Million Death Study
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Million Death Study
The Million Death Study (MDS) is an ongoing human premature mortality study conducted in India. It began in 1998 and ended in 2014 . Among a sample size of 14 million Indians, approximately 1 million deaths are assigned as medical causes through the Verbal Autopsy method to determine disease patterns and direct public health policy. The principal investigator of the study is Dr. Prabhat Jha, director of the Centre for Global Health Research and professor of epidemiology at the Dalla Lana School of Public Health, University of Toronto, Canada. Context In India, like many low and middle-income countries, the vast majority of deaths occur at home without medical attention (over 75%), rather than with the standard of hospital care and supervision common in high-income countries before death. As a result, estimates suggest a majority of the approximately 60 million global annual deaths, and specifically over half of the Indian at-home deaths, are undocumented and do not have a medical ...
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India
India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the south, the Arabian Sea on the southwest, and the Bay of Bengal on the southeast, it shares land borders with Pakistan to the west; China, Nepal, and Bhutan to the north; and Bangladesh and Myanmar to the east. In the Indian Ocean, India is in the vicinity of Sri Lanka and the Maldives; its Andaman and Nicobar Islands share a maritime border with Thailand, Myanmar, and Indonesia. Modern humans arrived on the Indian subcontinent from Africa no later than 55,000 years ago., "Y-Chromosome and Mt-DNA data support the colonization of South Asia by modern humans originating in Africa. ... Coalescence dates for most non-European populations average to between 73–55 ka.", "Modern human beings—''Homo sapiens''—originated in Africa. Then, int ...
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World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of health". Headquartered in Geneva, Switzerland, it has six regional offices and 150 field offices worldwide. The WHO was established on 7 April 1948. The first meeting of the World Health Assembly (WHA), the agency's governing body, took place on 24 July of that year. The WHO incorporated the assets, personnel, and duties of the League of Nations' Health Organization and the , including the International Classification of Diseases (ICD). Its work began in earnest in 1951 after a significant infusion of financial and technical resources. The WHO's mandate seeks and includes: working worldwide to promote health, keeping the world safe, and serve the vulnerable. It advocates that a billion more people should have: universal health care coverag ...
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Malaria
Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. Symptoms usually begin ten to fifteen days after being bitten by an infected mosquito. If not properly treated, people may have recurrences of the disease months later. In those who have recently survived an infection, reinfection usually causes milder symptoms. This partial resistance disappears over months to years if the person has no continuing exposure to malaria. Malaria is caused by single-celled microorganisms of the ''Plasmodium'' group. It is spread exclusively through bites of infected ''Anopheles'' mosquitoes. The mosquito bite introduces the parasites from the mosquito's saliva into a person's blood. The parasites travel to the liver where they mature and reproduce. Five species of ''Plasmodium'' can infect and be spread by h ...
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Tetanus
Tetanus, also known as lockjaw, is a bacterial infection caused by ''Clostridium tetani'', and is characterized by muscle spasms. In the most common type, the spasms begin in the jaw and then progress to the rest of the body. Each spasm usually lasts a few minutes. Spasms occur frequently for three to four weeks. Some spasms may be severe enough to fracture bones. Other symptoms of tetanus may include fever, sweating, headache, trouble swallowing, high blood pressure, and a fast heart rate. Onset of symptoms is typically three to twenty-one days following infection. Recovery may take months. About ten percent of cases prove to be fatal. ''C. tetani'' is commonly found in soil, saliva, dust, and manure. The bacteria generally enter through a break in the skin such as a cut or puncture wound by a contaminated object. They produce toxins that interfere with normal muscle contractions. Diagnosis is based on the presenting signs and symptoms. The disease does not spread between pe ...
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Signs And Symptoms
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showing on a medical scan. A symptom is something out of the ordinary that is experienced by an individual such as feeling feverish, a headache or other pain or pains in the body. Signs and symptoms Signs A medical sign is an objective observable indication of a disease, injury, or abnormal physiological state that may be detected during a physical examination, examining the patient history, or diagnostic procedure. These signs are visible or otherwise detectable such as a rash or bruise. Medical signs, along with symptoms, assist in formulating diagnostic hypothesis. Examples of signs include elevated blood pressure, nail clubbing of the fingernails or toenails, staggering gait, and arcus senilis and arcus juvenilis of the eyes. Indicati ...
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Verbal Autopsy
Verbal autopsy (VA) is a method of gathering information about symptoms and circumstances for a deceased individual to determine their cause of death. Health information and a description of events prior to death are acquired from conversations or interviews with a person or persons familiar with the deceased and analyzed by health professionals or computer algorithms to assign likely cause(s) of death. Verbal autopsy is used in settings where most deaths are otherwise undocumented, which typically means in low- and middle-income countries. Estimates suggest a majority of the 60 million annual global deaths occur without medical attention or official medical certification of the cause of death. VA attempts to establish causes of death for otherwise undocumented subjects, allowing scientists to analyze disease patterns and direct public health policy decisions. Noteworthy large-scale uses of the verbal autopsy method include the Million Death Study in India, China's national progra ...
