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DYNAMICS OF FREQUENCY OF DEATH AND MORTALITY RATE IN THE REPUBLIC OF KAZAKHSTAN
Tochiyeva Zorina, Al-Farabi Kazakh National University, Almaty, Kazakhstan
E-mail: zarina.zt@mail.ru
Abstract. This article presents the results of an analysis of the dynamics of the frequency of death and mortality rate in the Republic of Kazakhstan in the period 2018-2020. Using regression analysis the main trends of deaths and mortality rate by place, gender, and country level.
Key words: dynamics, mortality rate, death, Kazakhstan, region.
Introduction
The excessive number of tragic deaths observed during the COVID-19 pandemic was a global public health problem [1]. Мore than 6.5 million deaths registrated from confirmed cases of coronavirus infection [2]. In order to assess the epidemic situation, continuous monitoring of the dynamics of the number of cases and the medico-statistical mortality rate was carried out [3]. This assessment makes it possible to develop effective management-oriented measures (health care planning, etc.) for the population medical's health aimed at mortality reduction [4]. Since the pandemic emerged, several studies have been conducted in Kazakhstan to assess mortality from coronavirus infection [5, 6]. At the same time, there is a shortage of work assessing the dynamics and structure of regional mortality in Kazakhstan.
The present study aimed to investigate the dynamics of death outcomes and mortality rate in the Republic of Kazakhstan (population study).
Materials and Methods
The primary source of information was official data on deaths (RPN database, "Register of Death Certificates") of the Republic of Kazakhstan.
The depth of the study was from 2018 to 2020. To calculate medical and statistical indicators, we used data from the Statistical Agency of the Republic of Kazakhstan on the number of attached population. The dynamics of deaths are assessed by determining trends (ascending or descending). The method of single-factor linear regression was used to assess the statistical significance of the obtained trends. The results of the regression analysis were presented as non-standardized coefficients (b) and the level of statistical significance (p).
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Results
Table 1 presents data on the number of deaths among Kazakhstan population, considering nosological forms, excluding gender. In 2018, the number of deaths in the Republic was
105 304 cases, in 2019 - 107 314 cases; and in 2020 - 141180 cases. There is a tendency for an increase in death outcomes; however, the trend is statistically insignificant (regression statistic b=17938.0, p=0.302). According to the averaged data (XX for 2018-2020), the dominant causes of death in the Kazakhstan population (without regard to gender) are: 1 ranked - diseases of the circulatory system ("I"), 2 ranked - diseases of the nervous system ("G"), rank 3 - diseases of respiratory organs ranked 3 - diseases of respiratory organs ("J"), ranked 4 - malignant neoplasms ("C"), rank 5 - diseases of the digestive organs ("K").
The number of deaths from infectious and parasitic diseases ( B), from diseases associated with pregnancy, childbirth, and O), from diseases not classified under other headings ("R"), other headings ("R"), from respiratory diseases ("J") and diseases of the nervous system ("G") increased in 1.5 times in 2020 compared with 2018.The progress of the number of death outcomes was as follows: 2018. - 53993 cases, in 2019 - 55415 cases, and in 2020 r. - 73648 cases. The trend of increasing deaths is statistically insignificant (regression statistic b=9827.5, p=0.292). The leading causes of death in Kazakhstan's male population, according to averaged data (XX for 20182020), are: 1 ranked 1 - diseases of the circulatory system ("I"), 2 ranked - Respiratory diseases ("J"), rank 3 - diseases of the nervous ("G"), rank 4 - malignant neoplasms ("C"), rank 5 - diseases of the digestive organs ("K"). The number of deaths among men from infectious and parasitic diseases increased by 1.5 or more times in 2020 compared to 2018. of deaths among men from infectious and parasitic diseases ("B"), from diseases not classified under other headings ("R"), from diseases of the skin and subcutaneous tissue ("L"), diseases of the nervous system ("G") and diseases of the respiratory organs ("J"). In 2018, the number of death outcomes was as follows: 2018 - 51311 cases, in 2019 - 51899 cases, and 2020 - 67532 cases. The dynamics of deaths showed an increasing trend; however, unreliable (regression statistics b=8110.5, p=0.313).
The leading causes of death in the Kazakhstan female population, according to averaged data (X for 2018-2020), are: 1 ranked - diseases of the nervous system ("G"), rank 2 - diseases of the circulatory system ("I"), rank 3 - respiratory diseases ("J"), rank 4 ranked place - malignant neoplasms ("C"), ranked 5 - diseases not classified in other headings ("R").
