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HIV Remains a Key Killer in Zambia: Results of Community-Based Mortality Surveillance
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HIV Remains a Key Killer in Zambia: Results of Community-Based Mortality Surveillance


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Poster presented at AIDS 2014.

Poster presented at AIDS 2014.

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    • 1. Stanley Kamocha1 ■ Robert Mswia2 ■ Peter Chipimo1 ■ Sheila S. Mudenda3 ■ Palver Sikanyiti3 ■ Fatma Soud1 ■ Melissa A. Marx1 1Centers for Disease Control and Prevention, Zambia ■ 2MEASURE Evaluation, U.S.A ■ 3Central Statistical Office, Zambia. HIV Remains a Key Killer in Zambia: Results of Community-Based Mortality Surveillance Methods • Mortality data was collected using the Sample Vital Registration with Verbal Autopsy (SAVVY) methods. • A census was conducted in 76 clusters chosen by stratified cluster-sampling in January 2011. • Data were collected on the number of deaths in the year prior to the census. • Subsequently, trained interviewers conducted verbal autopsy (VA) interviews with close relatives of those deceased. • Additional deaths were identified prospectively for 12 months and VA interviews were conducted for those deaths. • Two physicians independently reviewed each VA questionnaire to determine probable cause of death using the ICD-10 coding principles. Introduction • Despite a decline in HIV prevalence from 2001 to 2009, HIV/AIDS is still a burden, affecting the health and wellbeing of the population in Zambia • National data on mortality are not available due to a poorly functioning vital statistics system. • Among adults, diseases of circulatory system (11.8%) and tuberculosis (9.3%) were the second and third leading causes of death, respectively. • HIV/AIDS was the third leading cause of death, after malaria, accidents and injuries, among 5-14 year-olds and accounted for 7.9% of deaths in all age groups. • Among children under five, HIV/AIDS accounted for 7.3% of all deaths. • HIV/AIDS is the leading cause of death in Zambia, contributing about 20% of all deaths for males and females. Figure 2: HIV Specific Causes of Death in Zambia 2010-12 (%) Acknowledgments We would like to acknowledge the following: • Central Statistical Office for conducting the survey • The Centers for Disease Control and Prevention (CDC) for financial and technical support • MEASURE Evaluation for the technical assistance Presented at AIDS 2014 – Melbourne, Australia Conclusions • HIV/AIDS remains the leading cause of death in Zambian adults. • HIV/AIDS is the third leading cause of death for children >5 years of age. • It accounts for over 7% of deaths in children <5 years of age. 1.6 16.6 33.8 46.6 1.6 14 33.3 51.1 0 10 20 30 40 50 60 HIV disease resulting in other conditions Unspecified HIV disease HIV disease resulting in other specific diseases HIV disease resulting in infectious & parasitic diseases Urban Rural Figure 3: Causes of Death for Indirect HIV Deaths in Zambia 2010-12 (%) Policy Implications • Interventions to improve access to ARVs and palliative care need to continue to receive support throughout Zambia. • Community-based mortality surveillance can be used to collect HIV/AIDS mortality data in settings where vital and particularly death registration is incomplete. Literature Cited Central Statistical Office [Zambia], Central Board of Health [Zambia], and ORC Macro. 2003. Zambia Demographic and Health Survey 2001-2002. Calverton, Maryland, USA: Central Statistical Office, Central Board of Health, and ORC Macro. Central Statistical Office (CSO), Ministry of Health (MOH), Tropical Diseases Research Centre (TDRC), University of Zambia and Macro International Inc. 2009. Zambia Demographic and Health Survey 2007. Calverton, Maryland, USA: CSO and Macro International Inc. Central Statistical Office (CSO) 2014 , Sample Vital Registration with Verbal Autopsy, 2010-12. Lusaka, Zambia. Figure 1: Leading Causes of Death in Zambia 2010-12 (%) Contact Information Sheila S. Mudenda Palver Sikanyiti Stanley Kamocha Objective • To describe the leading cause of death using community- based mortality surveillance data. Results • The census covered 176,226 residents of whom 48.8% were male. The mean age was 20.5 years (SE=0.15). • Of the 2,750 people who died within the reference period (15.6/1,000), 1,472 (53.5%) were male; 1,705 (62.0%) were adults (15 years and older), 143 (5.2%) were 5-14 year-olds, and 902 (32.8%) were 0-4 year olds. • HIV/AIDS was the leading cause of death among adults accounting for 484 deaths (28.4% of all deaths). • Over half of all deaths (245, 50.6%) were among men and 239 deaths (49.4%) were among women. Poster Number: PE100 5.0 9.9 1.2 1.3 1.5 1.8 2.4 3.1 3.8 5.6 5.7 5.9 6.2 6.5 9.8 10.9 19.3 4.3 10.2 1.5 0.4 1.6 2.3 1.4 3.1 3.2 4.1 4.8 4.9 9.0 5.9 5.3 4.4 12.2 21.5 25 20 15 10 5 0 5 10 15 20 25 Ill-defined & undetermined causes All other remaining causes Maternal causes Disorders of the kidney Meningitis Senility/Old age Diabetes mellitus Neoplasms Stillbirth Diarrhoeal diseases Perinatal and neonatal conditions Pneumonia/ARI Diseases of the circulatory system Tuberculosis Malnutrition Injuries & Accidents AFI / Malaria HIV-related diseases Females Males 4.2 3.9 4.0 4.0 4.0 4.3 4.3 8.0 8.1 11.1 11.4 11.5 21.3 0 10 20 30 Ill-defined causes Tuberculosis Disorders of the kidney Diarrhoeal diseases Diseases of oesophagus/stomach/duodenum Remainder of infect. & parasitic diseases Other specified perinatal Pneumonia/ARI AFI/Malaria Diseases of the circulatory system Maternal causes Injuries & Accidents Malnutrition