HIV/AIDS-related mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites

ABSTRACT

Glob Health Action

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.

Streatfield, P. K., Khan, W. A., Bhuiya, A., Hanifi, S. M., Alam, N., Millogo, O., Sie, A., Zabre, P., Rossier, C., Soura, A. B., Bonfoh, B., Kone, S., Ngoran, E. K., Utzinger, J., Abera, S. F., Melaku, Y. A., Weldearegawi, B., Gomez, P., Jasseh, M., Ansah, P., Azongo, D., Kondayire, F., Oduro, A., Amu, A., Gyapong, M., Kwarteng, O., Kant, S., Pandav, C. S., Rai, S. K., Juvekar, S., Muralidharan, V., Wahab, A., Wilopo, S., Bauni, E., Mochamah, G., Ndila, C., Williams, T. N., Khagayi, S., Laserson, K. F., Nyaguara, A., Van Eijk, A. M., Ezeh, A., Kyobutungi, C., Wamukoya, M., Chihana, M., Crampin, A., Price, A., Delaunay, V., Diallo, A., Douillot, L., Sokhna, C., Gomez-Olive, F. X., Mee, P., Tollman, S. M., Herbst, K., Mossong, J., Chuc, N. T., Arthur, S. S., Sankoh, O. A., Byass, P.

Pages:25370, Volume:7, Edition:11/8/2014, Date,

Link: https://www.ncbi.nlm.nih.gov/pubmed/25377330

Notes:Streatfield, P Kim|Khan, Wasif A|Bhuiya, Abbas|Hanifi, Syed M A|Alam, Nurul|Millogo, Ourohire|Sie, Ali|Zabre, 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, Valerie|Diallo, Aldiouma|Douillot, Laetitia|Sokhna, Cheikh|Gomez-Olive, F Xavier|Mee, Paul|Tollman, Stephen M|Herbst, Kobus|Mossong, Joel|Chuc, Nguyen T K|Arthur, Samuelina S|Sankoh, Osman A|Byass, Peter|eng|101594/Wellcome Trust/United Kingdom|WT081993MA/Wellcome Trust/United Kingdom|5U22/PS022179_10/PS/NCHHSTP CDC HHS/|098610/Wellcome Trust/United Kingdom|058893/Z/99/A/Wellcome Trust/United Kingdom|091758/Wellcome Trust/United Kingdom|Medical Research Council/United Kingdom|084538/Wellcome Trust/United Kingdom|097318/Wellcome Trust/United Kingdom|U22 PS022179/PS/NCHHSTP CDC HHS/|085477/Z/08/Z/Wellcome Trust/United Kingdom|MC_UP_A900_1123/Medical Research Council/United Kingdom|069683/Z/02/Z/Wellcome Trust/United Kingdom|Research Support, N.I.H., Extramural|Research Support, Non-U.S. Gov’t|Research Support, U.S. Gov’t, P.H.S.|2014/11/08 06:00|Glob Health Action. 2014 Oct 29;7:25370. doi: 10.3402/gha.v7.25370. eCollection 2014.

ISBN: 1654-9880 (Electronic)|1654-9880 (Linking) Permanent ID: PMC4220131 Accession Number: 25377330

