Rising incidence and prevalence of orphanhood in Manicaland, Zimbabwe, 1998 to 2003
Rising incidence and prevalence of orphanhood in Manicaland, Zimbabwe, 1998 to 2003
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DOI：
10.1097/01.aids.0000166095.62187.df
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发表时间：
2005-04-29
期刊：
影响因子：
3.8
通讯作者：
Gregson, S
中科院分区：
文献类型：
--
作者：
Watts, H;Lopman, B;Gregson, S
目的：量化和描述津巴布韦东部马尼卡兰孤儿发病率。设计：开放队列研究。方法：统计分析1998-2000年和2001-2003年4个社会经济阶层家庭普查中13740和10308名0-14岁儿童的数据，以及两次普查中的10184名儿童结果：所有形式的乳腺癌的患病率均有所增加。非孤儿中失去父母的总体比率为每1000人年（py）27.5人。父源孤儿的发生率（20.2/1000 py）高于母源孤儿的发生率（9.1/1000 py），母源孤儿失去父亲的速度比父源孤儿失去母亲的速度快。父亲和母亲的孤儿发生率随年龄的增长而增加。父亲孤儿中母亲双胞胎和双胞胎的发生率每年上升20%[发生率比（IRR）= 1.20; 95%CI，1.06-1.35]，每年上升71（IRR = 1.71; 95%CI，1.25-2.33），但父源性孤儿和双源性孤儿的发生率没有变化。对于82%的父母死亡的儿童，父母在基线时是艾滋病毒阳性。与非孤儿相比，更多的新的父亲孤儿和双孤儿-但不是新的母亲孤儿-离开了他们的基准家庭。死亡率高于非孤儿与孕产妇orphis.Conclusions之间观察到的死亡率最高的孤儿比孤儿：孤儿的发病率和患病率高，并增加由于艾滋病毒在津巴布韦东部。孤儿发病率模式不同于孤儿流行率模式，如果支助方案要在高度脆弱时期帮助儿童，就需要了解孤儿发病率模式。(c)2005年利平科特威廉姆斯&威尔金斯。
Objective: To quantify and describe orphan incidence in Manicaland, eastern Zimbabwe.Design: Open cohort study.Methods: Statistical analysis of data on 13 740 and 10 308 children, aged 0-14 years, enumerated in household censuses in four socio-economic strata, 1998-2000 and 2001-2003, and 10 184 children seen in both censuses (74% follow-up).Results: Prevalence of all forms of orphanhood increased. The overall rate of losing a parent amongst non-orphans was 2 7.5 per 1000 person-years (py). Paternal orphan incidence (20.2 per 1000 py) was higher than maternal orphan incidence (9.1 per 1000py) and maternal orphans lost their fathers at a faster rate than paternal orphans lost their mothers. Paternal and maternal orphan incidence increased with age. incidence of maternal orphanhood and double orphanhood amongst paternal orphans rose at 20% per annum [incidence rate ratio (IRR) = 1.20; 95% CI, 1.06-1.35] and 71 % per annum (IRR = 1.71; 95% CI, 1.25-2.33), respectively, 1998-2003, but incidence of paternal orphanhood and double orphanhood amongst maternal orphans were unchanged. For 82% of children with a parent who died, the parent was HIV-positive at baseline. More new paternal and double orphans - but not new maternal orphans - than non-orphans had left their baseline household. Mortality was higher in orphans than non-orphans with the highest death rates observed amongst maternal orphans.Conclusions: Orphan incidence and prevalence are high and increasing due to HIV in eastern Zimbabwe. Orphan incidence patterns differ from orphan prevalence patterns and need to be understood if support programmes are to assistchildren during periods of high vulnerability. (c) 2005 Lippincott Williams & Wilkins.