ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

Geographical variation in mortality rate from liver disease in the Republic of Moldova


Introduction. The high mortality due to liver diseases in the Republic of Moldova is associated with alcohol consumption, especially home-made wine. The weak gender difference for this cause of death is a specific feature of the Moldova mortality pattern.
The objective of the study was to examine the changes in the regional mortality rates from liver diseases in the Republic of Moldova after independence.
Material and methods. A de-personalized database of medical death certificates available since 1991, the results of the last two population censuses conducted in 2004 and 2014 and the official population estimates for the early 1990s were used. Standardized mortality rates for the liver diseases were computed for three periods: 1991-1995 (socioeconomic crisis), 2002-2006 (stagnation period) and 2012-2016 (improvement period). Global and local spatial autocorrelation techniques were applied.
Results. In the northern districts, the municipality of Chisinau and Transnistria, mortality from liver disease was considerably lower than in the central and southern areas, traditionally occupied by winemaking. Moran’s index was positive and statistically significant. Clusters of “high-high” and “low-low” mortality were identified in the central and northern regions, respectively.
Conclusions. Anti-alcohol measures aimed at reducing the consumption of home-made wine must be implemented in the identified backward areas, to diminish regional inequalities in mortality due to liver disease.
Keywords: liver cirrhosis, regional differentiation, alcohol consumption, Eastern Europe.

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Address for correspondence:
Department of Social Medicine and Management, ”Nicolae Testemitanu” State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
Address: Gheorghe Asachi Str. no. 58, ap. 20. Chisinau, MD-2028 Republic of Moldova
Email:; Phone 373-687-904-94


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Penina O. Geographical variation in mortality rate from liver disease in the Republic of Moldova. Arch Balk Med Union. 2022;57(2):144-151.