Mortality in the Great Maghreb (1990-2015): causes of death and trends.

Objectives: To describe trends of gross and specific mortality rates for all five countries of the Great Maghreb and to identify the typology and the main causes of death during the period 1990-2015.
Methods: This is an observational and descriptive study of causes of death in the Great Maghreb (Tunisia, Algeria, Morocco, Mauritania and Libya) using the database Global Burden of Diseases (GBD) of the Institute for Health Metrics and Evaluation (IHME). Causes of death were categorized according to the IHME into three categories: "Communicable Diseases", "Non Communicable Diseases" and "Trauma". These following tracer years (1995, 2005, 2015) were considered in the study of global and specific causes of death by country, disease group, sex and age group.
Results: During the period 1990-2015, the general trend in gross mortality rates was going down, reaching in 2015 rates that varied from 547/100 000 inhabitants in Tunisia to 437/100 000 inhabitants in Algeria. The trend in specific mortality from Communicable Diseases has been declining, particularly in Mauritania. Among the "Top 10" list of causes of death, four to eight were "Non Communicable Diseases" including ischemic heart disease, which was ranked first in the Maghreb except Mauritania. For children under 5 years old, prematurity was the leading cause of death in the five Maghreb countries in 2015.
Conclusion: This analysis of causes of death in the Great Maghreb confirmed the similarity of the epidemiological transition and health priorities. Hence the urgency of developing common North African strategies for monitoring, training and intervention in public health.