Mortality reduction associated with HIV/AIDS care and antiretroviral treatment in rural Malawi: evidence from registers, coffin sales and funerals.
Mandere, Bester C
Schouten, Eric J
Harries, A D
AffiliationThyolo District Health Services, Ministry of Health and Population, Thyolo, Malawi.
MetadataShow full item record
AbstractBACKGROUND: To report on the trend in all-cause mortality in a rural district of Malawi that has successfully scaled-up HIV/AIDS care including antiretroviral treatment (ART) to its population, through corroborative evidence from a) registered deaths at traditional authorities (TAs), b) coffin sales and c) church funerals. METHODS AND FINDINGS: Retrospective study in 5 of 12 TAs (covering approximately 50% of the population) during the period 2000-2007. A total of 210 villages, 24 coffin workshops and 23 churches were included. There were a total of 18,473 registered deaths at TAs, 15781 coffins sold, and 2762 church funerals. Between 2000 and 2007, there was a highly significant linear downward trend in death rates, sale of coffins and church funerals (X(2) for linear trend: 338.4 P<0.0001, 989 P<0.0001 and 197, P<0.0001 respectively). Using data from TAs as the most reliable source of data on deaths, overall death rate reduction was 37% (95% CI:33-40) for the period. The mean annual incremental death rate reduction was 0.52/1000/year. Death rates decreased over time as the percentage of people living with HIV/AIDS enrolled into care and ART increased. Extrapolating these data to the entire district population, an estimated 10,156 (95% CI: 9786-10259) deaths would have been averted during the 8-year period. CONCLUSIONS: Registered deaths at traditional authorities, the sale of coffins and church funerals showed a significant downward trend over a 8-year period which we believe was associated with the scaling up HIV/AIDS care and ART.
- Changing mortality rates and causes of death for HIV-infected individuals living in Southern Alberta, Canada from 1984 to 2003.
- Authors: Krentz HB, Kliewer G, Gill MJ
- Issue date: 2005 Mar
- AIDS mortality before and after the introduction of highly active antiretroviral therapy: does it vary with socioeconomic group in a country with a National Health System?
- Authors: Borrell C, Rodríguez-Sanz M, Pasarín MI, Brugal MT, García-de-Olalla P, Marí-Dell'Olmo M, Caylà J
- Issue date: 2006 Dec
- Patient retention and attrition on antiretroviral treatment at district level in rural Malawi.
- Authors: Massaquoi M, Zachariah R, Manzi M, Pasulani O, Misindi D, Mwagomba B, Bauernfeind A, Harries AD
- Issue date: 2009 Jun
- A public health approach to rapid scale-up of antiretroviral treatment in Malawi during 2004-2006.
- Authors: Lowrance DW, Makombe S, Harries AD, Shiraishi RW, Hochgesang M, Aberle-Grasse J, Libamba E, Schouten E, Ellerbrock T, Kamoto K
- Issue date: 2008 Nov 1
- Changes in mortality following HIV and AIDS and estimation of the number of people living with diagnosed HIV/AIDS in Australia, 1981-2003.
- Authors: Nakhaee F, Black D, Wand H, McDonald A, Law M
- Issue date: 2009 Jun