HIV/AIDS-related mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites
Author(s)
Type
Journal Article
Abstract
BACKGROUND: As the HIV/AIDS pandemic has evolved over recent decades, Africa has been the most affected region, even though a large proportion of HIV/AIDS deaths have not been documented at the individual level. Systematic application of verbal autopsy (VA) methods in defined populations provides an opportunity to assess the mortality burden of the pandemic from individual data. OBJECTIVE: To present standardised comparisons of HIV/AIDS-related mortality at sites across Africa and Asia, including closely related causes of death such as pulmonary tuberculosis (PTB) and pneumonia. DESIGN: Deaths related to HIV/AIDS were extracted from individual demographic and VA data from 22 INDEPTH sites across Africa and Asia. VA data were standardised to WHO 2012 standard causes of death assigned using the InterVA-4 model. Between-site comparisons of mortality rates were standardised using the INDEPTH 2013 standard population. RESULTS: The dataset covered a total of 10,773 deaths attributed to HIV/AIDS, observed over 12,204,043 person-years. HIV/AIDS-related mortality fractions and mortality rates varied widely across Africa and Asia, with highest burdens in eastern and southern Africa, and lowest burdens in Asia. There was evidence of rapidly declining rates at the sites with the heaviest burdens. HIV/AIDS mortality was also strongly related to PTB mortality. On a country basis, there were strong similarities between HIV/AIDS mortality rates at INDEPTH sites and those derived from modelled estimates. CONCLUSIONS: Measuring HIV/AIDS-related mortality continues to be a challenging issue, all the more so as anti-retroviral treatment programmes alleviate mortality risks. The congruence between these results and other estimates adds plausibility to both approaches. These data, covering some of the highest mortality observed during the pandemic, will be an important baseline for understanding the future decline of HIV/AIDS.
Date Issued
2014-10-29
Date Acceptance
2014-09-02
Citation
Global Health Action, 2014, 7
ISSN
1654-9880
Publisher
Co-Action Publishing
Journal / Book Title
Global Health Action
Volume
7
Copyright Statement
© 2014 INDEPTH Network. This is an Open Access article distributed under the terms of the Creative Commons CC-BY 4.0License (http://creativecommons.org/licenses/by/4.0/), allowing third parties to copy and redistribute the material in any medium or format andto remix,transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/25377330
PII: 25370
Subjects
Africa
Asia
HIV/AIDS
INDEPTH Network
InterVA
Mortality
Verbal Autopsy
tuberculosis
Acquired Immunodeficiency Syndrome
Adolescent
Adult
Africa
Aged
Asia
Autopsy
Cause of Death
Child
Child, Preschool
Data Collection
Databases, Factual
Demography
Female
HIV Infections
Humans
Infant
Infant, Newborn
Male
Middle Aged
Population Surveillance
Publication Status
Published
Coverage Spatial
United States
Article Number
ARTN 25370