Hivaids-related Mortality In Addis Ababa City Administration

Measurement of the impact of HIV/AIDS on mortality is of fundamental importance to developrnprogrammes to mitigate the effects of the epidemic in Ethiopia, similar to other countries in sub-rnSaharan Africa. Little is known about the HIV/AIDS-related mortality in the general populationrnof the country and especially in Addis Ababa. A prospective surveillance of deaths at burials inrnAddis Ababa is initiated, since information on vital events in Ethiopia, as in most of sub-SaharanrnAfrica, is defective. In this study, verbal autopsy (VA) and clinician review techniques were usedrnto assess the cause specific mortality (CSM) in general and HIV/AIDS-related mortality inrnparticular, in the general population of Addis Ababa.rnSince February 8, 2001 a prospective surveillance started at all the available and functioningrnburial sites (n=70) in the rural and urban localities of Addis Ababa, collecting information onrnname, sex, age, address, date of burial and presumed cause of death of the deceased. Burial sitesrnincluded: all 51 orthodox churchyards, eight mosque-based, seven municipal-based, tworncommunity-based “Yesenbete mahber”, one catholic-based, and one Jewish “Bete-Israel”rncemetery. Verbal autopsy (VA) was conducted at 414 selected households, three to four monthsrnafter death, involving 10 teams of two interviewers. Two independent clinicians reviewed andrnassessed the VA questionnaires and assigned causes of death. Hospital records for those whorndied in Addis Ababa hospitals were traced and assessed and compared with VA-derived causesrnof death.rnIn three months, 5,133 deaths were registered (45% females and 55% males). The CDR wasrnestimated yielding to 8.23 per 1000 population per year. Neonatal mortality and infant mortalityrnwas 29/1000 and 42/1000 live births, respectively. For females, the peak percentage of deathsrnwas 11% in the age group 25-29 years, whereas for males the peak percentage of deaths wasrn9.6% in the age group 35-39 years. A total of 414 deaths were selected for VA: 44, 108 and 262rnfor neonates, children and adults, respectively. Response rate for the three age strata rangedrnbetween 66-76%. The major cause of death was TB/HIV/AIDS-related disease in 127 deathsrn(41.4%) of which 96 deaths (48%) were adults and 31 deaths (29.0%) were under-12 year olds.rnOf the 96 (48%) adult deaths due to TB/HIV/AIDS, 48 (50%) were males and 48 (50%) females,rnwith a male to female ratio of 1:1. Being single and age group of 60-69 years showedrnsignificantly higher risk of mortality due to TB/HIV/AIDS.rnIn the absence of vital events registration in Addis Ababa, surveillance for burials appeared to berna good method to estimate mortality. Through VA and physician review, the impact ofrnTB/HIV/AIDS on mortality was estimated. Although epidemiological models revealed similarrnestimates, counting of deaths and providing numbers of the Addis Ababa population that die ofrnTB/HIV/AIDS may stimulate better policy makers and public health workers to act immediatelyrnto this devastating epidemic.rnIt is recommended that the surveillance for burials should continue for long-term basis, as it mayrnprovide additional information on mortality (i.e. seasonal variation, and geographic differencesrnwithin Addis Ababa), and may also allow for analysis of mortality trends

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