title: Impact of AIDS on adult mortality: a morgue-based study in Pointe-Noire, Republic of Congo.
abstract: OBJECTIVE
  To measure the impact of AIDS on adult mortality by systematically investigating all deaths during 3 months, in the city of Pointe-Noire where the HIV epidemic emerged 20 years ago and levelled-off around 5% among adults.
  
  
  METHODS
  : Exhaustive morgue-based study, in a city where by law all bodies should be registered at the morgue before they can be legally buried.
  
  
  METHODS
  From 30 June to 19 October 2001, a clinical examination of all bodies registered at the morgue was performed by a physician, and blood samples were systematically drawn for HIV testing. Relatives were interviewed on circumstances of death. Additional information was gathered from hospital files for cases previously hospitalized. Age- and sex-specific mortality rates were calculated using the population at risk derived from the 2001 census.
  
  
  RESULTS
  Overall, 1309 adult deaths were investigated and 96.5% of the bodies registered at the morgue were tested for HIV. Forty-five percent of the deaths (570) were due to AIDS. The HIV prevalence was higher in female than in male deaths (57.1 versus 44.8%; P < 0.001). The AIDS-mortality rate among adults was 6.3 per thousand for women and 4.9 per thousand for men. Among 1000 young adults aged 15 years, 442 girls and 482 boys will not reach age 60 years (45q15). Without AIDS these would have been 216 and 307, respectively.
  
  
  CONCLUSIONS
  Our study provides a direct measure of the impact of AIDS on mortality relative to other causes. In the most productive age group, 25-44 years, mortality is tripled by AIDS.
authors.affiliation: Institut National d'Etudes Démographiques, Mortality, Health and Epidemiology Department, Paris, France. lecoeur@ined.fr
authors.forename: Sophie
authors.initials: S
authors.lastname: Le Coeur
authors.forename: Gaston
authors.initials: G
authors.lastname: Halembokaka
authors.forename: Myriam
authors.initials: M
authors.lastname: Khlat
authors.forename: Nicolas
authors.initials: N
authors.lastname: Brouard
authors.forename: Francke
authors.initials: F
authors.lastname: Purhuence
authors.forename: Pierre
authors.initials: P
authors.lastname: M'Pelé
authors.forename: Gaelle
authors.initials: G
authors.lastname: Baty
authors.forename: Francis
authors.initials: F
authors.lastname: Barin
authors.forename: Marc
authors.initials: M
authors.lastname: Lallemant
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods; D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001344:Autopsy; D002423:Cause of Death; D003223:Congo / Q000453:epidemiology; D003644:Death Certificates; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution