebrovascular diseases 4804 12.7 79.3 Cancers 5593 12.9 88.5 Cerebrovascular diseases 4286 10.0 64.9

4 Diabetes mellitus 2199 5.7 36.2 Diabetes mellitus 3025 8.0 50.0 Diabetes mellitus 3280 8.0 51.9 Diabetes mellitus 4264 10.0 64.6

5 Hypertensive Disease 1854 4.8 30.6 Hypertensive Disease 1869 4.9 30.9 Hypertensive Disease 1983 5.0 31.4 HIV disease (AIDS) 2624 6.0 39.8

6 Accidents 1543 4.0 25.4 Acute Respiratory Infections 1354 3.6 22.4 Accidents 1649 4.0 26.1 Hypertensive Disease 2596 6.0 39.3

7 Acute Respiratory Infections 1462 3.8 24.1 Accidents 1273 3.4 21.0 Acute Respiratory Infections 1506 3.0 23.8 Accidents 1524 4.0 23.1

8 Nutritional Deficiencies and nutritional anemia

1016 2.6 16.7 Diseases of the Urinary System 896 2.4 14.8 HIV disease (AIDS) 1238 3.0 19.6 Assault (homicide) 1147 3.0 17.4

9 Diseases of the Urinary System 918 2.4 15.1 Nutritional Deficiencies and nutritional anemia

703 1.9 11.6 Assault (homicide) 1190 3.0 18.8 Acute Respiratory Infections 1060 2.0 16.1

10 Intestinal infectious diseases 720 1.9 11.9 Intestinal infectious diseases 602 1.6 9.9 Diseases of the Urinary System 744 2.0 11.8 Chronic lower respiratory diseases 783 2.0 11.9

Symptoms, signs and ill-defined Conditions

3280 8.5 Symptoms, signs and ill-defined Conditions



1788 4.2

All Other Deaths 9109 23.6 All Other Deaths 8382 22.1 All Other Deaths 10680 24.7 All Other Deaths 9899 23.0

Total Deaths 38526 Total Deaths 37855 Total Deaths 43219 Total Deaths 43036

Note: Refer to CAREC ranking list (Appendix C) for details on the ICD9/ICD10 groupings used for the above as they may differ from those used in other listings



Page 3

TABLE 3B. TEN LEADING CAUSES OF DEATH: MALES – CAREC MEMBER COUNTRIES

1985 1990 1995 2000

Rank

1985 1990 1995 2000



2 Cancers 2576 12.6 85.9 Cancers 2591 13.0 86.3 Cancers 3013 12.8 96.4 Cancers 3396 14.5 104.0

3 Cerebrovascular diseases 2349 11.5 78.3 Cerebrovascular diseases 2192 11.0 73.0 Cerebrovascular diseases 2888 12.3 92.4 Cerebrovascular diseases 1987 8.5 60.8

4 Accidents 1140 5.6 38.0 Diabetes mellitus 1241 6.2 41.3 Diabetes mellitus 1379 5.9 44.1 Diabetes mellitus 1793 7.6 54.9

5 Diabetes mellitus 878 4.3 29.3 Accidents 952 4.8 31.7 Accidents 1229 5.2 39.3 HIV disease (AIDS) 1664 7.1 51.0

6 Hypertensive Disease 796 3.9 26.5 Hypertensive Disease 823 4.1 27.4 Assault (homicide) 1032 4.4 33.0 Hypertensive Disease 1154 4.9 35.3

7 Acute Respiratory Infections 755 3.7 25.2 Acute Respiratory Infections 710 3.6 23.6 Hypertensive Disease 867 3.7 27.7 Accidents 1132 4.8 34.7

8 Diseases of the Urinary System 578 2.8 19.3 Diseases of the Urinary System 569 2.9 18.9 HIV disease (AIDS) 835 3.6 26.7 Assault (homicide) 984 4.2 30.1


556 2.7 18.5 Nutritional Deficiencies and nutritional anemia

355 1.8 11.8 Acute Respiratory Infections 822 3.5 26.3 Acute Respiratory Infections 561 2.4 17.2

10 Intestinal infectious diseases 416 2.0 13.9 Intestinal infectious diseases 352 1.8 11.7 Diseases of the Urinary System 449 1.9 14.4 Chronic lower respiratory diseases 557 2.4 17.1





948 4.0

All other male deaths 5320 26.0 All other male deaths 5005 25.1 All other male deaths 6129 26.1 All other male deaths 5717 24.3

Total Deaths 20464 Total Deaths 19939 Total Deaths 23454 100 Total Deaths 23500




Page 5

TABLE 3C. TEN LEADING CAUSES OF DEATH: FEMALES – CAREC MEMBER COUNTRIES1985 1990 1995 2000

Rank

1985 1990 1995 2000



2 Cerebrovascular diseases 2648 14.7 86.3 Cerebrovascular diseases 2612 14.6 85.6 Cerebrovascular diseases 3168 16.1 99.1 Cancers 2901 14.9 87.0

3 Cancers 2348 13.0 76.5 Cancers 2352 13.1 77.1 Cancers 2580 13.1 80.7 Diabetes mellitus 2470 12.7 74.1

4 Diabetes mellitus 1321 7.3 43.0 Diabetes mellitus 1784 10.0 58.5 Diabetes mellitus 1901 9.7 59.5 Cerebrovascular diseases 2298 11.8 68.9

5 Hypertensive Disease 1058 5.9 34.5 Hypertensive Disease 1046 5.8 34.3 Hypertensive Disease 1116 5.7 34.9 Hypertensive Disease 1442 7.4 43.2

6 Acute Respiratory Infections 707 3.9 23.0 Acute Respiratory Infections 644 3.6 21.1 Acute Respiratory Infections 683 3.5 21.4 HIV disease (AIDS) 959 4.9 28.8



348 1.9 11.4 Accidents 418 2.1 13.1 Acute Respiratory Infections 498 2.6 14.9

8 Accidents 403 2.2 13.1 Diseases of the Urinary System 327 1.8 10.7 HIV disease (AIDS) 403 2.1 12.6 Accidents 385 2.0 11.5

9 Diseases of the Urinary System 340 1.9 11.1 Accidents 321 1.8 10.5 Septicimia, except Neonatal 343 1.7 10.7 Diseases of the nervous System,except meningitis

336 1.7 10.1

10 Intestinal infectious diseases 304 1.7 9.9 Intestinal infectious diseases 250 1.4 8.2 Diseases of the nervous System,except meningitis

295 1.5 9.2 Respiratory disorders specific to the perinatal period

290 1.5 8.7

Symptoms, signs and ill-defined Conditions 1673 9.3




All other male deaths 3789 21.0 All other male deaths 3377 18.8 All other male deaths 4277 21.8 All other male deaths 3907 20.1

Total Deaths 18062 Total Deaths 17916 Total Deaths 19652 Total Deaths 19472




Page 5

TABLE 4A. TEN LEADING CAUSES OF DEATH BY AGE GROUP: CAREC MEMBER COUNTRIES1985

Rank 0-4 05-14 15-24 25-44 45-64 65+

Cause of Death n % Rate Cause of Death n % Rate Cause of Death n % Rate Cause of Death n % Rate Cause of Death n % Rate Cause of Death n % Rate


496 12.2 8.2 Accidents 121 19.6 2.0 Accidents 269 22.1 4.4 Accidents 464 15.3 7.6 Cancers 1535 19.7 25.3 Heart Disease 4404 20.7 72.6

2 Intestinal infectious diseases 453 11.2 7.5 Heart Disease 50 8.1 0.8 Assault (homicide) 113 9.3 1.9 Cancers 366 12.1 6.0 Heart Disease 1510 19.3 24.9 Cerebrovascular diseases 3713 17.4 61.2

3 Slow Fetal Growth, fetal malnut., short gestation, low birth weight.

403 9.9 6.6 Diseases of the nervous System, except meningitis

49 8.0 0.8 Cancers 80 6.6 1.3 Heart Disease 337 11.1 5.6 Cerebrovascular diseases 1038 13.3 17.1 Cancers 2849 13.4 46.9

4 Acute Respiratory Infection 385 9.5 6.3 Cancers 43 7.0 0.7 Heart Disease 73 6.0 1.2 Assault (homicide) 145 4.8 2.4 Diabetes mellitus 698 8.9 11.5 Hypertensive Disease 1372 6.4 22.6

5 Hypoxia, birth asphyxia and other resp. conditions



58 4.8 1.0 Cerebrovascular diseases 129 4.3 2.1 Hypertensive Disease 372 4.8 6.1 Diabetes mellitus 1368 6.4 22.5

6 Congenital malformations, deformations and chromosomal abnormalities.

320 7.9 5.3 Congenital malformations, deformations and chromosomal abnormalities.

31 5.0 0.5 Intentional self-harm (suicide)

43 3.5 0.7 Diabetes mellitus 104 3.4 1.7 Accidents 265 3.4 4.4 Acute Respiratory Infection 781 3.7 12.9

7 Accidents 128 3.2 2.1 Acute Respiratory Infection 26 4.2 0.4 Cerebrovascular diseases 31 2.5 0.5 Cirrhosis and certain other chronic diseases of liver

102 3.4 1.7 Cirrhosis and certain other chronic diseases of liver

231 3.0 3.8 Diseases of the Urinary System

575 2.7 9.5

8 Fetus & newborn affected by obstetric complications, and birth trauma

81 2.0 1.3 Intestinal infectious diseases 16 2.6 0.3 Complications of pregnancy, childbirth & puerperium



201 2.6 3.3 Atherosclerosis 430 2.0 7.1

9 Heart Disease 80 2.0 1.3 Cerebrovascular diseases 13 2.1 0.2 Diseases of the Urinary System


77 2.5 1.3 Acute Respiratory Infection 147 1.9 2.4 Chronic & unspec. bronchitis, emphysema & Asthma

394 1.8 6.5

10 Diseases of the nervous System, except meningitis


11 1.8 0.2 Acute Respiratory Infection 27 2.2 0.4 Acute Respiratory Infection 75 2.5 1.2 Chronic & unspec. bronchitis, Emphysema & Asthma

139 1.8 2.3 Nutritional Deficiencies and Nutritional Anemia

309 1.4 5.1


314 7.7 Symptoms, signs and ill-defined conditions





2041 9.6

All other Deaths 958 23.6 All other Deaths 171 27.8 All other Deaths 338 27.8 All other Deaths 928 30.6 All other Deaths 1275 16.3 All other Deaths 3075 14.4

Total Deaths 4058 Total Deaths 616 Total Deaths 1216 Total Deaths 3032 Total Deaths 7805 Total Deaths 21311




Page 7

TABLE 4B. TEN LEADING CAUSES OF DEATH BY AGE GROUP: CAREC MEMBER COUNTRIES1990

Rank 0-4 05-14 15-24 25-44 45-64 65+


1 Slow Fetal Growth, fetal malnutrition, short gestation, low birth wt.

468 14.8 7.7 Accidents 126 22.1 2.1 Accidents 206 19.0 3.4 Cancers 419 13.2 6.9 Heart Disease 1483 20.3 24.5 Heart Disease 4552 20.6 75.2

2 Hypoxia, Birth Asphyxia and other respiratory conditions

393 12.4 6.5 Diseases of the nervous System, except Meningitis


95 8.8 1.6 Accidents 336 10.6 5.5 Cancers 1389 19.0 22.9 Cerebrovascular diseases 3599 16.3 59.4

3 Intestinal infectious diseases 373 11.8 6.2 Cancers 44 7.7 0.7 Assault (homicide) 94 8.7 1.6 Heart Disease 331 10.4 5.5 Cerebrovascular diseases 952 13.0 15.7 Cancers 2934 13.3 48.5

4 Congenital malformations, deformations and chromosomal abnormalities

257 8.1 4.2 Acute Respiratory Infection 41 7.2 0.7 Heart Disease 79 7.3 1.3 Intentional self-harm (suicide)

152 4.8 2.5 Diabetes mellitus 813 11.1 13.4 Diabetes Mellitus 2072 9.4 34.2

5 Nutritional Deficiencies and Nutritional Anemia

246 7.8 4.1 Nutritional Deficiencies and Nutritional Anemia

32 5.6 0.5 Cancers 58 5.4 1.0 Cerebrovascular diseases 151 4.8 2.5 Hypertensive Disease 333 4.6 5.5 Hypertensive Disease 1446 6.5 23.9

6 Acute Respiratory Infection 242 7.6 4.0 Heart Disease 31 5.4 0.5 Diseases of the nervous System, except meningitis

53 4.9 0.9 Assault (homicide) 147 4.6 2.4 Accidents 219 3.0 3.6 Acute Respiratory Infection 838 3.8 13.8

7 Accidents 107 3.4 1.8 Intestinal infectious diseases 20 3.5 0.3 Nutritional Deficiencies and Nutritional Anemia

35 3.2 0.6 Diabetes Mellitus 101 3.2 1.7 Diseases of the Urinary System


568 2.6 9.4

8 Heart Disease 78 2.5 1.3 Assault (homicide) 16 2.8 0.3 Diseases of the Urinary System

28 2.6 0.5 HIV disease (AIDS) 96 3.0 1.6 Cirrhosis and certain other chronic diseases of liver

186 2.5 3.1 Atherosclerosis 302 1.4 5.0

9 Fetus & newborn affected by obstetric complications, birth trauma

74 2.3 1.2 Congenital malformations, deformations and chromosomal abnormalities.

