Mortality impact of AIDS in Addis Ababa, Ethiopia.
OBJECTIVE
To measure the impact of HIV on mortality in Addis Ababa, Ethiopia.


METHODS
A retrospective review of burials at three cemeteries, 1987-2001 and a prospective surveillance of burials at all (n = 70) cemeteries, February-May, 2001.


METHODS
The age, sex, and date of burial were recorded; in the absence of denominators, we compared the ratio of deaths of persons 25-49 versus 5-14 years of age per calendar year, using logistic regression, adjusting for sex and site. The age- and sex- specific mortality were calculated and compared with pre-HIV mortality in 1984.


RESULTS
Of 17,519 deaths, retrospectively reviewed, complete data were available for 6342 (47%) females and 7269 (53%) males. During 1987-2001, the '25-49' versus '5-14' group all-cause mortality ratio increased by 8.5% per calendar year (P < 0.05). A total of 5101 deaths were recorded in the prospective surveillance. Crude mortality rates were 9.5/1000 per year (men) and 7.1/1000 per year (women). In comparison with 1984, 5.0-times as many men and 5.3-times as many women died in the age group 35-39 years. Attributing the increase in mortality in ages 15-60 to HIV in the period 1984-2001, Ethiopian men and women have a probability of 18.8 and 17.8%, respectively, of dying of HIV before age 60.


CONCLUSIONS
Burials increased significantly among the '25-49', versus the '5-14' group, during the period 1987-2001. This trend, and a five-times higher mortality in 2001 than in 1984 in those aged 35-39 years demonstrate a severe impact of HIV on mortality. Continuing surveillance of burials is recommended.
Sanders
Eduard J
EJ
Ethio-Netherlands AIDS Research Project, Ethiopian Health and Nutrition Research Institute, Addis Ababa University, Addis Ababa, Ethiopia. Eduard@enarp.com
Araya
Tekebash
T
Kebede
Derege
D
Schaap
Ab J
AJ
Nagelkerke
Nico D
ND
Coutinho
Roel A
RA
D000163:Acquired Immunodeficiency Syndrome / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003644:Death Certificates; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011446:Prospective Studies; D012189:Retrospective Studies; D017678:Sex Distribution