Population Health and Demography, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
Population Health and Demography, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
BMJ Open. 2022 Jun 30;12(6):e058962. doi: 10.1136/bmjopen-2021-058962.
Tuberculosis (TB) and HIV/AIDS are public health concerns in Papua New Guinea (PNG). This study examines TB and HIV/AIDS mortalities and associated sociodemographic factors in PNG.
As part of a longitudinal study, verbal autopsy (VA) interviews were conducted using the WHO 2016 VA Instrument to collect data of 926 deaths occurred in the communities within the catchment areas of the Comprehensive Health and Epidemiological Surveillance System from 2018 to 2020.InterVA-5 cause of deaths analytical tool was used to assign specific causes of death (COD). Multinomial logistic regression analyses were conducted to identify associated sociodemographic factors, estimate adjusted ORs (AOR), 95% CIs and p values.
TB and HIV/AIDS were the leading CODs from infectious diseases, attributed to 9% and 8% of the total deaths, respectively.Young adults (25-34 years) had the highest proportion of deaths from TB (20%) and the risk of dying from TB among this age group was five times more likely than those aged 75+ years (AOR: 5.5 (95% CI 1.4 to 21.7)). Urban populations were 46% less likely to die from this disease compared rural ones although the difference was not significant (AOR: 0.54 (95% CI 0.3 to 1.0)). People from middle household wealth quintile were three times more likely to die from TB than those in the richest quintile (AOR: 3.0 (95% CI 1.3 to 7.4)).Young adults also had the highest proportion of deaths to HIV/AIDS (18%) and were nearly seven times more likely to die from this disease compared with those aged 75+years (AOR: 6.7 (95% CI 1.7 to 25.4)). Males were 48% less likely to die from HIV/AIDS than females (AOR: 0.52 (95% CI 0.3 to 0.9)). The risk of dying from HIV/AIDS in urban population was 54% less likely than their rural counterparts (AOR: 0.46 (95% CI 0.2 to 0.9)).
TB and HIV/AIDS interventions are needed to target vulnerable populations to reduce premature mortality from these diseases in PNG.
结核病（TB）和艾滋病是巴布亚新几内亚（PNG）的公共卫生关注点。本研究探讨了 PNG 中结核病和艾滋病的死亡率及其相关社会人口因素。
作为一项纵向研究的一部分，使用世卫组织 2016 年的死因推断工具进行了口头尸检（VA）访谈，以收集 2018 年至 2020 年期间综合卫生和流行病学监测系统集水区内社区中发生的 926 例死亡病例的数据。使用 InterVA-5 死因分析工具来分配特定的死因。进行多项逻辑回归分析以确定相关的社会人口因素，估计调整后的比值比（AOR）、95%置信区间（CI）和 P 值。
结核病和艾滋病是传染病的主要死因，分别占总死亡人数的 9%和 8%。年轻人（25-34 岁）死于结核病的比例最高（20%），且该年龄段死于结核病的风险是 75 岁以上人群的五倍（AOR：5.5（95%CI 1.4 至 21.7））。与农村地区相比，城市人口死于这种疾病的风险低 46%，尽管差异不显著（AOR：0.54（95%CI 0.3 至 1.0））。来自中等家庭财富五分位数的人死于结核病的可能性是最富裕五分位数的人的三倍（AOR：3.0（95%CI 1.3 至 7.4））。年轻人也有最高比例的艾滋病死亡（18%），与 75 岁以上的人相比，死于这种疾病的风险几乎高出七倍（AOR：6.7（95%CI 1.7 至 25.4））。男性死于艾滋病的风险比女性低 48%（AOR：0.52（95%CI 0.3 至 0.9））。与农村地区相比，城市人口死于艾滋病的风险低 54%（AOR：0.46（95%CI 0.2 至 0.9））。
需要针对脆弱人群开展结核病和艾滋病干预措施，以减少 PNG 中这些疾病导致的过早死亡。