15 2.6 0.2 Acute Respiratory Infection 25 2.3 0.4 Diseases of the Nervous System, except Meningitis

84 2.6 1.4 Acute Respiratory Infection 116 1.6 1.9 Chronic & unspec. Bronchitis, Emphysema & Asthma

278 1.3 4.6

10 Diseases of the Nervous System, except meningitis

66 2.1 1.1 Cerebrovascular diseases 14 2.5 0.2 Cerebrovascular diseases 21 1.9 0.3 Acute Respiratory Infection 80 2.5 1.3 Chronic & unspec. Bronchitis, Emphysema & Asthma

98 1.3 1.6 Accidents 257 1.2 4.2

Symptoms, signs and ill-defined conditions






2341 10.6






Page 7

TABLE 4C. TEN LEADING CAUSES OF DEATH BY AGE GROUP: CAREC MEMBER COUNTRIES1995

Rank 0-4 05-14 15-24 25-44 45-64 65+


1 Hypoxia, birth asphyxia and other respiratory conditions

397 12.5 6.3 Accidents 151 29.7 2.4 Assault (homicide) 311 20.7 4.9 HIV disease (AIDS) 777 15.3 12.3 Heart Disease 1588 18.7 25.1 Heart Disease 4928 20.9 77.9

2 Intestinal infectious diseases 303 9.6 4.8 Cancers 38 7.5 0.6 Accidents 242 16.1 3.8 Assault (homicide) 565 11.1 8.9 Cancers 1467 17.3 23.2 Cerebrovascular diseases 4459 18.9 70.5

3 Respiratory disorders specific to the perinatal period



116 7.7 1.8 Cancers 522 10.3 8.3 Cerebrovascular diseases 1278 15.1 20.2 Cancers 3413 14.5 54.0

4 Congenital malformations, deformations and chromosomal abnormalities.

284 9.0 4.5 Heart Disease 29 5.7 0.5 Cancers 91 6.0 1.4 Accidents 497 9.8 7.9 Diabetes mellitus 901 10.6 14.3 Diabetes mellitus 2202 9.4 34.8

5 Slow Fetal Growth, fetal malnut., short gestation, low birth wt.

273 8.6 4.3 Assault (homicide) 28 5.5 0.4 HIV disease (AIDS) 89 5.9 1.4 Heart Disease 427 8.4 6.8 Hypertensive Disease 353 4.2 5.6 Hypertensive Disease 1516 6.4 24.0

6 Acute Respiratory Infection 189 6.0 3.0 Acute Respiratory Infection 21 4.1 0.3 Heart Disease 87 5.8 1.4 Intentional self-harm (suicide)

255 5.0 4.0 HIV disease (AIDS) 274 3.2 4.3 Acute Respiratory Infection 881 3.7 13.9

7 Accidents 103 3.3 1.6 Congenital malformations, deformations and chromosomal abnor.


55 3.7 0.9 Cerebrovascular diseases 195 3.8 3.1 Accidents 257 3.0 4.1 Septicimia, except Neonatal 442 1.9 7.0

8 Bacterial sepsis of newborn 74 2.3 1.2 HIV disease (AIDS) 15 2.9 0.2 Acute Respiratory Infection 36 2.4 0.6 Acute Respiratory Infection 156 3.1 2.5 Cirrhosis and certain other chronic diseases of liver


430 1.8 6.8


68 2.1 1.1 Intestinal infectious diseases 14 2.8 0.2 Diseases of the Urinary System

25 1.7 0.4 Diabetes mellitus 138 2.7 2.2 Acute Respiratory Infection 183 2.2 2.9 Accidents 312 1.3 4.9



12 2.4 0.2 Cerebrovascular diseases 23 1.5 0.4 Diseases of the nervous System, except meningitis



309 1.3 4.9







1232 5.2






Page 9

TABLE 4D. TEN LEADING CAUSES OF DEATH BY AGE GROUP: CAREC MEMBER COUNTRIES2000

Rank 0-4 05-14 15-24 25-44 45-64 65+



706 25.6 10.7 Accidents 115 22.3 1.7 Assault (homicide) 271 19.7 4.1 HIV disease (AIDS) 1624 28.8 24.6 Cancers 1795 19.8 27.2 Heart Disease 4631 20.2 70.2


295 10.7 4.5 Cancers 45 8.7 0.7 Accidents 215 15.6 3.3 Assault (homicide) 576 10.2 8.7 Heart Disease 1556 17.2 23.6 Cancers 3728 16.3 56.5

3 Intestinal infectious diseases 252 9.1 3.8 HIV disease (AIDS) 44 8.5 0.7 HIV disease (AIDS) 189 13.7 2.9 Cancers 565 10.0 8.6 Diabetes mellitus 1346 14.8 20.4 Cerebrovascular diseases 3301 14.4 50.0



39 7.6 0.6 Heart Disease 78 5.7 1.2 Accidents 442 7.8 6.7 Cerebrovascular diseases 775 8.5 11.7 Diabetes mellitus 2699 11.8 40.9

5 Bacterial sepsis of newborn 130 4.7 2.0 Heart Disease 36 7.0 0.5 Cancers 75 5.5 1.1 Heart Disease 374 6.6 5.7 HIV disease (AIDS) 578 6.4 8.8 Hypertensive Disease 1914 8.3 29.0

6 HIV disease (AIDS) 107 3.9 1.6 Assault (homicide) 24 4.7 0.4 Intentional self-harm (suicide)

61 4.4 0.9 Diabetes mellitus 172 3.0 2.6 Hypertensive Disease 549 6.1 8.3 Acute Respiratory Infection 733 3.2 11.1

7 Accidents 99 3.6 1.5 Septicimia, except Neonatal 19 3.7 0.3 Diseases of the nervous System, except meningitis


153 2.7 2.3 Accidents 269 3.0 4.1 Chronic lower respiratory diseases

564 2.5 8.5

8 Acute Respiratory Infection 76 2.8 1.2 Acute Respiratory Infection 19 3.7 0.3 Certain Vector-borne diseases and rabies

26 1.9 0.4 Cerebrovascular diseases 148 2.6 2.2 Diseases of the Urinary System


435 1.9 6.6

9 Diseases of the nervous System,except meningitis

61 2.2 0.9 Congenital malformations,deformations and chromosomal abnormalities.

17 3.3 0.3 Cerebrovascular diseases 19 1.4 0.3 Diseases of the nervous System,except meningitis


167 1.8 2.5 Septicimia, except Neonatal 360 1.6 5.5


56 2.0 0.8 Meningitis 16 3.1 0.2 Meningitis 18 1.3 0.3 Hypertensive Disease 94 1.7 1.4 Diseases of the nervous System,except meningitis

138 1.5 2.1 Diseases of the nervous System,except meningitis

317 1.4 4.8




68 4.9 1.0 Symptoms, signs and ill-defined Conditions



1075 4.7






Page 9

TABLE 5. DEATHS AND CRUDE MORTALITY RATES (PER 100,000 POPULATION) BY AGE GROUP AND GENDER FOR SELECTED DISEASES:CAREC MEMBER COUNTRIES

1985 1990 1995 2000

Disease AgeGroup

1985 1990 1995 2000

Total Female Male Total Female Male Total Female Male Total Female Male

n rate n rate n rate n rate n rate n rate n rate n rate n rate n rate n rate n rate

HIV Disease (AIDS) 0-4 1 0.1 1 0 0 0 16 2.4 6 1.8 10 2.9 39 6 24 7.5 15 4.6 107 16.5 52 16.3 55 16.7

5-14 0 0 0 0 0 0 1 0.1 0 0 1 0.1 15 1.1 9 1.3 6 0.9 44 3.3 25 3.8 19 2.8

15-24 2 0.2 1 0 1 0.2 15 1.2 4 0.6 11 1.8 89 7.4 50 8.3 39 6.5 189 15.4 107 17.5 82 13.3

25-44 8 0.5 1 0 7 1 96 5.9 25 3 71 8.8 777 42.4 240 25.7 537 59.8 1624 82 574 56.8 1050 108.4

45-64 1 0.1 0 0 1 0.3 31 4.2 4 1.1 27 7.5 274 32.5 68 15.9 206 49.5 578 60.6 176 36.4 402 85.6

65+ 1 0.3 0 0 1 0.6 3 0.7 1 0.4 2 1.1 34 8.1 10 4.3 24 12.7 67 15 17 6.9 49 24.5

Total 13 0.2 3 0.0 10 0.3 162 2.7 40 1.3 122 4.1 1238 19.6 403 12.6 835 26.7 2624 39.8 959 28.8 1664 51.0

Acute Respiratory Infections (ARI)

0-4 385 53.1 193 54 192 52.4 242 35.9 108 32.4 134 39.3 189 29.2 77 24.1 111 33.8 76 11.7 33 10.4 42 12.7

5-14 26 1.8 15 2 11 1.5 41 3 25 3.7 16 2.3 21 1.5 9 1.3 12 1.7 19 1.4 9 1.4 10 1.5

15-24 27 2 11 2 16 2.4 25 2 13 2.1 12 1.9 36 3 13 2.2 23 3.8 14 1.1 6 1 8 1.3

25-44 75 5 28 4 47 6.4 80 4.9 29 3.5 51 6.4 156 8.5 64 6.8 92 10.2 70 3.5 29 2.9 41 4.2

45-64 147 20 50 13 97 27.4 116 15.7 43 11.4 73 20.2 183 21.7 69 16.1 114 27.4 132 13.8 47 9.7 85 18.1

65+ 781 204.2 400 191 381 219.8 838 202.9 419 186.4 419 222.6 881 210.3 435 188.9 446 236.4 733 164.4 370 150.7 363 181.3

Total 1462 24.1 707 23.0 755 25.2 1354 22.4 644 21.1 710 23.6 1506 23.8 683 21.4 822 26.3 1060 16.1 498 14.9 561 17.2

Hypertensive Disease

0-4 14 1.9 13 4 1 0.3 2 0.3 0 0 2 0.6 0 0 0 0 0 0 2 0.3 0 0 2 0.6

5-14 2 0.1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0.2 0 0 3 0.4

15-24 5 0.4 2 0 3 0.5 7 0.6 3 0.5 4 0.6 7 0.6 5 0.8 2 0.3 10 0.8 4 0.7 6 1

25-44 64 4.3 28 4 36 4.9 54 3.3 29 3.5 25 3.1 76 4.1 34 3.6 42 4.7 94 4.7 54 5.3 40 4.1

45-64 372 50.7 188 50 184 52 333 45 161 42.6 172 47.6 353 41.8 156 36.4 197 47.4 549 57.6 277 57.2 272 57.9

65+ 1372 358.7 812 388 560 323 1446 350.1 840 373.7 606 321.9 1516 361.8 904 392.5 612 324.4 1914 429.4 1095 446 819 409.1

Total 1854 30.6 1058 35.0 796 26.5 1869 30.9 1046 34.3 823 27.4 1983 31.4 1116 34.9 867 27.7 2596 39.3 1442 43.2 1154 35.3

.../Cont’d Page 10



Page 11

TABLE 5 (Cont’d). DEATHS AND CRUDE MORTALITY RATES (PER 100,000 POPULATION) BY AGE GROUP AND GENDER FOR SELECTED DISEASES:CAREC MEMBER COUNTRIES

1985 1990 1995 2000

Disease AgeGroup

1985 1990 1995 2000



Cerebrovascular Diseases

0-4 36 5 18 5 18 4.9 18 2.7 8 2.4 10 2.9 11 1.7 6 1.9 5 1.5 6 0.9 2 0.6 4 1.2

5-14 13 0.9 7 1 6 0.8 14 1 10 1.5 4 0.6 3 0.2 2 0.3 1 0.1 5 0.4 4 0.6 1 0.1

15-24 31 2.3 11 2 20 3 21 1.7 7 1.1 14 2.2 23 1.9 12 2 11 1.8 19 1.5 7 1.1 12 1.9

25-44 129 8.7 54 7 75 10.3 151 9.3 66 8 85 10.6 195 10.6 83 8.9 112 12.5 148 7.5 64 6.3 84 8.7

45-64 1038 141.5 480 127 558 157.6 952 128.7 434 114.8 518 143.2 1278 151.4 570 133.1 708 170.2 775 81.3 343 70.9 432 92

65+ 3713 970.7 2054 982 1659 956.9 3599 871.3 2056 914.6 1543 819.7 4459 1064.2 2451 1064.1 2008 1064.4 3301 740.6 1864 759.2 1436 717.2

Total 4997 82.3 2648 86.0 2349 78.3 4804 79.3 2612 85.6 2192 73 6056 95.8 3168 99.1 2888 92.4 4286 64.9 2298 68.9 1987 60.8

Heart Disease 0-4 80 11 48 13 32 8.7 78 11.6 35 10.5 43 12.6 35 5.4 18 5.6 17 5.2 26 4 15 4.7 11 3.3

5-14 50 3.5 22 3 28 3.9 31 2.3 21 3.1 10 1.5 29 2.1 13 1.9 16 2.3 36 2.7 18 2.7 18 2.6

15-24 73 5.5 36 5 37 5.6 79 6.4 37 6 42 6.7 87 7.2 47 7.8 40 6.6 78 6.4 34 5.6 44 7.1

25-44 337 22.7 142 19 195 26.7 331 20.3 125 15.1 206 25.7 427 23.3 186 19.9 241 26.8 374 18.9 152 15 222 22.9

