Hosegood Victoria, Vanneste Anna-Maria, Timaeus Ian M
Africa Centre for Health and Population Studies, Mtubatuba, South Africa.
AIDS. 2004 Mar 5;18(4):663-71. doi: 10.1097/00002030-200403050-00011.
To quantify the contribution that AIDS makes to adult mortality in rural South Africa.
Demographic surveillance of the population in a rural area of northern KwaZulu Natal province.
The population and all adult deaths (n = 1021) in 2000 were enumerated. We conducted verbal autopsy interviews with the caregivers of those who died to identify the causes of adult deaths. A validation study of the verbal autopsy diagnoses was conducted on 109 individuals with hospital notes that could be located. Death rates and other mortality indices are both calculated directly and estimated indirectly by the orphanhood method.
Mortality in the study area rose sharply in the late-1990s. By 2000 the probability of dying between ages 15 and 60 was 58% for women and 75% for men. AIDS, with or without tuberculosis, is the leading cause of death in adulthood (48%). Injuries, mostly resulting from road traffic accidents or violence, cause 20% of deaths of men aged 15-44 years. In the age group 60 years or more, non-communicable diseases account for 76 and 71% of deaths of women and men respectively.
This population has experienced a sudden and massive rise in adult mortality. This can be accounted for by AIDS deaths. Mortality from non-communicable disease and (among men) injuries is also high. Antenatal HIV seroprevalence continued to rise in rural KwaZulu Natal in the late 1990s, reaching 40% in some clinics in this area. Adult mortality will continue to rise unless effective treatment interventions are introduced.
量化艾滋病对南非农村地区成人死亡率的影响。
对夸祖鲁-纳塔尔省北部农村地区的人口进行人口统计学监测。
统计2000年该地区的人口及所有成人死亡情况（n = 1021）。我们对死亡者的照料者进行了口头尸检访谈，以确定成人死亡原因。对109名能找到医院记录的个体进行了口头尸检诊断的验证研究。死亡率和其他死亡指数既直接计算，也通过孤儿法间接估算。
研究地区的死亡率在20世纪90年代后期急剧上升。到2000年，15至60岁之间女性的死亡概率为58%，男性为75%。艾滋病，无论是否合并结核病，是成人死亡的主要原因（48%）。伤害，主要由道路交通事故或暴力导致，占15至44岁男性死亡的20%。在60岁及以上年龄组中，非传染性疾病分别占女性和男性死亡的76%和71%。
该地区成人死亡率突然大幅上升，这可归因于艾滋病死亡。非传染性疾病和（男性中的）伤害导致的死亡率也很高。20世纪90年代后期，夸祖鲁-纳塔尔农村地区的产前艾滋病毒血清阳性率持续上升，该地区一些诊所达到了40%。除非引入有效的治疗干预措施，成人死亡率将继续上升。
