Trends in mortality from external causes in the Republic of Seychelles between 1989 and 2018

Abstract

Data on injury-related mortality are scarce in the African region. Mortality from external causes in the Seychelles was assessed, where all deaths are medically certified and the population is regularly enumerated. The four fields for underlying causes of death recorded were reviewed in the national vital statistics register. The age-standardised mortality rates were estimated (per 100,000 person-years) from external causes in 1989–1998, 1999–2008, and 2009–2018. Mortality rates per 100,000 person-years from external causes were 4–5 times higher among males than females, and decreased among males over the three 10-year periods (127.5, 101.4, 97.1) but not among females (26.9, 23.1, 26.9). The contribution of external causes to total mortality did not change markedly over time (males 11.6%, females 4.3% in 1989–2018). Apart from external deaths from undetermined causes (males 14.6, females 2.4) and “other unintentional injuries” (males 14.1, females 8.0), the leading external causes of death in 2009–2018 were drowning (25.9), road traffic injuries (18.0) and suicide (10.4) among males; and road traffic injuries (4.6), drowning (3.4) and poisoning (2.6) among females. Mortality from broad categories of external causes did not change consistently over time but rates of road traffic injuries increased among males. External causes contributed approximately 1 in 10 deaths among males and 1 in 20 among females, with no marked change in cause-specific rates over time, except for road traffic injuries. These findings emphasise the need for programs and policies in various sectors to address this large, but mostly avoidable health burden.

Changes in Mortality Related to Traumatic Brain Injuries in the Seychelles from 1989 to 2018

“…However, the TBI-related mortality among males was higher in Seychelles than reported in studies from Austria and Ecuador, but lower than in Finland and in the USA (24,(32)(33)(34)(35). The fairly high rates in Seychelles may be partly attributed to the high road traffic injury mortality rates, consistent with high rates in LMICs but was also lower (17.5%) than the global average of 23% (28,36). The lower rates in Seychelles compared to Finland (22.6 vs. 34.8 per 100,000) may also be attributed to the inclusion of the paediatric population in the former but not in the latter (32).…”

“…Further information about TBI-related deaths would be obtained more precisely from police records. The reduction in the TBI mortality cases between the two time periods could be attributed to improved documentation in the death certificates over time (28).…”

“…The population was 96,762 in 2018, (27) with a majority of inhabitants being of African descent. The population has been enumerated through national censuses every ten years, approximately, for the past few decades, with numbers annually adjusted following census by the administrative authorities (28,29).…”

“…Cause-specific mortality is available from the Seychelles Civil Registration and Vital Statistics system based on death certificates for all deaths in the country (28,29). Electronic data were available for the period between 1989 and 2018.…”

“…Electronic data were available for the period between 1989 and 2018. We previously published trends in mortality from external causes between 1989 and 2018 (28). This study focuses on TBI-related mortality.…”