45-64 1510 205.9 565 149 945 266.9 1483 200.5 559 147.9 924 255.5 1588 188.1 665 155.3 923 221.9 1556 163.2 573 118.4 983 209.3

65+ 4404 1151.4 2175 1040 2229 1285.6 4552 1102.1 2336 1039.1 2216 1177.3 4928 1176.2 2508 1088.8 2419 1282.3 4631 1039 2334 950.7 2296 1146.8

Total 6504 107.2 3011 98.0 3493 116.5 6629 109.5 3149 103.2 3480 115.9 7206 114.0 3487 109.1 3717 118.9 6764 102.5 3156 94.6 3607 110.4

Assault (Homicide) 0-4 10 1.4 4 1 6 1.6 8 2.5 9 2.4 0 2.6 19 2.9 8 2.5 11 3.3 12 1.9 4 1.3 8 2.4

5-14 10 0.7 2 0 8 1.1 2 1.2 14 0.3 0 2 28 2 7 1 21 3 24 1.8 8 1.2 16 2.3

15-24 113 8.5 18 3 95 14.4 15 7.6 79 2.4 0 12.7 311 25.8 27 4.5 284 47.1 271 22.1 26 4.3 245 39.8

25-44 145 9.8 23 3 122 16.7 26 9 121 3.1 0 15.1 565 30.8 74 7.9 490 54.6 576 29.1 78 7.7 497 51.3

45-64 42 5.7 8 2 34 9.6 11 6.6 38 2.9 0 10.5 132 15.6 29 6.8 103 24.8 134 14.1 19 3.9 115 24.5

65+ 32 8.4 10 5 22 12.7 10 6.8 18 4.4 0 9.6 45 10.7 9 3.9 36 19.1 69 15.5 23 9.4 46 23

Total 358 5.9 66 2.0 292 9.7 74 5.9 281 2.4 0 9.4 1190 18.8 156 4.9 1032 33.0 1147 17.4 160 4.8 984 30.1




Page 11

TABLE 5 (Cont’d). DEATHS AND CRUDE MORTALITY RATES (PER 100,000 POPULATION) BY AGE GROUP AND GENDER FOR SELECTED DISEASES: CAREC MEMBER COUNTRIES

1985 1990 1995 2000

Disease AgeGroup

1985 1990 1995 2000



Diabetes Mellitus 0-4 2 0.3 1 0 1 0.3 4 0.6 2 0.6 2 0.6 3 0.5 0 0 3 0.9 4 0.6 4 1.3 0 0

5-14 3 0.2 3 0 0 0 1 0.1 1 0.1 0 0 1 0.1 1 0.1 0 0 3 0.2 2 0.3 1 0.1

15-24 12 0.9 7 1 5 0.8 8 0.6 5 0.8 3 0.5 11 0.9 7 1.2 4 0.7 13 1.1 8 1.3 5 0.8

25-44 104 7 48 6 56 7.7 101 6.2 60 7.2 41 5.1 138 7.5 69 7.4 69 7.7 172 8.7 92 9.1 80 8.3

45-64 698 95.2 397 105 301 85 813 109.9 463 122.5 350 96.8 901 106.7 484 113 417 100.3 1346 141.1 751 155.2 595 126.7

65+ 1368 357.6 860 411 508 293 2072 501.6 1238 550.7 834 443.1 2202 525.6 1321 573.5 881 467 2699 605.5 1600 651.7 1099 548.9

Total 2199 36.2 1321 43.0 878 29.3 3025 50.0 1784 58.5 1241 41.3 3280 51.9 1901 59.5 1379 44.1 4264 64.6 2470 74.1 1793 54.9



Page 13

TABLE 6. POTENTIAL YEARS OF LIFE LOST (PYLL) AND PYLL RATE (PER 100,000) BY AGE GROUP AND GENDER FOR SELECTED DISEASES:CAREC MEMBER COUNTRIES

1985 1990 1995 2000

Disease Group Age Group 1985 1990 1995 2000


Hiv Disease (AIDS 0-4 PYLL 63 63 0 1000 375 625 2438 1500 938 6688 3250 3438

Rate 8.6 17.4 0.0 148.3 112.6 183.1 376.0 469.7 285.1 1031.2 1020.9 1041.3

5-14 PYLL 0 0 0 55 0 55 825 495 330 2420 1375 1045

Rate 0.0 0.0 0.0 4.1 0.0 8.0 60.1 72.7 47.7 179.7 206.8 153.3

15-24 PYLL 90 45 45 675 180 495 4005 2250 1755 8505 4815 3690

Rate 6.8 6.8 6.8 54.4 29.2 79.4 332.3 373.8 290.8 693.0 787.5 599.2

25-44 PYLL 240 30 210 2880 750 2130 23310 7200 16110 48720 17220 31500

Rate 16.2 4.0 28.8 176.5 90.5 265.3 1271.9 770.3 1794.1 2461.5 1703.6 3252.5

45-64 PYLL 10 0 10 310 40 270 2740 680 2060 5780 1760 4020

Rate 1.4 0.0 2.8 41.9 10.6 74.7 324.6 158.8 495.3 606.1 363.7 855.8

Total PYLL 403 138 265 4920 1345 3575 33318 12125 21193 72113 28420 43693

Rate 7.1 4.8 9.4 87.2 47.6 127.0 564.4 408.9 721.3 1171.6 919.9 1425.2

Acute Respirtory Infections (ARI) 0-4 PYLL 24063 12063 12000 15125 6750 8375 11813 4813 6938 6688 3250 3438

Rate 3319.5 3364.7 3275.3 2242.9 2026.6 2454.0 1822.3 1506.8 2109.6 732.5 647.8 795.1

5-14 PYLL 1430 825 605 2255 1375 880 1155 495 660 2420 1375 1045

Rate 101.0 117.8 84.5 166.4 205.2 128.4 84.1 72.7 95.4 77.6 74.4 80.7

15-24 PYLL 1215 495 720 1125 585 540 1620 585 1035 630 270 360

Rate 91.6 74.3 109.1 90.7 94.8 86.6 134.4 97.2 171.5 51.3 44.2 58.5

25-44 PYLL 2250 840 1410 2400 870 1530 4680 1920 2760 2100 870 1230

Rate 151.5 111.1 193.3 147.1 105.0 190.6 255.4 205.4 307.4 106.1 86.1 127.0

45-64 PYLL 9555 3250 6305 7540 2795 4745 11895 4485 7410 8580 3055 5525

Rate 1302.6 856.4 1781.0 1019.4 739.3 1312.1 1409.1 1047.4 1781.5 899.7 631.2 1176.2

Total PYLL 38513 17473 21040 28445 12375 16070 31163 12298 18803 17105 6753 10290

Rate 677.3 610.9 744.6 504.2 437.7 571.0 527.9 414.7 639.9 277.9 218.6 335.6




Page 13

TABLE 6 (Cont’d). POTENTIAL YEARS OF LIFE LOST (PYLL) AND PYLL RATE (PER 100,000) BY AGE GROUP AND GENDER FOR SELECTED DISEASES:CAREC MEMBER COUNTRIES

1985 1990 1995 2000

Disease Age Group 1985 1990 1995 2000


Hypertensive Disease 0-4 PYLL 910 845 65 130 0 130 0 0 0 130 0 130

Rate 125.5 235.7 17.7 19.3 0.0 38.1 0.0 0.0 0.0 20.0 0.0 39.4

5-14 PYLL 110 110 0 0 0 0 0 0 0 165 0 165

Rate 7.8 15.7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 12.3 0.0 24.2

15-24 PYLL 225 90 135 315 135 180 315 225 90 450 180 270

Rate 17.0 13.5 20.5 25.4 21.9 28.9 26.1 37.4 14.9 36.7 29.4 43.8

25-44 PYLL 1920 840 1080 1620 870 750 2280 1020 1260 2820 1620 1200

Rate 129.3 111.1 148.0 99.3 105.0 93.4 124.4 109.1 140.3 142.5 160.3 123.9

45-64 PYLL 3720 1880 1840 3330 1610 1720 3530 1560 1970 5490 2770 2720

Rate 507.1 495.4 519.7 450.2 425.9 475.6 418.2 364.3 473.6 575.7 572.3 579.1

Total PYLL 6885 3765 3120 5395 2615 2780 6125 2805 3320 9055 4570 4485

Rate 121.1 131.6 110.4 95.6 92.5 98.8 103.7 94.6 113.0 147.1 147.9 146.3

Cerebrovascular Disease 0-4 PYLL 2250 1125 1125 1125 500 625 687.5 375 312.5 375 125 250

Rate 310.4 313.8 307.1 166.8 150.1 183.1 106.1 117.4 95.0 57.8 39.3 75.7

5-14 PYLL 715 385 330 770 550 220 165 110 55 275 220 55

Rate 50.5 55.0 46.1 56.8 82.1 32.1 12.0 16.1 7.9 20.4 33.1 8.1

15-24 PYLL 1395 495 900 945 315 630 1035 540 495 855 315 540

Rate 105.2 74.3 136.4 76.2 51.1 101.0 85.9 89.7 82.0 69.7 51.5 87.7

25-44 PYLL 3870 1620 2250 4530 1980 2550 5850 2490 3360 4440 1920 2520

Rate 260.5 214.3 308.4 277.6 238.9 317.7 319.2 266.4 374.2 224.3 189.9 260.2

45-64 PYLL 10380 4800 5580 9520 4340 5180 12780 5700 7080 7750 3430 4320

Rate 1415.1 1264.8 1576.2 1287.1 1148.0 1432.4 1514.0 1331.1 1702.1 812.6 708.7 919.7

Total PYLL 18610 8425 10185 16890 7685 9205 20517.5 9215 11302.5 13695 6010 7685

Rate 327.3 294.5 360.4 299.4 271.8 327.0 347.5 310.7 384.7 222.5 194.5 250.7




Page 15


1985 1990 1995 2000



Heart Disease 0-4 PYLL 5000 3000 2000 4875 2188 2688 2188 1125 1063 1625 938 688

Rate 689.8 836.8 545.9 722.9 656.8 787.5 337.5 352.2 323.1 250.6 294.5 208.3

5-14 PYLL 2750 1210 1540 1705 1155 550 1595 715 880 1980 990 990

Rate 194.2 172.8 215.2 125.8 172.3 80.3 116.1 105.0 127.2 147.0 148.9 145.3

15-24 PYLL 3285 1620 1665 3555 1665 1890 3915 2115 1800 3510 1530 1980

Rate 247.7 243.2 252.3 286.6 269.9 303.1 324.8 351.4 298.3 286.0 250.2 321.5

25-44 PYLL 10110 4260 5850 9930 3750 6180 12810 5580 7230 11220 4560 6660

Rate 680.6 563.6 801.8 608.6 452.5 769.9 699.0 597.0 805.2 566.9 451.1 687.7

45-64 PYLL 15100 5650 9450 14830 5590 9240 15880 6650 9230 15560 5730 9830

Rate 2058.6 1488.8 2669.4 2005.0 1478.7 2555.2 1881.2 1553.0 2219.0 1631.6 1184.0 2092.7

Total PYLL 36245 15740 20505 34895 14348 20548 36388 16185 20203 33895 13748 20148

Rate 637.4 550.3 725.7 618.5 507.5 730.0 616.4 545.8 687.6 550.7 445.0 657.2

Assault (Homicide) 0-4 PYLL 625 250 375 1063 500 563 1187.5 500 687.5 750 250 500

Rate 86.2 69.7 102.4 74.1 168.9 0.0 183.2 156.6 209.1 115.7 78.5 151.5

5-14 PYLL 550 110 440 880 110 770 1540 385 1155 1320 440 880

Rate 38.8 15.7 61.5 8.1 114.9 0.0 112.1 56.5 166.9 98.0 66.2 129.1

15-24 PYLL 5085 810 4275 4230 675 3555 13995 1215 12780 12195 1170 11025

Rate 383.5 121.6 647.8 54.4 576.2 0.0 1161.1 201.9 2117.9 993.7 191.4 1790.3

25-44 PYLL 4350 690 3660 4410 780 3630 16950 2220 14700 17280 2340 14910

Rate 292.8 91.3 501.6 47.8 438.0 0.0 924.9 237.5 1637.0 873.0 231.5 1539.5

45-64 PYLL 420 80 340 490 110 380 1320 290 1030 1340 190 1150

Rate 57.3 21.1 96.0 14.9 100.5 0.0 156.4 67.7 247.6 140.5 39.3 244.8

Total PYLL 9855 1580 8275 11073 2175 8898 32265 3725 28510 30815 3700 27085

Rate 173.3 55.2 292.9 196.3 267.6 0.0 546.5 125.6 970.3 500.6 119.8 883.5




Page 15


1985 1990 1995 2000



Diabetes Mellitus 0-4 PYLL 125 63 63 250 125 125 188 0 188 250 250 0

Rate 17.2 17.4 17.1 37.1 37.5 36.6 28.9 0.0 57.0 38.6 78.5 0.0

5-14 PYLL 165 165 0 55 55 0 55 55 0 165 110 55

Rate 11.7 23.6 0.0 4.1 8.2 0.0 4.0 8.1 0.0 12.3 16.5 8.1

15-24 PYLL 540 315 225 360 225 135 495 315 180 585 360 225

Rate 40.7 47.3 34.1 29.0 36.5 21.6 41.1 52.3 29.8 47.7 58.9 36.5

25-44 PYLL 3120 1440 1680 3030 1800 1230 4140 2070 2070 5160 2760 2400

Rate 210.0 190.5 230.3 185.7 217.2 153.2 225.9 221.5 230.5 260.7 273.0 247.8

45-64 PYLL 6980 3970 3010 8130 4630 3500 9010 4840 4170 13460 7510 5950

Rate 951.6 1046.1 850.2 1099.1 1224.7 967.9 1067.3 1130.3 1002.5 1411.4 1551.7 1266.7