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Maternal Mortality
Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pregnancy, underlying conditions worsened by the pregnancy or management of these conditions. This can occur either while they are pregnant or within six weeks of resolution of the pregnancy. The CDC definition of pregnancy-related deaths extends the period of consideration to include one year from the resolution of the pregnancy. Pregnancy associated death, as defined by the American College of Obstetricians and Gynecologists (ACOG), are all deaths occurring within one year of a pregnancy resolution. Identification of pregnancy associated deaths is important for deciding whether or not the pregnancy was a direct or indirect contributing cause of the death. There are two main measures used when talking about the rates of maternal mortality in ...
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Statistical Power
In statistics, the power of a binary hypothesis test is the probability that the test correctly rejects the null hypothesis (H_0) when a specific alternative hypothesis (H_1) is true. It is commonly denoted by 1-\beta, and represents the chances of a true positive detection conditional on the actual existence of an effect to detect. Statistical power ranges from 0 to 1, and as the power of a test increases, the probability \beta of making a type II error by wrongly failing to reject the null hypothesis decreases. Notation This article uses the following notation: * ''β'' = probability of a Type II error, known as a "false negative" * 1 − ''β'' = probability of a "true positive", i.e., correctly rejecting the null hypothesis. "1 − ''β''" is also known as the power of the test. * ''α'' = probability of a Type I error, known as a "false positive" * 1 − ''α'' = probability of a "true negative", i.e., correctly not rejecting the null hypothesis Description For a ty ...
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Cervical Cancer
Cervical cancer is a cancer arising from the cervix. It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body. Early on, typically no symptoms are seen. Later symptoms may include abnormal vaginal bleeding, pelvic pain or pain during sexual intercourse. While bleeding after sex may not be serious, it may also indicate the presence of cervical cancer. Human papillomavirus infection (HPV) causes more than 90% of cases; most women who have had HPV infections, however, do not develop cervical cancer. HPV 16 and 18 strains are responsible for nearly 50% of high grade cervical pre-cancers. Other risk factors include smoking, a weak immune system, birth control pills, starting sex at a young age, and having many sexual partners, but these are less important. Genetic factors also contribute to cervical cancer risk. Cervical cancer typically develops from precancerous changes over 10 to 20 years. About 90% of cervical cancer cas ...
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Shally Awasthi
Shally Awasthi is an Indian professor and paediatric pulmonologist. She works at King George's Medical University, Lucknow, UP India. Awasthi was the first Indian scientist to be appointed to the Health-Security Interface Technical Advisory Group (HSI-TAG) of the World Health Organization (WHO). HSI-TAG comprises a group of experts formed to advise the WHO on worldwide issues concerning global health and security. Honors and Awards Awasthi is an elected fellow of all major Indian science academies namely the National Academy of Science, Indian Academy of Sciences, The National Academy of Medical Science, Indian National Science Academy 2020 and Indian Academy of Pediatrics. She was an Honorary Fellow of Royal College of Pediatrics and Child Health for 2018. The Department of Science and Technology Government of India honored her with its National Award for Outstanding Efforts in Science & Technology Communication through innovative and traditional methods in 2016. The Indian ...
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Sample Size
Sample size determination is the act of choosing the number of observations or Replication (statistics), replicates to include in a statistical sample. The sample size is an important feature of any empirical study in which the goal is to make statistical inference, inferences about a statistical population, population from a sample. In practice, the sample size used in a study is usually determined based on the cost, time, or convenience of collecting the data, and the need for it to offer sufficient statistical power. In complicated studies there may be several different sample sizes: for example, in a stratified sampling, stratified survey sampling, survey there would be different sizes for each stratum. In a census, data is sought for an entire population, hence the intended sample size is equal to the population. In experimental design, where a study may be divided into different treatment groups, there may be different sample sizes for each group. Sample sizes may be chosen in ...
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International Classification Of Diseases
The International Classification of Diseases (ICD) is a globally used diagnostic tool for epidemiology, health management and clinical purposes. The ICD is maintained by the World Health Organization (WHO), which is the directing and coordinating authority for health within the United Nations System. The ICD is originally designed as a health care classification system, providing a system of diagnostic codes for classifying diseases, including nuanced classifications of a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. This system is designed to map health conditions to corresponding generic categories together with specific variations, assigning for these a designated code, up to six characters long. Thus, major categories are designed to include a set of similar diseases. The ICD is published by the WHO and used worldwide for morbidity and mortality statistics, reimbursement systems, and automated d ...
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