HIV/AIDS-Related Mortality in Addis Ababa City Administration
Creators: name: Araya, Tekebash
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2001

description: Measurement of the impact of HIV/AIDS on mortality is of fundamental importance to develop programmes to mitigate the effects of the epidemic in Ethiopia, similar to other countries in sub- Saharan Africa. Little is known about the HIV/AIDS-related mortality in the general population of the country and especially in Addis Ababa. A prospective surveillance of deaths at burials in Addis Ababa is initiated, since information on vital events in Ethiopia, as in most of sub-Saharan Africa, is defective. In this study, verbal autopsy (VA) and clinician review techniques were used to assess the cause specific mortality (CSM) in general and HIV/AIDS-related mortality in particular, in the general population of Addis Ababa. Since February 8, 2001 a prospective surveillance started at all the available and functioning burial sites (n=70) in the rural and urban localities of Addis Ababa, collecting information on name, sex, age, address, date of burial and presumed cause of death of the deceased. Burial sites included: all 51 orthodox churchyards, eight mosque-based, seven municipal-based, two community-based "Yesenbete mahber", one catholic-based, and one Jewish "Bete-Israel" cemetery. Verbal autopsy (VA) was conducted at 414 selected households, three to four months after death, involving 10 teams of two interviewers. Two independent clinicians reviewed and assessed the VA questionnaires and assigned causes of death. Hospital records for those who died in Addis Ababa hospitals were traced and assessed and compared with VA-derived causes of death. In three months, 5,133 deaths were registered (45% females and 55% males). The CDR was estimated yielding to 8.23 per 1000 population per year. Neonatal mortality and infant mortality was 29/1000 and 42/1000 live births, respectively. For females, the peak percentage of deaths was 11% in the age group 25-29 years, whereas for males the peak percentage of deaths was 9.6% in the age group 35-39 years. A total of 414 deaths were selected for VA: 44, 108 and 262 for neonates, children and adults, respectively. Response rate for the three age strata ranged between 66-76%. The major cause of death was TB/HIV/AIDS-related disease in 127 deaths (41.4%) of which 96 deaths (48%) were adults and 31 deaths (29.0%) were under-12 year olds. Of the 96 (48%) adult deaths due to TB/HIV/AIDS, 48 (50%) were males and 48 (50%) females, with a male to female ratio of 1:1. Being single and age group of 60-69 years showed significantly higher risk of mortality due to TB/HIV/AIDS. In the absence of vital events registration in Addis Ababa, surveillance for burials appeared to be a good method to estimate mortality. Through VA and physician review, the impact of TB/HIV/AIDS on mortality was estimated. Although epidemiological models revealed similar estimates, counting of deaths and providing numbers of the Addis Ababa population that die of TB/HIV/AIDS may stimulate better policy makers and public health workers to act immediately to this devastating epidemic. It is recommended that the surveillance for burials should continue for long-term basis, as it may provide additional information on mortality (i.e. seasonal variation, and geographic differences within Addis Ababa), and may also allow for analysis of mortality trends