Total PYLL 10640 5725 4915 11520 6655 4865 13645 7225 6420 19205 10630 8575

Rate 187.1 200.2 173.9 204.2 235.4 172.9 231.1 243.6 218.5 312.0 344.1 279.7

Note: The PYLL is calculated for those under 65 years – Refer to Appendix B for formula



Page 17

TABLE 7A. CAUSES OF DEATH DUE TO COMMUNICABLE DISEASES: CAREC MEMBER COUNTRIES1985 1990 1995 2000

Rank 1985 1990 1995 2000


1 Acute Respiratory Infections 1462 48.4 24.1 Acute Respiratory Infections 1354 45.7 22.4 Acute Respiratory Infections 1506 33.3 23.8 HIV disease (AIDS) 2624 49.2 39.8

2 Intestinal infectious diseases 720 23.8 11.9 Intestinal infectious diseases 602 20.3 9.9 HIV disease (AIDS) 1238 27.4 19.6 Acute Respiratory Infections 1060 19.9 16.1

3 Septicimia, except Neonatal 336 11.1 5.5 Septicimia, except Neonatal 386 13.0 6.4 Septicimia, except Neonatal 638 14.1 10.1 Septicimia, except Neonatal 564 10.6 8.5

4 Meningitis 136 4.5 2.2 HIV disease (AIDS) 162 5.5 2.7 Intestinal infectious diseases 588 13.0 9.3 Intestinal infectious diseases 375 7.0 5.7

5 Tuberculosis 121 4.0 2.0 Meningitis 140 4.7 2.3 Tuberculosis 145 3.2 2.3 Tuberculosis 226 4.2 3.4

6 Certain diseases preventable by

immunization

42 1.4 0.7 Tuberculosis 103 3.5 1.7 Meningitis 129 2.9 2.0 Meningitis 158 3.0 2.4

7 HIV disease (AIDS) 13 0.4 0.2 Certain Vector-borne Diseases 33 1.1 0.5 Certain Vector-borne Diseases 43 1.0 0.7 Certain Vector-borne diseases

and rabies

114 2.1 1.7

8 Certain Vector-borne Diseases 5 0.2 0.1 Certain Vector-borne diseases

and rabies

28 0.9 0.5 Certain Vector-borne diseases

and rabies

28 0.6 0.4 Certain diseases preventable by

immunization

11 0.2 0.2

9 Certain Vector-borne diseases

and rabies

0 0.0 0.0 Certain Vector-borne diseases

and rabies

0 0.0 0.0 Certain diseases preventable by

immunization

14 0.3 0.2 Certain Vector-borne Diseases 0 0.0 0.0

10 Other infectious & parasitic

diseases

184 6.1 3.0 Other infectious & parasitic

diseases


diseases


diseases

198 3.7 3.0

Total 3019 Total 2965 Total 4516 Total 5330

Note: Refer to Appendix D for details on the ICD9/ICD10 classifications used for the above as they may differ from those used in other listings



Page 17

TABLE 7B. CAUSES OF DEATH DUE TO NEOPLASMS: CAREC MEMBER COUNTRIES1985 1990 1995 2000

Rank 1985 1990 1995 2000


1 Malignant neoplasm of digestive organs & peritoneum, except stomach and colon

830 16.4 13.7 Malignant neoplasm of digestive organs & peritoneum, except stomach and colon

673 13.3 11.1 Malignant Neoplasm of prostate 877 15.3 13.9 Malignant Neoplasm of prostate 1001 15.5 15.2

2 Malignant neoplasm of Stomach 659 13.0 10.9 Malignant Neoplasm of prostate 613 12.1 10.1 Malignant neoplasm of digestive organs & peritoneum, except stomach and colon

824 14.4 13.0 Malignant neoplasm of digestive organs & peritoneum, except stomach and colon

877 13.6 13.3

3 Malignant Neoplasm of prostate 503 9.9 8.3 Malignant neoplasm of Stomach 571 11.2 9.4 Malignant neoplasm of trachea,bronchus and lung

564 9.8 8.9 Malignant neoplasm of trachea,bronchus and lung

635 9.8 9.6

4 Malignant neoplasm of trachea,bronchus and lung


499 9.8 8.2 Malignant neoplasm of Stomach 498 8.7 7.9 Malignant neoplasm of female breast

571 8.8 8.7

5 Malignant neoplasm of uterus 454 9.0 7.5 Malignant neoplasm of uterus 493 9.7 8.1 Malignant neoplasm of female breast

475 8.3 7.5 Malignant neoplasm of uterus 540 8.4 8.2

6 Malignant neoplasm of female breast

412 8.1 6.8 Malignant neoplasm of female breast

463 9.1 7.6 Malignant neoplasm of uterus 457 8.0 7.2 Malignant neoplasm of lymphoid other hematopoietic and related tissue

514 8.0 7.8

7 Malignant neoplasm of lymphoid other hematopoietic and related tissue

350 6.9 5.8 Malignant neoplasm of lymphoid other hematopoietic and related tissue


428 7.5 6.8 Malignant neoplasm of Stomach 486 7.5 7.4

8 Malignant neoplasm of other genitourinary organs

307 6.1 5.1 Malignant neoplasm of colon and recto-sigmoid junction



378 5.8 5.7

9 Malignant neoplasm of colon and recto-sigmoid junction

270 5.3 4.4 Malignant neoplasm of other genitourinary organs



325 5.0 4.9

10 Malignant neoplasm of respiratory and intra-thoracic organ

75 1.5 1.2 Malignant neoplasm of respiratory and intra-thoracic organ



81 1.3 1.2

Malignant neoplasm of other and unspecfied sites

604 12 10.0 Malignant neoplasm of other and unspecfied sites



893 14 13.5

Benign carcinoma in situ and neoplasms of uncertain behaviour

138 2.7 2.3 Benign carcinoma in situ and neoplasms of uncertain behaviour


94 1.6 1.5 Carcinoma in situ, benign neoplasms and neoplasms of uncertain or unknown behaviour

159 2.5 2.4

Carcinoma in situ, benign neoplasms and neoplasms of uncertain or unknown behaviour




2 0.0 0.0





Page 19

TABLE 7Bi. CAUSES OF DEATH DUE TO NEOPLASMS – MALES: CAREC MEMBER COUNTRIES1985 1990 1995 2000

Rank 1985 1990 1995 2000


1 Malignant neoplasm of prostate 503 19.0 16.8 Malignant neoplasm of prostate 613 23.0 20.4 Malignant neoplasm of prostate 877 28.6 28.0 Malignant neoplasm of prostate 1001 28.9 30.6

2 Malignant neoplasm of digestive organs & peritoneum, execpt stomach and colon


383 14.4 12.8 Malignant neoplasm of digestive organs & peritoneum, execpt stomach and colon

443 14.5 14.2 Malignant neoplasm of other and unspecfied sites

484 14.0 14.8

3 Malignant neoplasm of Stomach 433 16.4 14.4 Malignant neoplasm of digestive organs & peritoneum, execpt stomach and colon



484 14.0 14.8


335 12.7 11.2 Malignant neoplasm of Stomach 367 13.8 12.2 Malignant neoplasm of trachea,bronchus and lung


481 13.9 14.7

5 Malignant neoplasm of other and unspecfied sites


316 11.9 10.5 Malignant neoplasm of Stomach 295 9.6 9.4 Malignant neoplasm of Stomach 294 8.5 9.0





290 8.4 8.9





189 5.4 5.8





103 3.0 3.2

9 Benign carcinoma in situ and neoplasms of uncertain behaviour




73 2.1 2.2





66 1.9 2.0

11 Carcinoma in situ, benign neoplasms and neoplasms of uncertain or unknown behaviour




0 0.0 0.0





Page 19

TABLE 7Bii. CAUSES OF DEATH DUE TO NEOPLASMS – FEMALES: CAREC MEMBER COUNTRIES1985 1990 1995 2000

Rank 1985 1990 1995 2000


1 Malignant neoplasm of uterus 454 18.8 14.8 Malignant neoplasm of uterus 493 20.4 16.2 Malignant neoplasm of female breast (C50 in women)

475 17.9 14.9 Malignant neoplasm of female breast (C50 in women)

569 19.0 17.1

2 Malignant neoplasm of female breast (C50 in women)

412 17.0 13.4 Malignant neoplasm of female breast (C50 in women)

463 19.2 15.2 Malignant neoplasm of uterus 457 17.2 14.3 Malignant neoplasm of uterus 540 18.1 16.2

3 Malignant neoplasm of digestive organs & peritoneum, execpt stomach and colon




405 13.5 12.1

4 Malignant neoplasm of other and unspecfied sites




393 13.1 11.8

5 Malignant neoplasm of Stomach 226 9.3 7.4 Malignant neoplasm of Stomach 204 8.5 6.7 Malignant neoplasm of Stomach 203 7.6 6.4 Malignant neoplasm of lymphoid other hematopoietic and related tissue

223 7.5 6.7





221 7.4 6.6




183 6.9 5.7 Malignant neoplasm of Stomach 192 6.4 5.8





189 6.3 5.7





153 5.1 4.6

10 Benign carcinoma in situ and neoplasms of uncertain behaviour




86 2.9 2.6





15 0.5 0.4

12 Carcinoma in situ, benign neoplasms and neoplasms of uncertain or unknown behaviour




2 0.1 0.1





Page 21

TABLE 7C. CAUSES OF DEATH DUE TO DISEASES OF THE CIRCULATORY SYSTEM: CAREC MEMBER COUNTRIES1985 1990 1995 2000

Rank 1985 1990 1995 2000


1 Cerebrovascular diseases 4997 35.2 82.3 Cerebrovascular diseases 4804 34.5 79.3 Cerebrovascular diseases 6056 38.3 95.8 Ischaemic heart diseases 4288 30.2 65.0

2 Ischaemic heart diseases 3390 23.9 55.9 Ischaemic heart diseases 3451 24.8 57.0 Ischaemic heart diseases 4133 26.1 65.4 Cerebrovascular diseases 4286 30.2 64.9

3 Pul circ.dis & Other heart Dis 3000 21.2 49.4 Pul circ.dis & Other heart Dis 3092 22.2 51.1 Pul circ.dis & Other heart Dis 2977 18.8 47.1 Hypertensive Disease 2596 18.3 39.3

4 Hypertensive Disease 1854 13.1 30.6 Hypertensive Disease 1869 13.4 30.9 Hypertensive Disease 1983 12.5 31.4 Pul circ.dis & Other heart Dis 2376 16.7 36.0

5 Atherosclerosis 462 3.3 7.6 Atherosclerosis 327 2.4 5.4 Atherosclerosis 264 1.7 4.2 Atherosclerosis 213 1.5 3.2

6 Acute rheumatic fever & chronic rheumatic heart diseases

114 0.8 1.9 Acute rheumatic fever & chronic rheumatic heart diseases



100 0.7 1.5

Other diseases of the cirulatory system

364 2.6 6.0 Other diseases of the cirulatory system

280 2.0 4.6 All other diseases of the circulatory system


327 2.3 5.0

All other diseases of the circulatory system




1 0.0 0.0





Page 21

TABLE 7D. CAUSES OF DEATH DUE TO CONDITIONS ORIGINATING IN THE PERINATAL PERIOD: CAREC MEMBER COUNTRIES1985 1990 1995 2000

Rank 1985 1990 1995 2000



454 40.3 7.5 Slow Fetal Growth, fetal malnut., short gestation, low birth wt.

