%0 Journal Article %T Changing causes of death in the West African town of Banjul, 1942-97 %A Sande Marianne A.B. van der %A Inskip Hazel M. %A Jaiteh Kebba O. %A Maine Nicholas P. %J Bulletin of the World Health Organization %D 2001 %I World Health Organization %X OBJECTIVE: To determine trends in the causes of death in a West African town. Mortality caused by infectious diseases is reported to be declining while degenerative and man-made mortality factors are increasingly significant. Most mortality analyses for sub-Saharan Africa have involved extrapolation and have not been derived from community-based data. METHODS: Historical data on causes of death coded by physicians were analysed for the urban population of Banjul for the period 1942-97. As the calculation of rates is not possible in the absence of a reliable population denominator, age-standardized proportional mortality ratios (PMRs) for men and women by major groups of causes of death were calculated, using the 1942-49 data for reference purposes. FINDINGS: Most deaths were attributable to communicable diseases. There was a shift in proportional mortality over the study period: the contribution of communicable diseases declined and that of noncommunicable diseases and injuries increased. These trends were more marked among men than women. CONCLUSIONS: The data illustrate that while noncommunicable diseases and injuries are emerging as important contributors to mortality in sub-Saharan Africa, communicable diseases remain significant causes of mortality and should not be neglected. %K cause of death %K mortality/trends %K communicable diseases/mortality %K communicable diseases/trends %K chronic disease/mortality %K chronic disease/trends %K Gambia %U http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862001000200008