HIV/AIDS-related mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites.
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Streatfield P Kim, Khan Wasif A, Bhuiya Abbas, Hanifi Syed M A, Alam Nurul, Millogo Ourohiré, Sié Ali, Zabré Pascal, Rossier Clementine, Soura Abdramane B, Bonfoh Bassirou, Kone Siaka, Ngoran Eliezer K, Utzinger Juerg, Abera Semaw F, Melaku Yohannes A, Weldearegawi Berhe, Gomez Pierre, Jasseh Momodou, Ansah Patrick, Azongo Daniel, Kondayire Felix, Oduro Abraham, Amu Alberta, Gyapong Margaret, Kwarteng Odette, Kant Shashi, Pandav Chandrakant S, Rai Sanjay K, Juvekar Sanjay, Muralidharan Veena, Wahab Abdul, Wilopo Siswanto, Bauni Evasius, Mochamah George, Ndila Carolyne, Williams Thomas N, Khagayi Sammy, Laserson Kayla F, Nyaguara Amek, Van Eijk Anna M, Ezeh Alex, Kyobutungi Catherine, Wamukoya Marylene, Chihana Menard, Crampin Amelia, Price Alison, Delaunay Valérie, Diallo Aldiouma, Douillot Laetitia, Sokhna Cheikh, Gómez-Olivé F Xavier, Mee Paul, Tollman Stephen M, Herbst Kobus, Mossong Joël, Chuc Nguyen T K, Arthur Samuelina S, Sankoh Osman A, Byass Peter
Аннотация
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.