469 41.6 7.7 Hypoxia, birth asphyxia and other respiratory conditions


707 52.7 10.7

2 Hypoxia, birth asphyxia and other respiratory conditions




213 15.9 3.2

3 Fetus & newborn affected by obstetric complications and birth trauma

83 7.4 1.4 Fetus & newborn affected by obstetric complications and birth trauma


275 18.1 4.3 Bacterial sepsis of newborn 130 9.7 2.0



0 0.0 0.0 Bacterial sepsis of newborn 74 4.9 1.2 Fetus & newborn affected by obstetric complications and birth trauma

44 3.3 0.7

5 Bacterial sepsis of newborn 0 0.0 0.0 Bacterial sepsis of newborn 0 0.0 0.0 Fetus & newborn affected by obstetric complications and birth trauma


4 0.3 0.1

6 Bacterial sepsis of newborn 0 0.0 0.0 Bacterial sepsis of newborn 0 0.0 0.0 Fetus & newborn affected by certain maternal conVVMditions

3 0.2 0.0 Fetus & newborn affected by certain maternal conditions

3 0.2 0.0

Remainder of certain conditions originating in the perinatal period

11 1.0 0.2 Remainder of certain conditions originating in the perinatal period



241 18.0 3.7

Other conditions orginating in perinatal period

185 16.4 3.0 Other conditions orginating in perinatal period



0 0.0 0.0





Page 23

TABLE 7E. CAUSES OF DEATH DUE TO EXTERNAL CONDITIONS: CAREC MEMBER COUNTRIES1985 1990 1995 2000

Rank 1985 1990 1995 2000


1 Land transport accidents 488 20.1 8.0 Land transport accidents 378 16.6 6.2 Assault (homicide) 1190 30.5 18.8 Assault (homicide) 1147 33.9 17.4

2 Assault (homicide) 358 14.7 5.9 Assault (homicide) 355 15.6 5.9 Land transport accidents 587 15.1 9.3 Land transport accidents 717 21.2 10.9

3 Accidental drowning and submersion

204 8.4 3.4 Intentional self-harm (suicide) 331 14.5 5.5 Intentional self-harm (suicide) 549 14.1 8.7 Intentional self-harm (suicide) 326 9.6 4.9

4 Accidental falls 171 7.0 2.8 Accidental drowning and submersion

194 8.5 3.2 Accidental drowning and submersion

271 6.9 4.3 Accidental drowning and submersion

253 7.5 3.8

5 Intentional self-harm (suicide) 161 6.6 2.7 Accidental falls 182 8.0 3.0 Accidental falls 208 5.3 3.3 Exposure to smoke fire & flames 79 2.3 1.2

6 Accidental poisoning by and exposure to noxious substances

81 3.3 1.3 Exposure to smoke fire & flames 56 2.5 0.9 Exposure to smoke fire & flames 76 1.9 1.2 Falls 66 1.9 1.0

7 Exposure to smoke fire & flames 66 2.7 1.1 Accidents caused by firearm discharge

35 1.5 0.6 Accidental poisoning by and exposure to noxious substances

51 1.3 0.8 Accidental threats to breathing 63 1.9 1.0

8 Accidents caused by firearm discharge

63 2.6 1.0 Accidental poisoning by and exposure to noxious substances

13 0.6 0.2 Falls 32 0.8 0.5 Accidental poisoning by and exposure to noxious substances

23 0.7 0.3

9 Falls 0 0.0 0.0 Falls 0 0.0 0.0 Accidental threats to breathing 31 0.8 0.5 Exposure to electric current 19 0.6 0.3

10 Accidental threats to breathing 0 0.0 0.0 Accidental threats to breathing 0 0.0 0.0 Accidents caused by firearm discharge

27 0.7 0.4 Accidents caused by firearm discharge

16 0.5 0.2

11 Exposure to electric current 0 0 0.0 Exposure to electric current 0 0 0.0 Exposure to electric current 7 0 0.1 Accidental falls 1 0 0.0

Other unspecified transport accidents

131 5.4 2.2 Other accidents including late effects

329 14.5 5.4 Event of undetermined intent 491 12.6 7.8 Event of undetermined intent 337 9.9 5.1

All other Accidents 87 3.6 1.4 Event of undetermined intent 317 13.9 5.2 All other Accidents 185 4.7 2.9 All other Accidents 262 7.7 4.0

Other accidents including late effects

252 10.4 4.2 All other Accidents 56 2.5 0.9 Other accidents including late effects

157 4.0 2.5 All other external causes 53 1.6 0.8

Event of undetermined intent 366 15.1 6.0 Other unspecified transport accidents

30 1.3 0.5 All other external causes 21 0.5 0.3 Other unspecified transport accidents

23 0.7 0.3

All other external causes 0 0.0 0.0 All other external causes 0 0.0 0.0 Other unspecified transport accidents

17 0.4 0.3 Other accidents including late effects

2 0.1 0.0

Totals 2428 Total 2276 Total 3900 Total 3387




Page 23

TABLE 7F. CAUSES OF DEATH DUE TO ALL OTHER DISEASES: CAREC MEMBER COUNTRIES1985 1990 1995 2000

Rank 1985 1990 1995 2000


1 Diabetes mellitus 2199 23.3 36.2 Diabetes mellitus 3025 33.1 50.0 Diabetes mellitus 3280 34.0 51.9 Diabetes mellitus 4264 40.5 64.6


1016 10.8 16.7 Diseases of the Urinary System 896 9.8 14.8 Diseases of the Urinary System 744 7.7 11.8 Chronic lower respiratory diseases 783 7.4 11.9

3 Diseases of the Urinary System 918 9.7 15.1 Nutritional Deficiencies and nutritional anemia



747 7.1 11.3

4 Chronic & unspec. bronchitis, emphysema & Asthma



437 4.5 6.9 Diseases of the Urinary System 727 6.9 11.0


574 6.1 9.5 Chronic & unspec. bronchitis, emphysema & Asthma

479 5.2 7.9 Chronic lower respiratory diseases 405 4.2 6.4 Congenital malformations, deformations and chromosomal abnor.

360 3.4 5.5

6 Cirrhosis and certain other chronic diseases of liver


407 4.5 6.7 Congenital malformations, deformations and chromosomal abnormalities


349 3.3 5.3


389 4.1 6.4 Congenital malformations, deformations and chromosomal abnormalities


345 3.6 5.5 Nutritional deficiencies and nutritional anemia

326 3.1 4.9

8 Mental and behavioural disorders 221 2.3 3.6 Mental and behavioural disorders 171 1.9 2.8 Chronic & unspecified bronchitis, emphysema & Asthma

218 2.3 3.4 Mental and behavioural disorders 180 1.7 2.7

9 Appendicitis, hernia of abdominal cavity and intestinal obstruction

180 1.9 3.0 Appendicitis, hernia of abdominal cavity and intestinal obstruction

154 1.7 2.5 Mental and behavioural disorders 175 1.8 2.8 Appendicitis, hernia of abdominal cavity and intestinal obstruction

178 1.7 2.7

10 Complications of pregnancy, childbirth & puerperium

86 0.9 1.4 Hyperplasia of prostate 73 0.8 1.2 Appendicitis, hernia of abdominal cavity and intestinal obstruction

153 1.6 2.4 Hyperplasia of prostate 84 0.8 1.3





Page 25

TABLE 7F. CAUSES OF DEATH DUE TO ALL OTHER DISEASES: CAREC MEMBER COUNTRIES1985 1990 1995 2000

Rank 1985 1990 1995 2000


11 Hyperplasia of prostate 81 1 1.3 Complications of pregnancy, childbirth & puerperium

63 1 1.0 Nutritional deficiencies and nutritional anemia

148 2 2.3 Pregnancy, childbirth, and the puerperium

66 1 1.0

12 Nutritional deficiencies and nutritional anemia

0 0.0 0.0 Nutritional deficiencies and nutritional anemia

0 0.0 0.0 Hyperplasia of prostate 87 0.9 1.4 Chronic & unspec. bronchitis, emphysema & Asthma

3 0.0 0.0

13 Chronic lower respiratory diseases 0 0.0 0.0 Chronic lower respiratory diseases 0 0.0 0.0 Complications of pregnancy, childbirth & puerperium


2 0.0 0.0

14 Pregnancy, childbirth, and the puerperium

0 0.0 0.0 Pregnancy, childbirth, and the puerperium

0 0.0 0.0 Pregnancy, childbirth, and the puerperium

35 0.4 0.6 Complications of pregnancy, childbirth & puerperium

0 0.0 0.0

All other diseases of the digestive system

1214 12.9 20.0 Residual 894 9.8 14.8 All other diseases of the digestive system

1003 10.4 15.9 Remainder of all other diseases 1325 12.6 20.1

Residual 820 8.7 13.5 All other diseases of the digestive system

866 9.5 14.3 Residual 614 6.4 9.7 All other diseases of the digestive system

846 8.0 12.8

Other chronic pulmonary disease, due to external agents & other diseases of respiratory system

597 6.3 9.8 Other chronic pulmonary disease, due to external agents & other diseases of respiratory system


398 4.1 6.3 Remainder of diseases of the respiratory system

282 2.7 4.3

Remainder of diseases of the respiratory system

0 0.0 0.0 Remainder of diseases of the respiratory system

0 0.0 0.0 Remainder of all other diseases 379 3.9 6.0 Residual 13 0.1 0.2

Remainder of all other diseases 0 0.0 0.0 Remainder of all other diseases 0 0.0 0.0 Remainder of diseases of the respiratory system


5 0.0 0.1





Page 25

TABLE 8A. POTENTIAL YEARS OF LOST LIFE (PYLL) and PYLL RATE BY AGE GROUP: COMMUNICABLE DISEASES; NEOPLASMS; CIRCULATORY DISORDERSCAREC MEMBER COUNTRIES

1985 1990 1995 2000

Age Group COMMUNICABLE DISEASES NEOPLASMS CIRCULATORY DISORDERS

1985 1990 1995 2000 1985 1990 1995 2000 1985 1990 1995 2000

0-4 PYLL 62313 48250 40375 34000 2813 2875 2438 3500 8313 6375 3063 2125

Rate 8596.2 7155.0 6228.5 5242.9 388.0 426.3 376.0 539.7 1146.7 945.4 472.4 327.7

5-14 PYLL 4290 5115 4355 6655 3025 2640 2925 2805 3795 2805 2145 2420

Rate 303.0 377.3 317.1 494.2 213.6 194.8 213.0 208.3 268.0 206.9 156.2 179.7

15-24 PYLL 3825 4140 8550 12600 4005 3195 4455 3870 5265 5040 5445 4905

Rate 288.4 333.7 709.4 1026.7 302.0 257.5 369.6 315.3 397.0 406.3 451.8 399.7

25-44 PYLL 5670 9660 34800 58710 11820 13230 16320 17940 16740 16740 21600 19500

Rate 381.7 592.1 1898.8 2966.2 795.7 810.9 890.5 906.4 1126.9 1026.0 1178.6 985.2

45-64 PYLL 3470 3340 7050 9350 15710 14290 14960 18300 30110 28360 32940 29540

Rate 473.1 451.6 835.2 980.4 2141.7 1932.0 1772.2 1918.9 4104.9 3834.2 3902.2 3097.4

Total PYLL 79567.5 70505 95130 121315 37372.5 36230 41097.5 46415 64222.5 59320 65192.5 58490

Rate 1399.4 1249.7 1611.4 1970.9 657.3 642.2 696.1 754.1 1129.5 1051.5 1104.3 950.2




Page 27

TABLE 8B (Cont’d). POTENTIAL YEARS OF LOST LIFE (PYLL) and PYLL RATE BY AGE GROUP: PERINATAL CONDITIONS; EXTERNAL CAUSES; OTHER DISEASESCAREC MEMBER COUNTRIES

1985 1990 1995 2000

Age Group PERINATAL CONDITIONS EXTERNAL CAUSES OTHER DISEASES

1985 1990 1995 2000 1985 1990 1995 2000 1985 1990 1995 2000

0-4 PYLL 66250 69938 94063 83625 10063 9313 9375 7688 84250 47500 39000 35688

Rate 9139.4 10371.1 14510.8 12895.3 1388.1 1381.0 1446.3 1185.4 11622.5 7043.8 6016.4 5503.1

5-14 PYLL 0 0 0 0 8635 9240 13520 8635 11275 9295 9035 6820

Rate 0.0 0.0 0.0 0.0 609.8 681.6 984.5 641.3 796.3 685.7 657.9 506.5

15-24 PYLL 0 45 0 0 22815 20700 33435 27405 13095 11790 12150 10080

Rate 0.0 3.6 0.0 0.0 1720.5 1668.6 2774.0 2233.1 987.5 950.4 1008.1 821.4

25-44 PYLL 30 30 60 0 24120 22320 44340 39060 25740 27270 29850 28440

Rate 2.0 1.8 3.3 0.0 1623.7 1368.0 2419.4 1973.4 1732.8 1671.4 1628.8 1436.9

45-64 PYLL 0 0 0 0 4030 3740 5730 5310 20790 19230 21640 26020

Rate 0.0 0.0 0.0 0.0 549.4 505.6 678.8 556.8 2834.3 2599.8 2563.5 2728.3

Total PYLL 66280 70013 94123 83625 69663 65313 106400 88098 155150 115085 111675 107048

Rate 1165.7 1241.0 1594.3 1358.6 1225.2 1157.7 1802.3 1431.2 2728.7 2039.9 1891.6 1739.1



