Identifying deaths from AIDS in South Africa
Identifying deaths from AIDS in South Africa
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DOI：
10.1097/00002030-200501280-00012
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发表时间：
2005-01-28
期刊：
影响因子：
3.8
通讯作者：
Bradshaw, D
中科院分区：
文献类型：
--
作者：
Groenewald, P;Nannan, N;Bradshaw, D
目的：量化南非HIV/AIDS误分类为艾滋病相关疾病的死亡人数。设计：对生命登记数据进行回顾分析。方法：利用生命登记死因档案计算1996年和2000-2001年的特定死因死亡率，并应用ASSA2000模型按年龄和性别估计总死亡率。对这两个时期的年龄别死亡率的差异进行了检验，以确定与艾滋病毒死亡具有相同年龄模式的死亡率显著上升的情况，从而很可能被错误地归类为艾滋病死亡。结果：艾滋病毒相关死亡的年龄别死亡率的增加表现出明显的年龄模式，这在其他地方也有观察到。在调查的22个潜在死因中，有9个以相同的不同年龄模式增加(结核病、肺炎、腹泻、脑膜炎、其他呼吸系统疾病、非传染性胃肠炎、其他传染病和寄生虫病、缺乏性贫血和蛋白质能量营养不良)，可被视为与艾滋病有关的疾病。这些疾病的增加占与艾滋病毒/艾滋病有关的总死亡人数的61%。加上死亡证明上被归类为艾滋病毒相关的死亡人数，总数占2000年ASSA2000艾滋病死亡人数模型估计数的93%。结论：由于很大比例的艾滋病死亡似乎被归类为艾滋病相关疾病，如果不参考艾滋病毒，南非的死亡统计数据不能以面值来解释，因为很大一部分由艾滋病毒感染引起的死亡被错误地归类。(C)2005年，Lippincott Williams&Wilkins。
Objective: To quantify the HIV/AIDS deaths misclassified to AIDS-related conditions in South Africa.Design: Retrospective analysis of vital registration data.Methods: Cause-specific death rates for 1996 and 2000-2001 were calculated using vital registration cause-of-death profiles applied to a model (ASSA2000) estimate of total mortality rates by age and sex. The difference in the age-specific death rates for these two periods was examined to identify conditions where there was a noticeable increase in mortality following the same age pattern as the HIV deaths, thus likely to be misclassified AIDS deaths.Results: The increase in the age-specific death rates for HIV-related deaths showed a distinct age pattern, which has been observed elsewhere. Out of the 22 potential causes of death investigated, there were nine that increased in the same distinct age pattern (tuberculosis, pneumonia, diarrhoea, meningitis, other respiratory disease, non-infective gastroenteritis, other infectious and parasitic diseases, deficiency anaemias and protein energy malnutrition) and could be considered AIDS-related conditions. The increase in these conditions accounted for 61% of the total deaths related to HIV/AIDS. When added to the deaths classified as HIV-related on the death certificate, the total accounts for 93% of the ASSA2000 model estimates of the number of AIDS deaths in 2000.Conclusion: As a large proportion of AIDS deaths appear to be classified to AIDS-related conditions, without reference to HIV, interpretation of death statistics in South Africa cannot be made on face value as a large proportion of deaths caused by HIV infection are misclassified. (c) 2005 Lippincott Williams & Wilkins.