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An attempt was made to describe the disease patterns among blacks on the basis of registered deaths, which have been collected for the whole of the RSA since 1978. The pattern of cause-specific proportional mortality resembled that of an underdeveloped population. It was noticed that the data were not suitable for detailed descriptions because there was evidence of under-registration and misclassification, in particular in the national states. A large proportion (20% on average) of the deaths are classified as caused by symptoms, signs and ill-defined conditions. It is recommended that the process of registration be reviewed in order to improve the quality of the data so necessary for epidemiological and health care research.

This study was undertaken to describe the causes of non-natural death in children aged under 15 years in the Cape Peninsula. Information was abstracted from the official death register kept at the South African Police Mortuary in Cape Town for the period of 1 July 1966-30 June 1981. During the 15-year period 3 248 medicolegal autopsies were performed on children under 15 years of age who had died of non-natural causes. There were significantly higher percentages of Coloureds and Blacks, males, and children aged under 6 years in the sample than in the general population aged under 15 years in the Cape Peninsula. The majority of deaths (54,4%) were caused by road traffic injuries. Other important causes of deaths were burns (12,8%), drowning (11,0%), assault/abuse (5,4%) and poisoning (3,3%). Special attention was paid to the causes of fatal head injuries--head injury alone was given as the cause of death in 819 autopsies (25,2%). The majority of fatal head injuries (72,4%) were also caused by road traffic accidents. This study demonstrates the alarming number of deaths from non-natural causes among children aged under 15 years in the Cape Peninsula. The finding that more than half of these deaths were due to road traffic accidents indicates the impact that successful intervention could have.

To investigate mortality in South Asian patients with insulin-treated diabetes and compare it with mortality in non South Asian patients and in the general population. A prospective cohort study was conducted of 828 South Asian and 27 962 non South Asian patients in the UK with insulin-treated diabetes diagnosed at ages under 50 years. The patients were followed for up to 28 years. Ethnicity was determined by analysis of names. Standardized mortality ratios (SMRs) were calculated, comparing mortality in the cohort with expectations from the mortality experience of the general population. SMRs were significantly raised in both groups of patients, particularly the South Asians, and especially in women and subjects with diabetes onset at a young age. The SMRs for South Asian patients diagnosed under age 30 years were 3.9 (95% CI 2.0–6.9) in men and 10.1 (5.6–16.6) in women, and in the corresponding non South Asians were 2.7 (2.6–2.9) and 4.0 (3.6–4.3), respectively. The SMR in women was highly significantly greater in South Asians than non South Asians. The mortality in the young-onset patients was due to several causes, while that in the patients diagnosed at ages 30–49 was largely due to cardiovascular disease, which accounted for 70% of deaths in South Asian males and 73% in females. South Asian patients with insulin-treated diabetes suffer an exceptionally high mortality. Clarification of the full reasons for this mortality are needed, as are measures to reduce levels of known cardiovascular disease risk factors in these patients. Diabet. Med. (2004) [ABSTRACT FROM AUTHOR]

SummaryAims To assess mortality in patients with diabetes incident under the age of 30 years. Methods A cohort of 23 752 diabetic patients diagnosed under the age of 30 years from throughout the United Kingdom was identified during 1972–93 and followed up to February 1997. Following notification of deaths during this period, age- and sex-specific mortality rates, attributable risks and standardized mortality rates were calculated. Results The 23 752 patients contributed a total of 317 522 person-years of follow-up, an average of 13.4 years per subject. During follow-up 949 deaths occurred in patients between the ages of 1 and 84 years, 566 in males and 383 in females. All-cause mortality rates in the patients with diabetes exceeded those in the general population at all ages and within the cohort were higher for males than females at all ages except between 5 and 15 years. The relative risk of death (standardized mortality ratio, SMR), was higher for females than males at all ages, being 4.0 (95% CI 3.6–4.4) for females and 2.7 (2.5–2.9) for males overall, but reaching a peak of 5.7 (4.7–7.0) in females aged 20–29, and of 4.0 (3.1–5.0) in males aged 40–49. Attributable risks, or the excess deaths in persons with diabetes compared with the general population, increased with age in both sexes. Conclusions This is the first study from the UK of young patients diagnosed with diabetes that is large enough to calculate detailed age-specific mortality rates. This study provides a baseline for further studies of mortality and change in mortality within the United Kingdom. [ABSTRACT FROM AUTHOR]

SummaryAims To measure cause-specific mortality, by age, in patients with insulin-treated diabetes incident at a young age. Methods A cohort of 23 752 patients with insulin-treated diabetes diagnosed under the age of 30 years, from throughout the United Kingdom, was identified during 1972–93 and followed to February 1997. Death certificates have been obtained for deaths during the follow-up period and cause-specific mortality rates and standardized mortality ratios by age and sex are reported. Results During the follow-up period 949 deaths occurred and at all ages mortality rates were considerably higher than in the general population. Acute metabolic complications of diabetes were the greatest single cause of excess death under the age of 30 years. Cardiovascular disease was responsible for the greatest proportion of the deaths from the age of 30 years onwards. Conclusions Deaths in patients with diabetes diagnosed under the age of 30 have been reported and comparisons drawn with mortality in the general population. To reduce these deaths attention must be paid both to the prevention of acute metabolic deaths and the early detection and treatment of cardiovascular disease and associated risk factors. [ABSTRACT FROM AUTHOR]