Page 27

TABLE 9A. STANDARDISED MORTALITY RATES BY AGE GROUP: CAREC MEMBER COUNTRIES – 1985

CTC DESCRIPTION 0-4 05-14 15-24 25-44 45-64 65+

1.00 COMMUNICABLE DISEASES

1.01 Intestinal infectious diseases 3811.2 78.3 57.5 83.9 234.1 2858.5

1.02 Tuberculosis 16.8 9.8 15.7 80.2 247.4 855.9

1.03 Certain Vector-borne diseases and rabies 0 0 0 0 0 0

1.04 Certain diseases preventable by immunization 25.2 14.7 15.7 25.5 73.6 242.2

1.05 Meningitis 597.3 24.5 47.1 32.8 93.6 452.2

1.06 Septicimia, except Neonatal 437.5 34.3 47.1 72.9 341 3036.2

1.07 HIV disease (AIDS) 8.4 0 10.5 29.2 6.7 16.1

1.08 ARIs 3239.1 127.3 141.2 273.5 983 12613

1.09 Other infectious & parasitic diseases 244 88.1 109.8 87.5 334.4 678.3

1.11 Certain Vector-borne Diseases 8.4 4.9 0 3.6 6.7 16.1

2.00 NEOPLASMS

2.01 Malignant neoplasm of Stomach 0 0 0 102.1 1230.4 7154.4

2.02 Malignant neoplasm of colon and recto-sigmoid junction 0 0 0 32.8 588.5 2793.9

2.03 Malignant neoplasm of digestive organs & peritoneum, except 25.2 0 26.2 164.1 1812.2 8123.4

2.04 Malignant neoplasm of trachea, bronchus and lung 0 0 20.9 94.8 1143.5 4182.8

2.05 Malignant neoplasm of respiratory and intra-thoracic organ 0 4.9 0 10.9 200.6 662.1

2.06 Malignant neoplasm of female breast (C50 in women) 8.4 0 0 211.5 1183.6 2810.1

2.07 Malignant neoplasm of uterus 0 0 5.2 200.6 1217.1 3423.8

2.10 Malignant Neoplasm of prostate 0 0 0 0 428 7073.6

2.11 Malignant neoplasm of other genitourinary organs 67.3 14.7 31.4 91.2 688.8 2616.3

2.12 Malignant neoplasm of lymphatic and hematopoietic 143 141.9 193.5 211.5 608.5 1905.7

2.14 Malignant neoplasm of other and unspecfied sites 50.5 48.9 141.2 215.2 1163.6 5264.9

2.15 Carcinoma in situ, benign neoplasms of uncertain or unknown behavior 0 0 0 0 0 0

2.16 Benign carcinoma in situ and neoplasms of uncertain or unknown behavior 84.1 58.7 47.1 102.1 240.7 662.1




Page 29

TABLE 9A (Cont’d). STANDARDISED MORTALITY RATES BY AGE GROUP: CAREC MEMBER COUNTRIES – 1985

CTC DESCRIPTION 0-4 05-14 15-24 25-44 45-64 65+

3.00 DISEASES OF THE CIRCULATORY SYSTEM

3.01 Acute rheumatic fever & chronic rheumatic heart diseases 0 102.8 125.5 116.7 120.4 306.8

3.02 Hypertensive Disease 117.8 9.8 26.2 233.4 2487.6 22157.6

3.03 Ischaemic heart diseases 67.3 9.8 31.4 547.1 6392.9 36321.1

3.04 Pul circ. dis & Other heart Diseases 605.8 132.1 224.9 565.3 3584.3 34496.1

3.07 Cerebrovascular diseases 302.9 63.6 162.2 470.5 6941.3 59964.5

3.08 Atherosclerosis 16.8 0 0 0 153.8 6944.4

3.09 All other diseases of the circulatory system 0 0 0 0 0 0

3.10 Other diseases of the cirulatory system 8.4 19.6 41.8 102.1 454.7 4102.1

4.00 CERTAIN CONDITIONS ORIGINATING IN THE PERINATAL PERIOD

4.01 Fetus & newborn affected by certain maternal conditions 159.9 0 0 0 0 0

4.02 Fetus & newborn affected by obstetric complic. birth trauma 681.5 0 0 0 0 0

4.03 Slow Fetal Growth, fetal malnut., short gestation, low birth wt 3390.5 0 0 3.6 0 0

4.04 Respiratory disorders specific to the perinatal period 0 0 0 0 0 0

4.05 Bacterial sepsis of newborn 0 0 0 0 0 0

4.06 Remainder of certain cond. originating in the perinata period 92.5 0 0 0 0 0

4.07 Hypoxia, birth asphyxia and other resp. conditions 3070.8 0 0 0 0 0

4.08 Other conditions orginating in perinatal period 1522.8 0 0 0 0 0

5.00 EXTERNAL CAUSES

5.01 Land transport accidents 134.6 186 585.9 612.7 615.2 969

5.02 Other unspecified transport accidents 75.7 97.9 109.8 94.8 193.9 355.3

5.03 Falls 0 0 0 0 0 0

5.04 Accidents caused by firearm discharge 0 4.9 136 94.8 46.8 32.3

5.05 Accidental drowning and submersion 109.4 83.2 214.5 291.8 240.7 242.2

5.06 Accidental threats to breathing 0 0 0 0 0 0

5.07 Exposure to electric current 0 0 0 0 0 0

5.08 Exposure to smoke fire & flames 218.7 29.4 15.7 25.5 40.1 290.7

5.09 Accidental poisoning by and exposure to noxious substances 50.5 58.7 47.1 105.8 80.2 145.3




Page 29

TABLE 9A (Cont’d). STANDARDISED MORTALITY RATES BY AGE GROUP: CAREC MEMBER COUNTRIES – 1985

CTC DESCRIPTION 0-4 05-14 15-24 25-44 45-64 65+

5.10 All other Accidents 42.1 9.8 94.2 83.9 93.6 355.3

5.11 Intentional self-harm (suicide) 0 19.6 224.9 233.4 180.6 339.1

5.12 Assault (homicide) 84.1 48.9 591.1 528.8 280.9 516.8

5.13 Event of undetermined intent 193.5 107.7 428.9 477.8 461.4 613.7

5.14 All other external causes 0 0 0 0 0 0

5.15 Accidental falls 67.3 44 73.2 105.8 167.2 1388.9

5.16 Other accidents including late effects 378.6 78.3 130.8 277.2 294.2 694.4

6.00 ALL OTHER DISEASES

6.01 Diabetes mellitus 16.8 14.7 62.8 379.3 4667.6 22093

6.02 Nutritional deficiencies and nutritional anemia 0 0 0 0 0 0

6.03 Mental and behavioural disorders 84.1 34.3 52.3 113.1 361.1 1728

6.04 Diseases of the nervous System, except meningitis 631 239.8 303.4 280.8 655.3 3375.3

6.05 Chronic lower respiratory diseases 0 0 0 0 0 0

6.06 Remainder of diseases of the respiratory system 0 0 0 0 0 0

6.07 Appendicitis, hernia of abdom. cavity and intestinal obstruction 143 29.4 36.6 54.7 240.7 1582.7

6.08 Cirrhosis and certain other chronic diseases of liver 126.2 34.3 36.6 372 1544.7 2147.9

6.09 All other diseases of the digestive system 1808.9 78.3 204 543.4 2039.6 7638.9

6.10 Diseases of the Urinary system 159.9 53.8 146.5 280.8 1344.1 9286.2

6.11 Hyperplasia of prostate 0 0 0 0 33.4 1227.4

6.12 Pregnancy, childbirth, and the puerperium 0 0 0 0 0 0

6.13 Congenital malformations, deformations and chromosomal abnormalities 2692.2 151.7 94.2 29.2 26.7 96.9

6.14 Remainder of all other diseases 0 0 0 0 0 0

6.15 Nutritional Deficiencies and nutritional anemia 4173 161.5 125.5 189.6 508.2 4990.3

6.16 Chronic & unspec. Bronchitis, Emphysema & Asthma 286.1 44 73.2 145.9 929.5 6363

6.17 Diseases due to external agents & other diseases of respiratory system 656.2 73.4 109.8 175.1 715.5 5248.7

6.18 Complications of pregnancy, childbirth & puerperium 0 4.9 151.7 200.6 0 0

6.21 Residual 563.7 83.2 125.5 364.7 835.9 7751.9

7.00 Symptoms, signs and ill-defined Conditions 2641.8 254.5 664.3 831.5 2634.7 32961.9




Page 31

TABLE 9B. STANDARDISED MORTALITY RATES BY AGE GROUP: CAREC MEMBER COUNTRIES – 1990

CTC DESCRIPTION 0-4 05-14 15-24 25-44 45-64 65+


1.01 Intestinal infectious diseases 3138.1 97.9 62.8 87.5 214 2164.1

1.02 Tuberculosis 33.7 9.8 5.2 65.6 207.3 759

1.03 Certain Vector-borne diseases and rabies 0 0 0 0 0 0

1.04 Certain diseases preventable by immunization 8.4 34.3 5.2 0 26.7 226.1

1.05 Meningitis 504.8 29.4 57.5 76.6 120.4 339.1

1.06 Septicimia, except Neonatal 488 19.6 31.4 131.3 428 3472.2

1.07 HIV disease (AIDS) 134.6 4.9 78.5 350.1 207.3 48.4

1.08 ARIs 2036 200.7 130.8 291.8 775.7 13533.6

1.09 Other infectious & parasitic diseases 101 44 73.2 145.9 227.4 678.3

1.11 Certain Vector-borne Diseases 50.5 14.7 36.6 25.5 26.7 80.7

2.00 NEOPLASMS

2.01 Malignant neoplasm of Stomach 0 0 5.2 76.6 902.8 6508.4

2.02 Malignant neoplasm of colon and recto-sigmoid junction 0 4.9 10.5 36.5 508.2 3294.6

2.03 Malignant neoplasm of digestive organs & peritoneum, execpt 16.8 0 10.5 153.2 1210.4 7041.3

2.04 Malignant neoplasm of trachea,bronchus and lung 0 0 10.5 113.1 1230.4 4425.1

2.05 Malignant neoplasm of respiratory and intra-thoracic organ 16.8 0 10.5 21.9 167.2 565.2

2.06 Malignant neoplasm of female breast (C50 in women) 0 0 0 240.7 1223.8 3439.9

2.07 Malig.neoplasm of uterus(inc.ICD10(2.07,2.08,2.09 0 0 20.9 302.7 1130.1 3666

2.10 Malignant Neoplasm of prostate 0 0 0 3.6 454.7 8688.6


2.12 Malig.neoplasm of lymphatic and hematopoietic 201.9 127.3 104.6 277.2 809.1 2244.8


2.15 Carcinoma in situ, benign neoplasms of uncertain or unkn 0 0 0 0 0 0

2.16 Benign carcinoma in situ and neoplasms of uncerta 50.5 19.6 68 80.2 267.5 742.9




Page 31

TABLE 9B (Cont’d). STANDARDISED MORTALITY RATES BY AGE GROUP: CAREC MEMBER COUNTRIES – 1990

CTC DESCRIPTION 0-4 05-14 15-24 25-44 45-64 65+


3.01 Acute rheumatic fever & chronic rheumatic heart diseases 16.8 53.8 83.7 116.7 86.9 177.6

3.02 Hypertensive Disease 16.8 0 36.6 196.9 2226.8 23352.7


3.04 Pul circ.dis & Other heart Diseases 614.2 93 319.1 634.6 3236.6 36143.4


3.08 Atherosclerosis 16.8 4.9 0 14.6 93.6 4877.3

3.09 All other diseases of the circulatory system 0 0 0 0 0 0

3.10 Other diseases of the cirulatory system 16.8 24.5 26.2 65.6 361.1 3133.1


4.01 Fetus & newborn affected by certain maternal conditions 101 0 0 0 0 0

4.02 Fetus & newborn affected by obstetric complic.birth trauma 622.6 0 0 3.6 0 0

4.03 Slow Fetal Growth,fetal malnut.,short gestation,low birth wt 3937.4 0 0 0 0 0

4.04 Respiratory disorders specific to the perinatal period 0 0 0 0 0 0

4.05 Bacterial sepsis of newborn 0 0 0 0 0 0

4.06 Remainder of certain cond.originating in the perinata period 42.1 0 0 0 0 0

4.07 Hypoxia,birth asphyxia and other resp. conditions 3306.4 0 5.2 0 0 0

4.08 Other conditions orginating in perinatal period 1405 0 0 0 0 16.1


5.01 Land transport accidents 143 205.6 340 455.9 501.5 742.9

5.02 Other unspecified transport accidents 16.8 14.7 26.2 25.5 40.1 113

5.03 Falls 0 0 0 0 0 0

5.04 Accidents caused by firearm discharge 8.4 9.8 31.4 54.7 66.9 16.1


5.06 Accidental threats to breathing 0 0 0 0 0 0

5.07 Exposure to electric current 0 0 0 0 0 0






Page 33

TABLE 9B (Cont’d). STANDARDISED MORTALITY RATES BY AGE GROUP: CAREC MEMBER COUNTRIES – 1990

CTC DESCRIPTION 0-4 05-14 15-24 25-44 45-64 65+


5.11 Intentional self-harm (suicide) 0 44 496.9 554.4 327.7 387.6

5.12 Assault (homicide) 143 78.3 491.7 536.1 327.7 452.2

5.13 Event of undetermined intent 210.3 83.2 340 397.5 381.2 516.8

5.14 All other external causes 0 0 0 0 0 0

5.15 Accidental falls 92.5 24.5 68 102.1 200.6 1485.8

5.16 Other accidents including late effects 311.3 200.7 261.5 331.9 367.8 839.8


6.01 Diabetes mellitus 33.7 4.9 41.8 368.4 5436.7 33462.5

6.02 Nutritional deficiencies and nutritional anemia 0 0 0 0 0 0

6.03 Mental and behavioural disorders 8.4 34.3 31.4 109.4 227.4 1453.5

6.04 Diseases of the nervous System,except meningitis 555.3 249.6 277.2 306.4 581.8 3230

6.05 Chronic lower respiratory diseases 0 0 0 0 0 0

6.06 Remainder of diseases of the respiratory system 0 0 0 0 0 0

6.07 Appendicitis,hernia of abdom. cavity and intestinal obstruc. 101 14.7 15.7 76.6 140.4 1469.6

6.08 Cirrhosis and certain other chronic diseases of liver 42.1 14.7 31.4 258.9 1243.8 2083.3

