Gregson S, Anderson R M, Ndlovu J, Zhuwau T, Chandiwana S K
Wellcome Trust Centre for the Epidemiology of Infectious Disease, Zoology Department, Oxford University, UK.
AIDS. 1997 Aug;11(10):1269-80. doi: 10.1097/00002030-199710000-00011.
To describe recent mortality trends in rural Zimbabwe and to assess the impact of HIV-1 infection.
Comparative, cross-sectional, retrospective, demographic survey with 1-year follow-up. Parallel HIV-1 surveillance. Comparison of results with 1992 national census and vital registration data and results from mathematical model-based population projections.
Residents of 929 (745 revisited in 1995) households in two rural areas of Manicaland Province, Zimbabwe, with contrasting HIV-1 prevalence: Honde and Rusitu valleys. Subjects gave information on parental survival for 2320 resident children. Female residents aged 13-49 years (n = 1237) provided information on birth histories and child survival. Consenting women attending local antenatal clinics (n = 487) provided blood samples for HIV-1 screening and demographic information.
HIV-1 prevalence in pregnant women; per capita death registration rates; incidence of parental death for children aged under 8 years; infant mortality and age-specific death probabilities.
HIV-1 prevalence was high in each study area. Death registration and age-specific mortality have begun to rise. The largest increases were seen in the area of higher HIV-1 prevalence (Honde) and among younger adults, particularly men. Incidence of parental death was observed to be rising. Increases in registered deaths were concentrated among HIV-1-associated causes.
The observed increases in mortality by age, sex and cause of death were consistent with those expected early in a severe HIV-1 epidemic, on the basis of mathematical model projections and observations elsewhere in Africa. Further rises in mortality, particularly among women and young children, and consequent increases in orphanhood, are to be expected in rural areas of Zimbabwe.
描述津巴布韦农村地区近期的死亡率趋势，并评估人类免疫缺陷病毒1型（HIV-1）感染的影响。
进行为期1年随访的比较性、横断面、回顾性人口统计学调查。并行开展HIV-1监测。将结果与1992年全国人口普查及人口动态登记数据以及基于数学模型的人口预测结果进行比较。
津巴布韦马尼卡兰省两个农村地区929户家庭的居民（1995年对其中745户进行了回访），这两个地区HIV-1流行率存在差异：洪德谷和鲁西图谷。受试者提供了2320名常住儿童的父母生存情况信息。13至49岁的女性居民（n = 1237）提供了生育史和儿童生存情况信息。同意参与的当地产前诊所就诊女性（n = 487）提供了用于HIV-1筛查的血样和人口统计学信息。
孕妇中的HIV-1流行率；人均死亡登记率；8岁以下儿童父母的死亡发生率；婴儿死亡率和特定年龄的死亡概率。
每个研究地区的HIV-1流行率都很高。死亡登记和特定年龄死亡率开始上升。HIV-1流行率较高的地区（洪德）以及较年轻成年人，尤其是男性中增幅最大。观察到父母死亡发生率在上升。登记死亡人数的增加集中在与HIV-1相关的病因中。
根据数学模型预测和非洲其他地区的观察结果，观察到的按年龄、性别和死因划分的死亡率上升与严重HIV-1疫情早期预期的情况一致。预计津巴布韦农村地区的死亡率将进一步上升，尤其是妇女和幼儿中的死亡率，孤儿数量也会随之增加。
