According to Lancet Global Health report, Over 60% of individuals in Sierra Leone die prematurely, before age 70 years, most from preventable or treatable causes.
The report stated that Sierra Leone’s child and maternal mortality rates are among the highest in the world, noting that little is known about the causes of premature mortality in the country.
“To rectify this, the Ministry of Health and Sanitation of Sierra Leone launched the Sierra Leone Sample Registration System (SL-SRS) of births and deaths. Here, we report cause-specific mortality from the first SL-SRS round, representing deaths from 2018 to 2020,” they stated in the report.
The report noted that the Countrywide Mortality Surveillance for Action platform established the SL-SRS, which involved conducting electronic verbal autopsies in 678 randomly selected villages and urban blocks throughout the country, adding that 61 surveyors, in teams of four or five, enrolled people and ascertained deaths of individuals younger than 70 years in 2019–20, capturing verbal autopsies on deaths from 2018 to 2020.
“Centrally, two trained physicians independently assigned causes of death according to the International Classification of Diseases (tenth edition). SL-SRS death proportions were applied to 5-year mortality averages from the UN World Population Prospects (2019) to derive cause-specific death totals and risks of death nationally and in four Sierra Leone regions, with comparisons made with the Western region where Freetown, the capital, is located. We compared SL-SRS results with the cause-specific mortality estimates for Sierra Leone in the 2019 WHO Global Health Estimates,” they stated.
Lancet Global Health further noted that “Between Sept 1, 2019, and Dec 15, 2020, we enrolled 343 000 people and ascertained 8374 deaths of individuals younger than 70 years.”
They found out that Malaria was the leading cause of death in children and adults, nationally and in each region, representing 22% of deaths under age 70 years in 2020, adding that other infectious diseases accounted for an additional 16% of deaths.
“Overall maternal mortality ratio was 510 deaths per 100 000 live births, and neonatal mortality rate was 31·1 deaths per 1000 live births, both among the highest rates in the world,” the report stated.
They revealed that Haemorrhage was the major cause of maternal mortality and birth asphyxia or trauma was the major cause of neonatal mortality.
They however noted that excess deaths were not detected in the months of 2020 corresponding to the peak of the COVID-19 pandemic, adding that half of the deaths occurred in rural areas and at home.
“If the Northern, Eastern, and Southern regions of Sierra Leone had the lower death rates observed in the Western region, about 20 000 deaths (just over a quarter of national total deaths in people younger than 70 years) would have been avoided. WHO model-based data vastly underestimated malaria deaths and some specific causes of injury deaths, and substantially overestimated maternal mortality,” Lancet Global Health stated.