Seasonal patterns of mortality in medical admissions at Groote Schuur Hospital, Cape Town: 2002-2009

Across the world, studies have shown that hospital mortality may be influenced by seasonal factors. Very few studies examining this phenomenon have been conducted in South Africa. This study aimed to determine whether there are seasonal patterns of mortality associated with medical causes of admission to a hospital in Cape Town, and to identify demographic risk factors and specific disease categories that are associated with increased susceptibility to seasonal mortality. Part A is the protocol that was developed for the study. It begins with a summary of key aspects of the literature review. The aim, hypotheses and objectives of the study are then described, followed by a detailed account of the study methodology, ethical issues, plans for communication of the study findings and logistics. The protocol was approved by the Research Ethics Committee at University of Cape Town. Part B is the structured literature review, in which studies describing trends in seasonal mortality, and associated risk factors and determinants of excess seasonal mortality, are discussed. International and local studies were included, in order to provide an appropriated background for this study. Part C is a presentation of the study findings in the form of a journal-ready manuscript for the South African Medical Journal. Graphs have been used to illustrate the trends in mortality for each year of the study period, and the relationship between mortality and average temperatures and precipitation. Interactions with seasonal mortality and gender, socioeconomic status, ethnicity and age-groups have also been illustrated. Results have been quantified with the calculation of mortality rate ratios with 95% confidence intervals. Patterns of mortality for circulatory, respiratory and gastrointestinal diseases, and cancer, are analysed. There is a brief discussion of the findings with suggestions for further research and public health interventions to reduce excess seasonal mortality in this setting. Part D is comprised of appendices containing relevant analyses that were not be included in the article, as well as other documents pertaining to the study. Tables and graphs have been annotated, and reference is made to these appendices in the article.

Grantor dc:publisher.institution

Department of Public Health and Family Medicine

Year dc:date.issued

2014

Author dc:creator

• Mudaly, Vanessa

Advisor dc:contributor.advisor

• Myer, Landon

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/11427/13246

OAI identifier oai:identifier

oai:open.uct.ac.za:11427/13246