Changing causes of death in the West African town of Banjul, 1942-97

M A van der Sande, H M Inskip, K O Jaiteh, N P Maine, G E Walraven, A J Hall, K P McAdam

Research output: Contribution to journalA1: Web of Science-articlepeer-review


OBJECTIVE: To determine trends in the causes of death in a West African town. Mortality caused by infectious diseases is reported to be declining while degenerative and man-made mortality factors are increasingly significant. Most mortality analyses for sub-Saharan Africa have involved extrapolation and have not been derived from community-based data.

METHODS: Historical data on causes of death coded by physicians were analysed for the urban population of Banjul for the period 1942-97. As the calculation of rates is not possible in the absence of a reliable population denominator, age-standardized proportional mortality ratios (PMRs) for men and women by major groups of causes of death were calculated, using the 1942-49 data for reference purposes.

FINDINGS: Most deaths were attributable to communicable diseases. There was a shift in proportional mortality over the study period: the contribution of communicable diseases declined and that of noncommunicable diseases and injuries increased. These trends were more marked among men than women.

CONCLUSION: The data illustrate that while noncommunicable diseases and injuries are emerging as important contributors to mortality in sub-Saharan Africa, communicable diseases remain significant causes of mortality and should not be neglected.

Original languageEnglish
JournalBulletin of the World Health Organization
Issue number2
Pages (from-to)133-141
Number of pages9
Publication statusPublished - 2001


  • Adult
  • Cause of Death
  • Chi-Square Distribution
  • Child
  • Communicable Diseases/epidemiology
  • Female
  • Gambia/epidemiology
  • Humans
  • Male
  • Poisson Distribution
  • Urban Population


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