6.09 All other diseases of the digestive system 252.4 53.8 115.1 499.7 1364.2 7348.2

6.10 Diseases of the Urinary System 143 44 146.5 288.1 1270.6 9173.1

6.11 Hyperplasia of prostate 0 0 0 0 40.1 1065.9

6.12 Pregnancy, childbirth, and the puerperium 0 0 0 0 0 0

6.13 Congenital malformations,deformations and chromosomal abnor. 2162.2 73.4 57.5 54.7 60.2 113

6.14 Remainder of all other diseases 0 0 0 0 0 0

6.15 Nutritional Deficiencies and nutritional anemia 2069.7 156.6 183.1 218.8 474.8 4005.2

6.16 Chronic & unspec. bronchitis,emphysema & Asthma 201.9 53.8 73.2 186 655.3 4489.7

6.17 Diseases due to external agents & other diseases of resp. sy 403.8 48.9 62.8 196.9 548.3 5248.7

6.18 Complications of pregnancy,childbirth &puerperium 0 9.8 78.5 164.1 6.7 0

6.21 Residual 420.7 68.5 256.3 587.2 809.1 7881.1





Page 33

TABLE 9C. STANDARDISED MORTALITY RATES BY AGE GROUP: CAREC MEMBER COUNTRIES – 1995

CTC DESCRIPTION 0-4 05-14 15-24 25-44 45-64 65+



1.02 Tuberculosis 25.2 0 26.2 142.2 334.4 742.9

1.03 Certain Vector-borne diseases and rabies 42.1 0 31.4 47.4 20.1 16.1

1.04 Certain diseases preventable by immunization 8.4 0 5.2 10.9 13.4 113

1.05 Meningitis 302.9 19.6 31.4 72.9 160.5 597.5

1.06 Septicimia, except Neonatal 361.8 24.5 62.8 178.7 535 7138.2

1.07 HIV disease (AIDS) 328.1 73.4 465.6 2833.8 1832.3 549.1

1.08 ARIs 1590.1 102.8 188.3 568.9 1223.8 14228

1.09 Other infectious & parasitic diseases 168.3 34.3 99.4 204.2 260.8 742.9

1.11 Certain Vector-borne Diseases 58.9 4.9 31.4 43.8 73.6 64.6

2.00 NEOPLASMS

2.01 Malignant neoplasm of Stomach 0 0 10.5 124 642 5814

2.02 Malignant neoplasm of colon and recto-sigmoid junction 0 0 5.2 51.1 555 3730.6

2.03 Malignant neoplasm of digestive organs & peritoneum, execpt 16.8 0 36.6 175.1 1518 8607.9

2.04 Malignant neoplasm of trachea,bronchus and lung 0 0 10.5 134.9 1277.3 5329.5

2.05 Malignant neoplasm of respiratory and intra-thoracic organ 0 0 0 7.3 153.8 613.7

2.06 Malignant neoplasm of female breast (C50 in women) 0 0 10.5 295.4 1344.1 3084.6

2.07 Malig.neoplasm of uterus 0 0 15.7 317.3 1023.1 3343

2.10 Malignant Neoplasm of prostate 0 0 5.2 0 501.5 12903.7


2.12 Malig.neoplasm of lymphatic and hematopoietic 101 93 224.9 324.6 722.2 2535.5


2.15 Carcinoma in situ, benign neoplasms of uncertain or unkn 16.8 9.8 10.5 32.8 33.4 290.7

2.16 Benign carcinoma in situ and neoplasms of uncerta 58.9 24.5 31.4 47.4 160.5 629.8




Page 35

TABLE 9C (Cont’d). STANDARDISED MORTALITY RATES BY AGE GROUP: CAREC MEMBER COUNTRIES – 1995

CTC DESCRIPTION 0-4 05-14 15-24 25-44 45-64 65+


3.01 Acute rheumatic fever & chronic rheumatic heart diseases 0 39.2 78.5 134.9 133.7 258.4

3.02 Hypertensive Disease 0 0 36.6 277.2 2360.6 24483.2


3.04 Pul circ.dis & Other heart Diseases 260.8 83.2 324.3 813.3 3617.8 32897.3


3.08 Atherosclerosis 0 0 0 3.6 80.2 4005.2

3.09 All other diseases of the circulatory system 8.4 4.9 5.2 18.2 147.1 1098.2

3.10 Other diseases of the cirulatory system 16.8 0 15.7 58.4 274.2 2261



4.02 Fetus & newborn affected by obstetric complic.birth trauma 504.8 0 0 0 0 0

4.03 Slow Fetal Growth,fetal malnut.,short gestation,low birth wt 2296.8 0 0 0 0 0

4.04 Respiratory disorders specific to the perinatal period 2481.9 0 0 0 0 0

4.05 Bacterial sepsis of newborn 622.6 0 0 0 0 0

4.06 Remainder of certain cond.originating in the perinata period 2010.8 0 0 7.3 0 0

4.07 Hypoxia,birth asphyxia and other resp. conditions 3340.1 0 0 0 0 16.1

4.08 Other conditions orginating in perinatal period 1379.8 0 0 0 0 0


5.01 Land transport accidents 176.7 205.6 580.6 802.4 648.7 1114.3

5.02 Other unspecified transport accidents 0 4.9 31.4 21.9 13.4 16.1

5.03 Falls 25.2 0 5.2 14.6 33.4 290.7

5.04 Accidents caused by firearm discharge 0 14.7 41.8 36.5 6.7 0


5.06 Accidental threats to breathing 143 4.9 0 21.9 13.4 16.1

5.07 Exposure to electric current 0 4.9 5.2 18.2 0 0

5.08 Exposure to smoke fire & flames 92.5 53.8 0 80.2 46.8 306.8

5.09 Accidental poisoning by and exposure to noxious substances 25.2 53.8 15.7 62 66.9 96.9




Page 35

TABLE 9C (Cont’d). STANDARDISED MORTALITY RATES BY AGE GROUP: CAREC MEMBER COUNTRIES – 1995

CTC DESCRIPTION 0-4 05-14 15-24 25-44 45-64 65+

5.10 All other Accidents 67.3 63.6 120.3 156.8 214 888.2

5.11 Intentional self-harm (suicide) 8.4 29.4 606.8 930 702.2 726.7

5.12 Assault (homicide) 159.9 137 1626.8 2060.6 882.7 726.7

5.13 Event of undetermined intent 227.2 107.7 345.2 554.4 528.3 1227.4

5.14 All other external causes 0 4.9 41.8 32.8 0 32.3

5.15 Accidental falls 67.3 39.2 36.6 204.2 200.6 1566.5

5.16 Other accidents including late effects 101 73.4 146.5 171.4 200.6 323


6.01 Diabetes mellitus 25.2 4.9 57.5 503.3 6025.1 35562

6.02 Nutritional deficiencies and nutritional anemia 395.4 9.8 5.2 14.6 100.3 1211.2

6.03 Mental and behavioural disorders 8.4 0 36.6 83.9 254.1 1615

6.04 Diseases of the nervous System,except meningitis 572.1 156.6 287.7 404.8 648.7 4990.3

6.05 Chronic lower respiratory diseases 67.3 29.4 31.4 58.4 494.9 4635

6.06 Remainder of diseases of the respiratory system 151.4 24.5 31.4 65.6 113.7 904.4

6.07 Appendicitis,hernia of abdom. cavity and intestinal obstruc. 84.1 24.5 10.5 76.6 167.2 1437.3


6.09 All other diseases of the digestive system 269.2 44 104.6 496 1885.8 8188

6.10 Diseases of the Urinary System 58.9 58.7 130.8 328.2 1156.9 6944.4

6.11 Hyperplasia of prostate 0 0 0 3.6 13.4 1356.6

6.12 Pregnancy, childbirth, and the puerperium 0 0 41.8 91.2 0 32.3

6.13 Congenital malformations,deformations and chromosomal abnor. 2389.4 97.9 68 58.4 120.4 145.3

6.14 Remainder of all other diseases 201.9 88.1 130.8 222.5 347.7 3052.3

6.15 Nutritional Deficiencies and nutritional anemia 572.1 58.7 104.6 156.8 254.1 2470.9

6.16 Chronic & unspec. bronchitis,emphysema & Asthma 58.9 24.5 26.2 94.8 300.9 2083.3

6.17 Diseases due to external agents & other diseases of resp. sy 193.5 39.2 88.9 193.3 481.5 3585.3

6.18 Complications of pregnancy,childbirth &puerperium 0 0 57.5 167.8 6.7 16.1

6.21 Residual 168.3 14.7 177.9 306.4 662 5797.8





Page 37

TABLE 9D (Cont’d). STANDARDISED MORTALITY RATES BY AGE GROUP: CAREC MEMBER COUNTRIES – 2000

CTC DESCRIPTION 0-4 05-14 15-24 25-44 45-64 65+



1.02 Tuberculosis 58.9 29.4 73.2 218.8 321 1098.2

1.03 Certain Vector-borne diseases and rabies 42.1 14.7 136 156.8 180.6 161.5

1.04 Certain diseases preventable by immunization 0 0 0 0 40.1 80.7

1.05 Meningitis 361.8 78.3 94.2 105.8 127.1 532.9

1.06 Septicimia, except Neonatal 328.1 93 41.8 229.8 434.7 5814

1.07 HIV disease (AIDS) 900.2 215.3 988.6 5922.9 3865.2 1082

1.08 ARIs 639.4 93 73.2 255.3 882.7 11837.9

1.09 Other infectious & parasitic diseases 126.2 29.4 52.3 229.8 307.6 823.6

1.11 Certain Vector-borne Diseases 0 0 0 0 0 0

2.00 NEOPLASMS

2.01 Malignant neoplasm of Stomach 8.4 4.9 10.5 80.2 835.9 5394.1

2.02 Malignant neoplasm of colon and recto-sigmoid junction 8.4 0 0 83.9 742.3 3892.1

2.03 Malignant neoplasm of digestive organs & peritoneum, execpt 16.8 9.8 15.7 255.3 1745.4 8559.4

2.04 Malignant neoplasm of trachea, bronchus and lung 0 0 15.7 105.8 1691.9 5604

2.05 Malignant neoplasm of respiratory and intra-thoracic organ 0 4.9 10.5 18.2 140.4 823.6

2.06 Malignant neoplasm of female breast (C50 in women) 8.4 4.9 5.2 393.9 1297.3 4295.9

2.07 Malig. neoplasm of uterus 0 0 15.7 320.9 1364.2 3924.4

2.10 Malignant Neoplasm of prostate 0 0 0 7.3 588.5 14631.8


2.12 Malig. neoplasm of lymphatic and hematopoietic 176.7 102.8 125.5 317.3 983 3391.5


2.15 Carcinoma in situ, benign neoplasms of uncertain or unkn 50.5 29.4 57.5 113.1 234.1 1065.9

2.16 Benign carcinoma in situ and neoplasms of uncerta 0 0 0 7.3 0 0




Page 37


CTC DESCRIPTION 0-4 05-14 15-24 25-44 45-64 65+


3.01 Acute rheumatic fever & chronic rheumatic heart diseases 16.8 53.8 94.2 124 133.7 242.2

3.02 Hypertensive Disease 16.8 14.7 52.3 342.8 3671.3 30910.9

3.03 Ischaemic heart diseases 16.8 14.7 68 514.2 7596.6 47852.1

3.04 Pul circ.dis & Other heart Diseases 185.1 107.7 245.9 725.8 2674.9 26695.7


3.08 Atherosclerosis 0 0 0 10.9 113.7 3100.8

3.09 All other diseases of the circulatory system 0 0 10.5 113.1 381.2 3795.2

3.10 Other diseases of the cirulatory system 0 0 0 0 0 16.1



4.02 Fetus & newborn affected by obstetric complic. birth trauma 370.2 0 0 0 0 0

4.03 Slow Fetal Growth, fetal malnut., short gestation, low birth wt 1792 0 0 0 0 0

4.04 Respiratory disorders specific to the perinatal period 5939.8 0 0 0 0 0

4.05 Bacterial sepsis of newborn 1093.7 0 0 0 0 0

4.06 Remainder of certain cond. originating in the perinata period 2002.4 0 0 0 0 0

4.07 Hypoxia, birth asphyxia and other resp. conditions 33.7 0 0 0 0 0

4.08 Other conditions orginating in perinatal period 0 0 0 0 0 0


5.01 Land transport accidents 210.3 234.9 638.2 930 902.8 1437.3

5.02 Other unspecified transport accidents 0 4.9 20.9 25.5 53.5 48.4

5.03 Falls 33.7 14.7 10.5 43.8 113.7 419.9

5.04 Accidents caused by firearm discharge 0 0 10.5 36.5 26.7 0


5.06 Accidental threats to breathing 193.5 9.8 15.7 29.2 40.1 258.4

5.07 Exposure to electric current 0 4.9 26.2 36.5 13.4 0






Page 39


CTC DESCRIPTION 0-4 05-14 15-24 25-44 45-64 65+


5.11 Intentional self-harm (suicide) 0 24.5 319.1 558 461.4 565.2

5.12 Assault (homicide) 101 117.5 1417.6 2100.7 896.1 1114.3

5.13 Event of undetermined intent 101 58.7 240.6 364.7 381.2 759

5.14 All other external causes 0 4.9 83.7 113.1 13.4 16.1

5.15 Accidental falls 0 0 0 0 0 16.1

5.16 Other accidents including late effects 0 0 0 7.3 0 0


6.01 Diabetes mellitus 33.7 14.7 68 627.3 9000.9 43588.5

6.02 Nutritional deficiencies and nutritional anemia 471.1 58.7 15.7 58.4 267.5 2955.4

6.03 Mental and behavioural disorders 16.8 4.9 20.9 138.6 327.7 1372.7

6.04 Diseases of the nervous System, except meningitis 513.2 190.9 198.8 539.8 922.8 5119.5

6.05 Chronic lower respiratory diseases 143 19.6 41.8 167.8 916.1 9108.5

6.06 Remainder of diseases of the respiratory system 168.3 24.5 36.6 182.4 528.3 1808.8

6.07 Appendicitis, hernia of abdom. cavity and intestinal obstruc. 75.7 24.5 41.8 47.4 227.4 1728


6.09 All other diseases of the digestive system 260.8 29.4 125.5 361.1 1330.7 7687.3

6.10 Diseases of the Urinary System 25.2 24.5 88.9 244.4 1270.6 7025.2

6.11 Hyperplasia of prostate 0 0 0 3.6 33.4 1243.5

6.12 Pregnancy, childbirth, and the puerperium 0 0 78.5 182.4 6.7 0

