Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue (Suite 600), Seattle, WA 98121, United States of America.
Bull World Health Organ. 2011 Apr 1;89(4):278-85. doi: 10.2471/BLT.11.086280. Epub 2011 Feb 17.
To quantify the deaths from human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) that are misattributed to other causes in South Africa's death registration data and to adjust for this bias.
Deaths in the World Health Organization's mortality database were distributed among 48 mutually exclusive causes. For each cause, age- and sex-specific global death rates were compared with the average rate among people aged 65-69, 70-74 and 75-79 years to generate "relative" global death rates. Relative rates were also computed for South Africa alone. Differences between global and South African relative death rates were used to identify the causes to which deaths from HIV/AIDS were misattributed in South Africa and quantify the HIV/AIDS deaths misattributed to each. These deaths were then reattributed to HIV/AIDS.
In South Africa, deaths from HIV/AIDS are often misclassified as being caused by 14 other conditions. Whereas in 1996-2006 deaths attributed to HIV/AIDS accounted for 2.0-2.5% of all registered deaths in South Africa, our analysis shows that the true cause-specific mortality fraction rose from 19% (uncertainty range: 7-28%) to 48% (uncertainty range: 38-50%) over that period. More than 90% of HIV/AIDS deaths were found to have been misattributed to other causes during 1996-2006.
Adjusting for cause of death misclassification, a simple procedure that can be carried out in any country, can improve death registration data and provide empirical estimates of HIV/AIDS deaths that may be useful in assessing estimates from demographic models.
量化南非死亡登记数据中因其他原因导致的艾滋病毒（HIV）感染或获得性免疫缺陷综合征（AIDS）死亡人数，并对这种偏差进行调整。
世界卫生组织的死亡率数据库中的死亡人数分布在 48 个相互排斥的原因中。对于每个原因，根据年龄和性别对全球特定死亡率进行了比较，并与 65-69 岁、70-74 岁和 75-79 岁人群的平均死亡率进行了比较，以生成“相对”全球死亡率。还单独计算了南非的相对死亡率。利用全球和南非相对死亡率之间的差异，确定了在南非因 HIV/AIDS 而死亡的原因，并量化了归因于每个原因的 HIV/AIDS 死亡人数。然后，这些死亡人数被重新归因于 HIV/AIDS。
在南非，HIV/AIDS 死亡人数经常被错误地归类为 14 种其他疾病的原因。1996-2006 年期间，归因于 HIV/AIDS 的死亡人数占南非所有登记死亡人数的 2.0-2.5%，而我们的分析表明，在此期间，特定原因死亡率的真实比例从 19%（不确定性范围：7-28%）上升到 48%（不确定性范围：38-50%）。1996-2006 年期间，发现超过 90%的 HIV/AIDS 死亡人数被错误地归因于其他原因。
通过对死因分类错误进行调整，这是一种在任何国家都可以进行的简单程序，可以改进死亡登记数据，并提供有关 HIV/AIDS 死亡人数的经验估计，这可能有助于评估人口模型的估计。
