Pictet G, Le Coeur S, M'Pelé P, Brouard N, Lallemant M
Mortality, Health and Epidemiology Department, Institut National d'Etudes Démographiques, Paris, France.
AIDS. 1998 Nov 12;12(16):2217-23. doi: 10.1097/00002030-199816000-00018.
To accurately measure AIDS-related mortality relative to other causes and its impact on life expectancy in Brazzaville, Congo.
Investigation of all deaths during a 1-month period in Brazzaville.
From 10 July to 9 August 1996, all bodies handled by Brazzaville's three morgues were examined by a physician. Relatives were interviewed on the circumstances of death, while additional clinical data were gathered from hospital files. Blood samples were systematically drawn from the bodies in two of the three morgues and tested for HIV antibodies.
Amongst the 756 bodies examined at the three morgues, 149 (19.7%) AIDS cases were identified. HIV-1 prevalence was 26.2% (38 out of 145) amongst the subjects in the two morgues where HIV serology was systematically performed. AIDS was the leading cause of death in adults (age > or = 15 years), with 25.1% (122 out of 487) of the adults diagnosed with AIDS. The proportion of adult female AIDS cases was significantly higher than the proportion of male cases (30.2 versus 21.0%; P < 0.05). Moreover, female AIDS cases were significantly younger than male cases (median age, 32 versus 42 years; P < 0.00001). Overall AIDS mortality rate amongst adults was 2.8 per 1000 for men and 3.2 per 1000 for women. The impact of AIDS on life expectancy at birth is 4.3 years for women and 3.3 years for men.
Our study provides a direct measure of AIDS contribution to mortality relative to other causes, using a rapid, low cost, reliable and replicable method. Clearly, the impact of AIDS is strongest on female life expectancy.
准确衡量刚果布拉柴维尔地区与艾滋病相关的死亡率相对于其他死因的情况及其对预期寿命的影响。
对布拉柴维尔1个月内所有死亡病例进行调查。
1996年7月10日至8月9日，布拉柴维尔的三家停尸房接收的所有尸体均由一名医生进行检查。就死亡情况对亲属进行访谈，同时从医院档案中收集更多临床数据。在三家停尸房中的两家，对尸体系统采集血样并检测HIV抗体。
在三家停尸房检查的756具尸体中，确诊149例（19.7%）艾滋病病例。在系统进行HIV血清学检测的两家停尸房的受试者中，HIV-1感染率为26.2%（145例中的38例）。艾滋病是成年人（年龄≥15岁）的主要死因，487名成年人中有25.1%（122例）被诊断为艾滋病。成年女性艾滋病病例的比例显著高于男性病例（30.2%对21.0%；P<0.05）。此外，女性艾滋病病例比男性病例明显年轻（中位年龄，32岁对42岁；P<0.00001）。成年人中艾滋病总体死亡率男性为每1000人中有2.8例，女性为每1000人中有3.2例。艾滋病对出生时预期寿命的影响女性为4.3年，男性为3.3年。
我们的研究使用一种快速、低成本、可靠且可重复的方法，直接衡量了艾滋病相对于其他死因对死亡率的影响。显然，艾滋病对女性预期寿命的影响最为显著。