6.13 Congenital malformations, deformations and chromosomal abnor. 2481.9 83.2 83.7 51.1 60.2 96.9

6.14 Remainder of all other diseases 597.3 127.3 329.5 645.5 1377.6 12403.1

6.15 Nutritional Deficiencies and nutritional anemia 0 0 0 3.6 0 16.1

6.16 Chronic & unspec. bronchitis, emphysema & Asthma 0 0 0 0 6.7 32.3

6.17 Diseases due to external agents & other diseases of resp. sy 0 0 5.2 0 0 64.6

6.18 Complications of pregnancy, childbirth & puerperium 0 0 0 0 0 0

6.21 Residual 0 0 5.2 7.3 6.7 145.3

7.00 Symptoms, signs and ill-defined Conditions 807.7 93 355.7 674.7 1424.4 17361.1




Page 39

FIGURE 1. CRUDE MORTALITY RATES (per 100,000 population) FOR SELECT DISEASES BY YEAR: CAREC MEMBER COUNTRIES



Page 41

FIGURE 2. POTENTIAL YEARS OF LIFE LOST BY SIX MAJOR CAUSE OF DEATH GROUPS: CAREC MEMBER COUNTRIES – 1985 1990 1995 2000



Page 41

FIGURE 3. POTENTIAL YEARS OF LIFE LOST BY SIX MAJOR CAUSE OF DEATH GROUPS FOR SELECTED DISEASES: CAREC MEMBER COUNTRIES – 2000



Page 43

APPENDIX A

POPULATION DISTRIBUTION BY AGE GROUP AND GENDER: CAREC MEMBER COUNTRIES

1985 1990 1995 2000

Age Group

1985 1990 1995 2000

Males Females Males Females Males Females Males Females

0-4 366383 358503 341282 333067 328849 319377 330132 318361

5-14 715688 700321 685349 670223 692043 681246 681547 665020

15-24 659966 666107 623570 616987 603418 601874 615814 611413

25-44 729597 755863 802745 828816 897963 934726 968484 1010819

45-64 354017 379504 361622 378043 415945 428203 469724 483970

65+ 173376 209126 188230 224808 188646 230338 200218 245512

Total 2999027 3069424 3002798 3051944 3126864 3195764 3265919 3335095



Page 43

APPENDIX B

FORMULAS USED

i. Crude Mortality Rate = Number of Deathsx 100,000

Total Population

ii. Age –Specific Death Rate = Number of Deaths in Specified Age-groupx 100,000

Total Population in Specified Age-group

iii. Cause –Specific Death Rate = Number of Deaths from Cancerx 100,000

Total Population

iv. Under 5 Mortality Rate = Number of Deaths of children under 5 yearsx 100,000

Total Population under 5 years

v. Age-Specific Potential Years of Life Lost = (65 - Midpoint of age group) x Number of deaths in age groupMidpoint of age group = [Age groups youngest age + oldest age + 1] ÷ 2

vi. Potential Years of Life Lost (PYLL) = Sum of Age-specific PYLL below the age of 65 years

vii. Working Years of Life Lost (15-64 years) = Sum of Age-specific WYLL from 15 to 64 years

viii. Potential Years of Life Lost Rare (<65 years) = PYLLx 100,000

Population under 65 years

ix. Working Years of Life Lost Rare (15-64 years) = WYLLx 100,000

Population 15-64 years



Page 45

APPENDIX C

CAREC RANKING LIST

Bel

COMMUNICABLE DISEASES EXTERNAL CAUSES

1 Intestinal infectious diseases (ICD9&10 1.01) 21 Accidents (ICD9&10 5.01-5.10)

2 Tuberculosis (ICD9&10 1.02) 22 Intentional self-harm (suicide) (ICD9&10 5.11)

3 Certain vector-borne diseases and rabies (ICD10 1.03) 23 Assault (homicide) (ICD9&10 5.12)

4 Certain diseases preventable by immunization (ICD9 1.03 & ICD10 1.04) ALL OTHER DISEASES

5 Meningitis (ICD9 1.07 & ICD10 1.05) 24 Diabetes mellitus (ICD9&10 6.01)

6 Septicemia, except neonatal (ICD9 1.05 & ICD10 1.06) 25 Nutritional deficiencies and nutritional anemia (ICD10 6.02)

7 HIV disease (AIDS) (ICD9 1.10 & ICD10 1.07) 26 Diseases of the nervous system, except meningitis (ICD9&10 6.04)

8 Acute respiratory infections (ICD9&10 1.08) 27 Chronic lower respiratory diseases (ICD10 6.05)

9 Certain vector-borne diseases (ICD9 1.04) 28 Appendicitis, hernia of abdominal cavity and intestinal obstruction (ICD9&10 6.07)

NEOPLASMS 29 Cirrhosis and certain other chronic diseases of liver (ICD9&10 6.08)

10 Cancers (ICD9 2.01-2.11 & ICD10 2.01-2.15) 30 Diseases of the urinary system (ICD9&10 6.10)

DISEASES OF THE CIRCULATORY SYSTEM 31 Hyperplasia of prostate (ICD9&10 6.11)

11 Heart diseases (ICD9 3.01;3.03-3.04 & ICD10 3.01;3.03-3.06) 32 Pregnancy, childbirth and the puerperium (ICD10 6.12)

12 Hypertensive diseases (ICD9&10 3.02) 33 Congenital malformations, deformations and chromosomal abnormalities (ICD9&10 6.13)

13 Cerebrovascular diseases (ICD9 3.05 & ICD10 3.07) 34 Nutritional deficiencies and nutritional anemia (ICD9 6.02)

14 Atherosclerosis (ICD9 3.06 & ICD10 3.08) 35 Chronic and unspecified bronchitis, emphysema and asthma (ICD9 6.05)

CERTAIN CONDITIONS ORIGINATING IN THE PERINATAL PERIOD 36 Complications of pregnancy, childbirth and the puerperium (ICD9 6.12)

15 Fetus and newborn affected by certain maternal conditions (ICD9&10 4.01)

16 Fetus and newborn affected by obstetric complications, birth trauma (ICD9&10 4.02)

17 Slow fetal growth, fetal malnutrition, short gestation, low birth weight (ICD9&10 4.03)

18 Respiratory disorders specific to the perinatal period (ICD10 4.04)

19 Bacterial sepsis of newborn (ICD10 4.05)

20 Hypoxia, birth asphyxia and other respiratory conditions (ICD9 4.04)



Page 45

APPENDIX D

MORTALITY TABULATION ICD9/ICD10 MERGER LISTING

This table reflects the merging of the PAHO ICD 9 and ICD 10 Mortality Tabulation Listing for the purpose of a four point analysis of mortality data in CAREC member countries. This compilation was specifically done to support the Caribbean Commission on Health and Development (CCHD). The list is by no way comprehensive as it was not possible to align all ICD9 tabulation codes with a corresponding ICD10 tabulation code and vice versa. The first three columns give the ICD 9 and ICD 10 tabulation codes and the CAREC assigned tabulation codes (CTC) used for the analysis. The column ‘Description’ outlines the descriptions used as taken from the PAHO ICD 9/ICD10 Mortality Tabulation Listing.

TABULATION CODESDESCRIPTION


ICD9 ICD10 CTC ICD9 ICD10 CTC

0.00 0.00 7.00 Symptoms, signs and ill-defined conditions

1.00 1.00 1.00 Communicable Diseases 3.00 3.00 3.00 Diseases of the Circulatory System1.01 1.01 1.01 Intestinal infectious diseases 3.01 3.01 3.01 Acute rheumatic fever and chronic rheumatic heart diseases1.02 1.02 1.02 Tuberculosis 3.02 3.02 3.02 Hypertensive diseases

* 1.03 1.03 Certain vector-borne diseases and rabies 3.03 3.03 3.03 Ischemic heart diseases1.03 1.04 1.04 Certain diseases preventable by immunization 3.04 3.04-3.06 3.04 Disease of pulmonary circulation and other forms of heart disease 1.07 1.05 1.05 Meningitis 3.05 3.07 3.07 Cerebrovascular diseases 1.05 1.06 1.06 Septicemia, except neonatal 3.06 3.08 3.08 Atherosclerosis 1.10 1.07 1.07 HIV disease (AIDS) * 3.09 3.09 All other diseases of the circulatory system

1.08 1.08 1.08 Acute respiratory infections 3.07 * 3.10 Other diseases of the circulatory system1.06,1.09 1.09 1.09 Other infectious and parasitic diseases

1.04 * 1.11 Certain vector-borne diseases2.00 2.00 2.00 Neoplasms 4.00 4.00 4.00 Certain conditions originating in the Perinatal Period2.01 2.01 2.01 Malignant neoplasm of stomach 4.01 4.01 4.01 Fetus and newborn affected by certain maternal conditions2.02 2.02 2.02 Malignant neoplasm of colon and recto-sigmoid junction 4.02 4.02 4.02 Fetus and newborn affected by obstetric complications, birth trauma2.03 2.03 2.03 Malignant neoplasm of digestive organs and peritoneum, except stomach and colon 4.03 4.03 4.03 Slow fetal growth, fetal malnutrition, short gestation, low birth weight2.04 2.04 2.04 Malignant neoplasm of trachea, bronchus and lung * 4.04 4.04 Respiratory disorders specific to the perinatal period

2.05 2.05 2.05 Malignant neoplasm of respiratory and intra-thoracic organs, except trachea, bronchus and lung

* 4.05 4.05 Bacterial sepsis of newborn

2.06 2.06 2.06 Malignant neoplasm of female breast (C50 in women) 4.05 4.06 4.06 Remainder of certain conditions originating in the perinatal period2.07 2.07-2.09 2.07 Malignant neoplasm of uterus 4.04 * 4.07 Hypoxia, birth asphyxia and other respiratory conditions2.08 2.10 2.10 Malignant neoplasm of prostate 4.06 * 4.08 Other conditions originating in perinatal period2.09 2.11 2.11 Malignant neoplasm of other genitourinary organs 2.10 2.12-2.13 2.12 Malignant neoplasm of lymphatic and hematopoietic tissue 2.11 2.14 2.14 Malignant neoplasm of other and unspecified sites

* 2.15 2.15 Carcinoma in situ, benign neoplasms and neoplasms of uncertain or unknown behavior2.12 * 2.16 Benign carcinoma in situ and neoplasms of uncertain or unknown behavior and unspecified

nature


Page 46



ICD9 ICD10 CTC ICD9 ICD10 CTC

5.00 5.00 5.00 External Causes 6.00 6.00 6.00 All other Diseases

5.01 5.01 5.01 Land transport accidents 6.01 6.01 6.01 Diabetes mellitus

5.02 5.02 5.02 Other and unspecified transport accidents * 6.02 6.02 Nutritional deficiencies and nutritional anemia

* 5.03 5.03 Falls 6.03 6.03 6.03 Mental and behavioral disorders

5.09 5.04 5.04 Accidents caused by firearm discharge 6.04 6.04 6.04 Diseases of the nervous system, except meningitis

5.07 5.05 5.05 Accidental drowning and submersion * 6.05 6.05 Chronic lower respiratory diseases

* 5.06 5.06 Accidental threats to breathing * 6.06 6.06 Remainder of diseases of the respiratory system

* 5.07 5.07 Exposure to electric current 6.07 6.07 6.07 Appendicitis, hernia of abdominal cavity and intestinal obstruction

5.06 5.08 5.08 Exposure to smoke, fire and flames 6.08 6.08 6.08 Cirrhosis and certain other chronic diseases of liver

5.03 5.09 5.09 Accidental poisoning by and exposure to noxious substances 6.09 6.09 6.09 All other diseases of the digestive system

5.04,5.08 5.10 5.10 All other accidents 6.10 6.10 6.10 Diseases of the urinary system

5.11 5.11 5.11 Intentional self-harm (suicide) 6.11 6.11 6.11 Hyperplasia of prostate

5.12 5.12 5.12 Assault (homicide) * 6.12 6.12 Pregnancy, childbirth and the puerperium

5.13 5.13 5.13 Event of undetermined intent 6.13 6.13 6.13 Congenital malformations, deformations and chromosomal abnormalities

* 5.14 5.14 All other external causes (Y35-Y36, Y85-Y89) * 6.14 6.14 Remainder of all other diseases

5.05 * 5.15 Accidental falls 6.02 * 6.15 Nutritional deficiencies and nutritional anemia

5.10 * 5.16 Other accidents including late effects 6.05 * 6.16 Chronic and unspecified bronchitis, emphysema and asthma

6.06 * 6.17 Other chronic pulmonary disease, pulmonary diseases due to external agents, and other diseases of respiratory system

6.12 * 6.18 Complications of pregnancy, childbirth and the puerperium

6.14 * 6.21 Residual

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