随着社会经济的发展，预防和治疗传染性疾病的改善以及非传染性疾病（例如超重/肥胖、久坐不动）危险因素的增加，近年来孟加拉国的成年人死亡以非传染性疾病为主。本研究使用马特拉卫生与人口监测系统（HDSS）的数据分析了特定原因死亡风险的趋势。我们使用自2003年至2017年的马特拉HDSS数据进行了一项追踪研究，该数据包括了孟加拉国昌德布尔地区约24万（2018年）的农村人口。HDSS通过口头尸检评估了所有死亡的原因，并使用《国际疾病统计分类第十版》对这些原因进行了分类。我们研究了19327起涉及2279237人年的死亡案例。我们计算了年度特定原因死亡率，并使用Cox比例风险模型估计了经过调整的比例风险。在15岁及以上的人群中，总死亡风险在研究期间有所下降，但中风的风险增加，心脏病和癌症的风险不变。这些原因在中年人和老年人中更为常见，因此承担着最大的负担。非传染性疾病以外的其他死因（如传染病和呼吸系统疾病、外伤、内分泌疾病等）的死亡率有所下降，但仍占所有死亡的30%以上。因此，整体死亡率的下降与非传染性疾病以外的死因的下降相关。死亡风险随年龄的增加而显著增加。男性患心脏病、癌症和其他疾病的死亡率高于女性，但中风则相反。低家庭财富五等分人群的死亡率高于高家庭财富五等分人群，非穆斯林高于穆斯林。从2003年至2017年，中风、心脏病和癌症的死亡率要么上升，要么保持不变，而其他死因则持续下降。加强预防和治疗非传染性疾病管理的医疗保健系统是迫切需要的。© 作者（或其雇主）2023。在CC BY-NC下允许重用。不得商业再利用。由BMJ出版。

With socioeconomic development, improvement in preventing and curing infectious diseases, and increased exposure to non-communicable diseases (NCDs) risk factors (eg, overweight/obesity, sedentary lifestyle), the majority of adult deaths in Bangladesh in recent years are due to NCDs. This study examines trends in cause-specific mortality risks using data from the Matlab Health and Demographic Surveillance System (HDSS).We conducted a follow-up study from 2003 to 2017 using data from Matlab HDSS, which covers a rural population of 0.24 million (in 2018) in Chandpur, Bangladesh. HDSS assessed the causes of all deaths using verbal autopsy and classified the causes using the 10th revision of the International Statistical Classification of Diseases. We examined 19 327 deaths involving 2 279 237 person-years.We calculated annual cause-specific mortality rates and estimated adjusted proportional HRs using a Cox proportional hazards model.All-cause mortality risk declined over the study period among people aged 15 and older, but the risk from stroke increased, and from heart disease and cancers remained unchanged. These causes were more common among middle-aged and older people and thus bore the most burden. Mortality from causes other than NCDs-namely, infectious and respiratory diseases, injuries, endocrine disorders and others-declined yet still constituted over 30% of all deaths. Thus, the overall mortality decline was associated with the decline of causes other than NCDs. Mortality risk sharply increased with age. Men had higher mortality than women from heart disease, cancers and other causes, but not from stroke. Lower household wealth quintile people have higher mortality than higher household wealth quintile people, non-Muslims than Muslims.Deaths from stroke, heart disease and cancers were either on the rise or remained unchanged, but other causes declined continuously from 2003 to 2017. Immediate strengthening of the preventive and curative healthcare systems for NCDs management is a burning need.© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.