AEGiS-14IAC: Cause-specific mortality in rural South Africa - HIV/AIDS and violence.

14th International AIDS Conference


Barcelona, Spain - July 7-12, 2002


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Cause-specific mortality in rural South Africa - HIV/AIDS and violence.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. C10661)

Vanneste A
Africa Centre for Health and Population Studies, Mtubatuba, South Africa


Introduction The Africa Centre Demographic Information System (ACDIS) collects thrice yearly demographic and health data from a population of 85,529 in a rural area of KwaZulu Natal with an antenatal seroprevalence in 1998 of 41.2%. A total of 1,008 adult deaths (15+ years) were identified in 2000. Causes of deaths were obtained by verbal autopsies.

METHODOLOGY: Nurses conduct verbal autopsy interviews with the care provider(s) of the deceased. Two independent physicians assess the cause of death. For AIDS, severe weight loss, the long duration of the disease and repeated episodes of illness facilitates diagnosis. A local tuberculosis program improves the validity of TB diagnosis.

RESULTS: 50% of all adult deaths occur between 20-49 years of age. AIDS-related deaths represent 48% of all adult mortality. In adults less than 60 years of age there are ten times more deaths due to AIDS (60%) than due to homicide (6%) which is the second largest cause of death. Tuberculosis without AIDS (6%) and neoplasms (4%) rank third and fourth. In the population 60 years and older, cerebro-vascular disease (27%), heart disease (19%), neoplasms (10%) diabetes (9%) and AIDS/TB (5%) are the most important causes of death.

CONCLUSION: In an area with such high levels of HIV/AIDS and violence, community based data on cause-specific mortality has clear advantages over hospital data. Many patients die at home and violent and accidental deaths often don't reach hospital. With hospital and vital registration data there is also a lack of consistency in the assignment of causes of death. The high proportion of AIDS-related and violent deaths in younger adults is a controversial issue in South Africa and has important policy implications.


Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Infections, HIV Seropositivity, Tuberculosis, Autopsy, Violence, Death, Interviews, South Africa, Seroepidemiologic Studies, Africa, Adult, Human, mortality, etiologyKWDaegis,acquiredimmunodeficiencysyndrome,hivinfections,hivseropositivity,tuberculosis,autopsy,violence,death,interviews,southafrica,seroepidemiologicstudies,africa,adult,human,mortality,etiology

020707
C10661

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.