Assessing adult mortality in HIV-1-afflicted Zimbabwe (1998 -2003)
OBJECTIVE: To compare alternative methods to vital registration systems for estimating adult mortality, and describe patterns of mortality in Manicaland, Zimbabwe, which has been severely affected by HIV. METHODS: We compared estimates of adult mortality from (1) a single question on household morta...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The World Health Organization
2006-01-01
|
| Series: | Bulletin of the World Health Organization |
| Subjects: | |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000300013 |
| _version_ | 1797288332154109952 |
|---|---|
| author | Lopman Ben A Barnabas Ruanne Hallett Timothy B Nyamukapa Constance Mundandi Costa Mushati Phyllis Garnett Geoff P Gregson Simon |
| author_facet | Lopman Ben A Barnabas Ruanne Hallett Timothy B Nyamukapa Constance Mundandi Costa Mushati Phyllis Garnett Geoff P Gregson Simon |
| author_sort | Lopman Ben A |
| collection | DOAJ |
| description | OBJECTIVE: To compare alternative methods to vital registration systems for estimating adult mortality, and describe patterns of mortality in Manicaland, Zimbabwe, which has been severely affected by HIV. METHODS: We compared estimates of adult mortality from (1) a single question on household mortality, (2) repeated household censuses, and (3) an adult cohort study with linked HIV testing from Manicaland, with a mathematical model fitted to local age-specific HIV prevalence (1998 -2000). FINDINGS: The crude death rate from the single question (29 per 1000 person-years) was roughly consistent with that from the mathematical model (22 -25 per 1000 person-years), but much higher than that from the household censuses (12 per 1000 person-years). Adult mortality in the household censuses (males 0.65; females 0.51) was lower than in the cohort study (males 0.77; females 0.57), while mathematical models gave a much higher estimate, especially for females (males 0.80 -0.83; females 0.75 -0.80). The population attributable fraction of adult deaths due to HIV was 0.61 for men and 0.70 for women, with life expectancy estimated to be 34.3 years for males and 38.2 years for females. CONCLUSION: Each method for estimating adult mortality had limitations in terms of loss to follow-up (cohort study), under-ascertainment (household censuses), transparency of underlying processes (single question), and sensitivity to parameterization (mathematical model). However, these analyses make clear the advantages of longitudinal cohort data, which provide more complete ascertainment than household censuses, highlight possible inaccuracies in model assumptions, and allow direct quantification of the impact of HIV. |
| first_indexed | 2024-03-07T18:47:47Z |
| format | Article |
| id | doaj.art-dc3daf9ce2584984963b6fd289fa4627 |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T18:47:47Z |
| publishDate | 2006-01-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-dc3daf9ce2584984963b6fd289fa46272024-03-02T02:19:47ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862006-01-01843189197Assessing adult mortality in HIV-1-afflicted Zimbabwe (1998 -2003)Lopman Ben ABarnabas RuanneHallett Timothy BNyamukapa ConstanceMundandi CostaMushati PhyllisGarnett Geoff PGregson SimonOBJECTIVE: To compare alternative methods to vital registration systems for estimating adult mortality, and describe patterns of mortality in Manicaland, Zimbabwe, which has been severely affected by HIV. METHODS: We compared estimates of adult mortality from (1) a single question on household mortality, (2) repeated household censuses, and (3) an adult cohort study with linked HIV testing from Manicaland, with a mathematical model fitted to local age-specific HIV prevalence (1998 -2000). FINDINGS: The crude death rate from the single question (29 per 1000 person-years) was roughly consistent with that from the mathematical model (22 -25 per 1000 person-years), but much higher than that from the household censuses (12 per 1000 person-years). Adult mortality in the household censuses (males 0.65; females 0.51) was lower than in the cohort study (males 0.77; females 0.57), while mathematical models gave a much higher estimate, especially for females (males 0.80 -0.83; females 0.75 -0.80). The population attributable fraction of adult deaths due to HIV was 0.61 for men and 0.70 for women, with life expectancy estimated to be 34.3 years for males and 38.2 years for females. CONCLUSION: Each method for estimating adult mortality had limitations in terms of loss to follow-up (cohort study), under-ascertainment (household censuses), transparency of underlying processes (single question), and sensitivity to parameterization (mathematical model). However, these analyses make clear the advantages of longitudinal cohort data, which provide more complete ascertainment than household censuses, highlight possible inaccuracies in model assumptions, and allow direct quantification of the impact of HIV.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000300013MortalityHIV infections/mortalityCensusesLife tablesCohort studiesZimbabwe |
| spellingShingle | Lopman Ben A Barnabas Ruanne Hallett Timothy B Nyamukapa Constance Mundandi Costa Mushati Phyllis Garnett Geoff P Gregson Simon Assessing adult mortality in HIV-1-afflicted Zimbabwe (1998 -2003) Bulletin of the World Health Organization Mortality HIV infections/mortality Censuses Life tables Cohort studies Zimbabwe |
| title | Assessing adult mortality in HIV-1-afflicted Zimbabwe (1998 -2003) |
| title_full | Assessing adult mortality in HIV-1-afflicted Zimbabwe (1998 -2003) |
| title_fullStr | Assessing adult mortality in HIV-1-afflicted Zimbabwe (1998 -2003) |
| title_full_unstemmed | Assessing adult mortality in HIV-1-afflicted Zimbabwe (1998 -2003) |
| title_short | Assessing adult mortality in HIV-1-afflicted Zimbabwe (1998 -2003) |
| title_sort | assessing adult mortality in hiv 1 afflicted zimbabwe 1998 2003 |
| topic | Mortality HIV infections/mortality Censuses Life tables Cohort studies Zimbabwe |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000300013 |
| work_keys_str_mv | AT lopmanbena assessingadultmortalityinhiv1afflictedzimbabwe19982003 AT barnabasruanne assessingadultmortalityinhiv1afflictedzimbabwe19982003 AT halletttimothyb assessingadultmortalityinhiv1afflictedzimbabwe19982003 AT nyamukapaconstance assessingadultmortalityinhiv1afflictedzimbabwe19982003 AT mundandicosta assessingadultmortalityinhiv1afflictedzimbabwe19982003 AT mushatiphyllis assessingadultmortalityinhiv1afflictedzimbabwe19982003 AT garnettgeoffp assessingadultmortalityinhiv1afflictedzimbabwe19982003 AT gregsonsimon assessingadultmortalityinhiv1afflictedzimbabwe19982003 |