title: The impact of HIV/AIDS on mortality and household mobility in rural Tanzania.
abstract: OBJECTIVE
  To assess the impact of the AIDS epidemic on mortality and household mobility before and after death.
  
  
  METHODS
  Open community cohort study with a demographic surveillance system and two sero-epidemiological surveys.
  
  
  METHODS
  Ten rounds of demographic surveillance were completed during 1994-1998 in the study area, which has a population of about 20 000 people in a rural ward in north-west Tanzania. Households with deaths were visited for a detailed interview, including a verbal autopsy. Data on HIV status were collected in two surveys of all residents aged 15-44 years.
  
  
  RESULTS
  Mortality rates among HIV-infected adults were 15 times higher than those among HIV-negative adults and HIV/AIDS was associated with nearly half of deaths at ages 15-44 years. Verbal autopsies without HIV test results considerably underestimated the proportion of deaths associated with HIV/AIDS. The mortality probability between 15 and 60 years was 49% for men and 46% for women and life expectancy was 43 years for men and 44 years for women. By their second birthday nearly one-quarter of the newborns of HIV-infected mothers had died, which was 2.5 times higher than among children of HIV-negative mothers. Mobility of household members before and after death was high. In 44% of households in which the head died all members moved out of the household.
  
  
  CONCLUSIONS
  In this rural population with HIV prevalence close to 7% among adults aged 15-44 years during the mid-1990s, HIV/AIDS is having substantial impact on adult mortality. A common response to death of a head of household in this community is household dissolution, which has implications for measurement of the demographic and socio-economic impact of AIDS.
authors.affiliation: National Institute for Medical Research, Mwanza, Tanzania
authors.forename: M
authors.initials: M
authors.lastname: Urassa
authors.forename: J T
authors.initials: JT
authors.lastname: Boerma
authors.forename: R
authors.initials: R
authors.lastname: Isingo
authors.forename: J
authors.initials: J
authors.lastname: Ngalula
authors.forename: J
authors.initials: J
authors.lastname: Ng'weshemi
authors.forename: G
authors.initials: G
authors.lastname: Mwaluko
authors.forename: B
authors.initials: B
authors.lastname: Zaba
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004641:Emigration and Immigration; D005191:Family Characteristics; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000401:mortality*; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D013636:Tanzania / Q000453:epidemiology
chemical_list: D015483:HIV Antibodies