The number of deaths from infectious diseases in the female population increased by 1.5 or more times in 2020 compared to 2018. of deaths in the female population from infectious and parasitic diseases ("B"), from diseases associated with pregnancy, childbirth, and the postpartum period ("O"), from diseases, not diseases not elsewhere classified ("R"), and respiratory diseases ("J").
Table 2 presents data on the frequency of deaths and the mortality rate for all nosological forms (by regions of the Republic of Kazakhstan, excluding gender). The
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trend of increasing mortality in the country is statistically insignificant (regression statistic b=83.85, p=0.336). According to the averaged data (XX for 2018-2020), the regions with the highest mortality rate (excluding gender) are Kostanay region, Pavlodar region, East Kazakhstan region, and Akmola oblast and Akmola oblast. In Nur-Sultan city and Mangistau oblast, the mortality rate is one of the lowest in the country. The regions with the highest mortality rates (XX for 2018-2020) in the male population include North Kazakhstan Oblast, Kostanai region, Pavlodar region, East Kazakhstan Oblast, and West Kazakhstan Oblast. The lowest "male" mortality rate is in Nur-Sultan, Mangistau oblast, and Shymkent city. The highest mortality rate in the female Kazakh population (XX for 2018-2020) was observed in the North Kazakhstan region, Kostanai region, East Kazakhstan region, Pavlodar region, and Akmola region, and the lowest - in Nur-Sultan, Mangistau region, and Kyzylorda region.
Table 1
Number of deaths among the population of Kazakhstan, taking into account Nosological forms (excluding gender)
Leading cause of death on ICD-10 Years
2018 2019 2020
A 725 736 761
B 355 401 1568
C 13051 13214 13425
D 486 431 574
E 4512 4630 6106
F 2576 2147 2088
G 16397 18255 24338
H 9 7 8
I 22703 22087 29680
J 14071 14099 20902
K 9917 10085 11814
L 170 190 244
M 1565 1481 1587
N 4524 4503 5233
O 58 46 95
P 731 750 779
Q 745 683 749
R 6308 7126 10114
S 1660 1843 2177
T 3903 4051 4783
U 0 0 3440
V 166 103 102
W 184 132 199
X 377 261 338
Y 91 36 57
Z 20 17 19
Conclusion
In Kazakhstan in 2018-2020, there is a statistically insignificant tendency to increase the number of deaths in the population. The most significant increase (relative to the previous year) in death outcomes was observed in 2020. This year the
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occurrence of the pandemic of COVID-19 was in the country. The leading causes of death in Kazakhstan population The leading causes of death in Kazakhstan's population (without regard to gender) are diseases of the circulatory system, diseases of the nervous system, respiratory diseases, malignant neoplasms and diseases of the digestive organs.
Table 2
Death rate and mortality rate by all nosological forms (by regions of Kazakhstan, without regard to gender)
Region Year
2018 2019 2020
N. Per 100 000 pop. N. Per 100 000 pop. N. Per 100 000 pop.
Total 105304 568,2 107314 567,3 141180 735,9
Akmola 6375 822,7 6261 798,8 7652 970,0
Aktobe 3556 411,8 4433 503,7 5893 658,7
Almaty 11763 583,3 11778 571,8 14389 685,1
Atyrau 2893 460,2 2417 376,6 4127 631,5
VKO 12363 885,4 12346 881,1 15057 1074,7
Zhambyl 6202 555,9 6250 552,8 7782 677,1
WKO 5270 782,6 5199 764,0 6472 942,2
Karaganda 8159 574,9 8974 626,6 12569 875,2
Kostanay 8210 945,8 8372 962,1 10061 1182,6
Kyzylorda 2506 327,5 2880 369,9 4388 551,9
Mangistau 2332 342,0 2407 339,9 3475 474,0
Pavlodar 7217 917,6 7223 909,4 8648 1084,5
SKO 6199 1067,6 6364 1096,9 7353 1274,6
Turkestan city 7919 416,9 8254 426,4 11191 566,7
Almaty city 7823 402,9 7680 379,8 10795 525,5
NurSultan 2959 269,5 2838 244,0 5277 437,5
Shymkent city 3558 348,1 3638 345,1 6051 557,9
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