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Adult mortality and probable cause of death in rural northern Malawi in the era of HIV treatment
- Source :
- Tropical Medicine & International Health, Chihana, M, Floyd, S, Molesworth, A, Crampin, A C, Kayuni, N, Price, A, Zaba, B, Jahn, A, Mvula, H, Dube, A, Ngwira, B, Glynn, J R & French, N 2012, ' Adult mortality and probable cause of death in rural northern Malawi in the era of HIV treatment ', Tropical Medicine and International Health, vol. 17, no. 8, pp. e74-83 . https://doi.org/10.1111/j.1365-3156.2012.02929.x
- Publication Year :
- 2012
- Publisher :
- Blackwell Publishing Ltd, 2012.
-
Abstract
- OBJECTIVES: Developing countries are undergoing demographic transition with a shift from high mortality caused by communicable diseases (CD) to lower mortality rates caused by non-communicable diseases (NCD). HIV/AIDS has disrupted this trend in sub-Saharan Africa. However in recent years HIV-associated mortality has been reduced with the introduction of widely available antiretroviral therapy (ART). Side effects of ART may lead to increased risk of cardiovascular diseases raising the prospects of an accelerated transition towards NCD as the primary cause of death. We report population-based data to investigate changes in cause of death owing to NCD during the first 4 years after introduction of HIV treatment. METHODS: We analysed data from a demographic surveillance system in Karonga district Malawi from September 2004 to August 2009. ART was introduced in mid-2005. Clinician review of verbal autopsies conducted 2-6 weeks after a death was used to establish a single principal cause of death. RESULTS: Over the entire period there were 905 deaths AIDS death rate fell from 505 to 160/100000 person-years and there was no evidence of an increase in NCD rates. The proportion of total deaths attributable to AIDS fell from 42% to 17% and from NCD increased from 37% to 49%. DISCUSSION: Our findings show that 4 years after the introduction of ART into HIV care in Karonga district all-cause mortality has fallen dramatically with no evidence of an increase in deaths owing to NCD. (c) 2012 Blackwell Publishing Ltd.
- Subjects :
- Gerontology
Adult
Male
Rural Population
Malawi
verbal autopsy
Adolescent
Population
Demographic transition
Autopsy
HIV Infections
cause of death
Young Adult
Age Distribution
Acquired immunodeficiency syndrome (AIDS)
Medicine
Humans
Young adult
Mortality
Sex Distribution
education
Cause of death
education.field_of_study
business.industry
Mortality rate
Public Health, Environmental and Occupational Health
HIV
Middle Aged
medicine.disease
Verbal autopsy
Infectious Diseases
Anti-Retroviral Agents
Socioeconomic Factors
Africa
Parasitology
Female
business
Alpha Supplement
Demography
Subjects
Details
- Language :
- English
- ISSN :
- 13653156 and 13602276
- Volume :
- 17
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Tropical Medicine & International Health
- Accession number :
- edsair.doi.dedup.....e52ef86403fd1071de937bd022a52d63