Author Address: Matlab HDSS, Bangladesh| International Centre for Diarrhoeal Disease Research, Bangladesh| INDEPTH Network, Accra, Ghana.|International Centre for Diarrhoeal Disease Research, Bangladesh| INDEPTH Network, Accra, Ghana| Bandarban HDSS, Bangladesh.|INDEPTH Network, Accra, Ghana| Chakaria HDSS, Bangladesh| Centre for Equity and Health Systems, International Centre for Diarrhoeal Disease Research, Bangladesh.|INDEPTH Network, Accra, Ghana| AMK HDSS, Bangladesh| Centre for Population, Urbanisation and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh.|INDEPTH Network, Accra, Ghana| Nouna HDSS, Burkina Faso| Nouna Health Research Centre, Nouna, Burkina Faso.|INDEPTH Network, Accra, Ghana| Ouagadougou HDSS, Burkina Faso| Institut Superieur des Sciences de la Population, Universite de Ouagadougou, Burkina Faso| Institut d’Etudes Demographique et du parcours de vie, Universite de Geneve, Geneva, Switzerland.|INDEPTH Network, Accra, Ghana| Ouagadougou HDSS, Burkina Faso| Institut Superieur des Sciences de la Population, Universite de Ouagadougou, Burkina Faso.|INDEPTH Network, Accra, Ghana| Taabo HDSS, Cote d’Ivoire| , Centre Suisse de Recherches Scientifiques en Cote d’Ivoire, Abidjan, Cote d’Ivoire.|INDEPTH Network, Accra, Ghana| Taabo HDSS, Cote d’Ivoire| , Universite Felix Houphoet-Boigny, Abidjan, Cote d’Ivoire.|INDEPTH Network, Accra, Ghana| Taabo HDSS, Cote d’Ivoire| , Swiss Tropical and Public Health Institute, Basel, Switzerland.|INDEPTH Network, Accra, Ghana| Kilite-Awlaelo HDSS, Ethiopia| Department of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.|INDEPTH Network, Accra, Ghana| Farafenni HDSS, The Gambia| Medical Research Council, The Gambia Unit, Fajara, The Gambia.|INDEPTH Network, Accra, Ghana| Navrongo HDSS, Ghana| Navrongo Health Research Centre, Navrongo, Ghana.|INDEPTH Network, Accra, Ghana| Dodowa HDSS, Ghana| Dodowa Health Research Centre, Dodowa, Ghana.|INDEPTH Network, Accra, Ghana| Ballabgarh HDSS, India| All India Institute of Medical Sciences, New Delhi, India.|INDEPTH Network, Accra, Ghana| Vadu HDSS, India| Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India.|INDEPTH Network, Accra, Ghana| Purworejo HDSS, Indonesia| Department of Public Health, Universitas Gadjah Mada, Yogyakarta, Indonesia.|INDEPTH Network, Accra, Ghana| Kilifi HDSS, Kenya| KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.|INDEPTH Network, Accra, Ghana| Kilifi HDSS, Kenya| KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya| Department of Medicine, Imperial College, St. Mary’s Hospital, London, United Kingdom.|INDEPTH Network, Accra, Ghana| Kisumu HDSS, Kenya| KEMRI/CDC Research and Public Health Collaboration and KEMRI Center for Global Health Research, Kisumu, Kenya.|INDEPTH Network, Accra, Ghana| Nairobi HDSS, Kenya| African Population and Health Research Center, Nairobi, Kenya.|INDEPTH Network, Accra, Ghana| Karonga HDSS, Malawi| African Population and Health Research Center, Nairobi, Kenya.|INDEPTH Network, Accra, Ghana| Karonga HDSS, Malawi| Karonga Prevention Study, Chilumba, Malawi| London School of Hygiene and Tropical Medicine, London, United Kingdom.|INDEPTH Network, Accra, Ghana| Niakhar HDSS, Senegal| Institut de Recherche pour le Developpement (IRD), Dakar, Senegal.|INDEPTH Network, Accra, Ghana| Agincourt HDSS, South Africa| MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.|INDEPTH Network, Accra, Ghana| Agincourt HDSS, South Africa| Institut de Recherche pour le Developpement (IRD), Dakar, Senegal| Umea Centre for Global Health Research, Umea University, Umea, Sweden.|INDEPTH Network, Accra, Ghana| Africa Centre HDSS, South Africa| Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, KwaZulu-Natal, South Africa.|INDEPTH Network, Accra, Ghana| Africa Centre HDSS, South Africa| Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, KwaZulu-Natal, South Africa| National Health Laboratory, Surveillance & Epidemiology of Infectious Diseases, Dudelange, Luxembourg.|INDEPTH Network, Accra, Ghana| FilaBavi HDSS, Vietnam| Health System Research, Hanoi Medical University, Hanoi, Vietnam.|INDEPTH Network, Accra, Ghana.|INDEPTH Network, Accra, Ghana| FilaBavi HDSS, Vietnam| Hanoi Medical University, Hanoi, Vietnam| osman.sankoh@indepth-network.org.|MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa| WHO Collaborating Centre for Verbal Autopsy, Umea Centre for Global Health Research, Umea University, Sweden.

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