Exposing misclassified HIV/AIDS deaths in South Africa
Exposing misclassified HIV/AIDS deaths in South Africa
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DOI：
10.2471/blt.11.086280
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发表时间：
2011-04-01
期刊：
影响因子：
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通讯作者：
Lozano, Rafael
中科院分区：
文献类型：
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作者：
Birnbaum, Jeanette Kurian;Murray, Christopher JL;Lozano, Rafael
目的量化南非死亡登记数据中被错误归因于其他原因的人类免疫缺陷病毒（HIV）感染或获得性免疫缺陷综合征（AIDS）死亡人数，并对这种偏倚进行调整。对于每种原因，将特定年龄和性别的全球死亡率与65-69岁，70-74岁和75-79岁人群的平均死亡率进行比较，以产生“相对”全球死亡率。还计算了仅南非的相对比率。全球和南非相对死亡率之间的差异被用来确定南非艾滋病毒/艾滋病死亡被错误归因的原因，并量化被错误归因的艾滋病毒/艾滋病死亡人数。这些死亡，然后重新归因于艾滋病毒/艾滋病。结果在南非，艾滋病毒/艾滋病的死亡往往被错误地归类为由14个其他条件。1996-2006年，艾滋病毒/艾滋病导致的死亡占南非所有登记死亡的2.0-2.5%，而我们的分析表明，在此期间，真正的特定原因死亡率从19%（不确定性范围：7-28%）上升到48%（不确定性范围：38-50%）。1996- 2006年，超过90%的HIV/AIDS死亡被错误归因于其他原因。结论调整死因分类错误是一个简单的程序，可以在任何国家进行，可以改善死亡登记数据，并提供HIV/AIDS死亡的经验估计，可能有助于评估人口统计模型的估计。
Objective To quantify the deaths from human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) that are misattributed to other causes in South Africa's death registration data and to adjust for this bias.Methods Deaths in the World Health Organization's mortality database were distributed among 48 mutually exclusive causes. For each cause, age- and sex-specific global death rates were compared with the average rate among people aged 65-69, 70-74 and 75-79 years to generate "relative" global death rates. Relative rates were also computed for South Africa alone. Differences between global and South African relative death rates were used to identify the causes to which deaths from HIV/AIDS were misattributed in South Africa and quantify the HIV/AIDS deaths misattributed to each. These deaths were then reattributed to HIV/AIDS.Findings In South Africa, deaths from HIV/AIDS are often misclassified as being caused by 14 other conditions. Whereas in 1996-2006 deaths attributed to HIV/AIDS accounted for 2.0-2.5% of all registered deaths in South Africa, our analysis shows that the true cause-specific mortality fraction rose from 19% (uncertainty range: 7-28%) to 48% (uncertainty range: 38-50%) over that period. More than 90% of HIV/AIDS deaths were found to have been misattributed to other causes during 1996-2006.Conclusion Adjusting for cause of death misclassification, a simple procedure that can be carried out in any country, can improve death registration data and provide empirical estimates of HIV/AIDS deaths that may be useful in assessing estimates from demographic models.