Bourne David E, Thompson MaryLou, Brody Linnea L, Cotton Mark, Draper Beverly, Laubscher Ria, Abdullah M Fareed, Myers Jonny E
School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
AIDS. 2009 Jan 2;23(1):101-6. doi: 10.1097/qad.0b013e32831c54bd.
South Africa has among the highest levels of HIV prevalence in the world. Our objectives are to describe the distribution of South African infant and child mortality by age at fine resolution, to identify any trends over recent time and to examine these trends for HIV-associated and non HIV-associated causes of mortality.
A retrospective review of vital registration data was conducted. All registered postneonatal deaths under 1 year of age in South Africa for the period 1997-2002 were analysed by age in months using a generalized linear model with a log link and Poisson family.
Postneonatal mortality increased each year over the period 1997-2002. A peak in HIV-related deaths was observed, centred at 2-3 months of age, rising monotonically over time.
We interpret the peak in mortality at 2-3 months as an indicator for paediatric AIDS in a South African population with high HIV prevalence and where other causes of death are not sufficiently high to mask HIV effects. Intrauterine and intrapartum infection may contribute to this peak. It is potentially a useful surveillance tool, not requiring an exact cause of death. The findings also illustrate the need for early treatment of mother and child in settings with very high HIV prevalence.
南非是世界上艾滋病毒感染率最高的国家之一。我们的目标是详细描述南非婴幼儿死亡率按年龄的分布情况，确定近期的任何趋势，并研究这些趋势中与艾滋病毒相关和非艾滋病毒相关的死亡原因。
对生命登记数据进行回顾性审查。使用具有对数链接和泊松族的广义线性模型，按月份对1997 - 2002年期间南非所有登记的1岁以下新生儿期后死亡情况进行分析。
在1997 - 2002年期间，新生儿期后死亡率逐年上升。观察到与艾滋病毒相关的死亡出现一个高峰，以2 - 3个月龄为中心，且随时间单调上升。
我们将2 - 3个月龄时的死亡率高峰解释为在艾滋病毒感染率高且其他死亡原因不足以掩盖艾滋病毒影响的南非人群中儿童艾滋病的一个指标。宫内和产时感染可能导致了这个高峰。它可能是一个有用的监测工具，不需要确切的死亡原因。这些发现还表明在艾滋病毒感染率非常高的环境中对母婴进行早期治疗的必要性。
