Morbidity and mortality in South African gold miners: impact of untreated disease due to human immunodeficiency virus.
A cohort of 1792 human immunodeficiency virus (HIV)-positive and 2970 HIV-negative South African miners was observed for 12 months starting in February 1998. All-cause hospitalizations and deaths were significantly associated with HIV infection (respective unadjusted incidence rate ratios, 2.9 and 9.2; respective 95% confidence intervals, 2.5-3.4 and 5.5-16.0). Tuberculosis (TB), bacterial pneumonia, cryptococcosis, and trauma were the major causes of admission for HIV-positive patients, whereas Pneumocystis carinii pneumonia was an uncommon cause (respective admission rates, 8.5, 6.9, 2.2, 6.0, and 0.53 admissions per 100 person-years). Enteritis, bronchitis, urinary tract infections, and soft-tissue infections were also significantly associated with HIV infection. Cryptococcosis caused 44% of deaths among HIV-positive patients. Trauma was the main hazard for HIV-negative men, causing 42% of admissions and 60% of deaths. A broad range of infectious conditions is significantly associated with HIV infection in South African miners. Identification and implementation of effective prophylactic regimens are urgently needed.
Corbett
Elizabeth L
EL
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom. elc1@mweb.co.zw
Churchyard
Gavin J
GJ
Charalambos
Salome
S
Samb
Badara
B
Moloi
Vicky
V
Clayton
Tim C
TC
Grant
Alison D
AD
Murray
Jill
J
Hayes
Richard J
RJ
De Cock
Kevin M
KM
D000328:Adult; D015331:Cohort Studies; D017281:Cost of Illness; D006046:Gold; D006678:HIV; D015658:HIV Infections / Q000191:economics / Q000453:epidemiology / Q000401:mortality*; D006281:Health Occupations; D006760:Hospitalization; D006801:Humans; D009017:Morbidity; D009026:Mortality; D011446:Prospective Studies; D013019:South Africa / Q000453:epidemiology
D006046:Gold