Sharp rise in deaths in South Africa is largely due to AIDS
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《英国医生杂志》
New statistics from the South African government show a 57% increase in the number of deaths between 1997 and 2002. Government statisticians believe that a large proportion of the increase is attributable to AIDS.
The figures have been produced by the country抯 statistician general of statistics, Pali Lehohla, whose own job is said to be under threat over a series of blunders in other statistical reports. Her position is thought to have been weakened further because this latest report is likely to embarrass President Thabo Mbeki, who has been ambivalent about dealing with the HIV and AIDS epidemic.
In people over 15 years old deaths increased by 62% over the period. The age group with the largest increase was 30 to 34 year olds, in whom the number of deaths more than doubled, from 18 903 to 46 758. A sharp increase over the same period also occurred in children aged under 4 years old, from 34 779 to 48 572 deaths.
Ms Lehohla said the data "provided indirect evidence that the HIV epidemic in South Africa is raising the mortality levels of prime aged adults, in that associated diseases are on the increase." Population growth would account for about 10% of the growth, according to the report.
One of the major challenges facing the statisticians compiling the data was the fact that deaths in South Africa are not always registered and that death certificates, when issued, do not accurately reflect the cause of death. For a variety of reasons (stigma, ignorance, insurance problems) the cause is often not put down by the certifying doctor as HIV or AIDS but is given as one of the common opportunistic infections associated with HIV infection. The number of death registrations has, however, increased in recent years.
The study reports: "It should be noted that the number of deaths which had tuberculosis or influenza and pneumonia as one of the reported causes, increased substantially over the period." (Influenza and pneumonia are treated as one category.)
In 1997, 1999, and 2001 the leading causes of death among people between the ages of 15 and 49 were tuberculosis, HIV, and influenza and pneumonia.
The three leading causes of death in children aged under 4 years were intestinal infectious diseases, malnutrition, and influenza and pneumonia. Medical statisticians say that the trend in these figures is an indication of the effects of the AIDS epidemic.
The focus of news reports in South Africa has been on the AIDS epidemic. But the study also clearly shows an increase in deaths from "lifestyle" diseases, such as heart disease and diabetes.
It is widely believed in South Africa by critics of President Mbeki that the government statistics department, known as Stats SA, was urged to collect the death statistics to prove the government抯 view that the facts of the HIV and AIDS epidemic were overstated. The department famously produced figures about three years ago that the president used to conclude that violence was a leading cause of death in the country rather than AIDS.
Conscious that their figures will be doubted, statisticians at Stats SA are willing to supply the raw data on CD to researchers to study the figures and methods by which the conclusions were reached.(Johannesburg Pat Sidley)
The figures have been produced by the country抯 statistician general of statistics, Pali Lehohla, whose own job is said to be under threat over a series of blunders in other statistical reports. Her position is thought to have been weakened further because this latest report is likely to embarrass President Thabo Mbeki, who has been ambivalent about dealing with the HIV and AIDS epidemic.
In people over 15 years old deaths increased by 62% over the period. The age group with the largest increase was 30 to 34 year olds, in whom the number of deaths more than doubled, from 18 903 to 46 758. A sharp increase over the same period also occurred in children aged under 4 years old, from 34 779 to 48 572 deaths.
Ms Lehohla said the data "provided indirect evidence that the HIV epidemic in South Africa is raising the mortality levels of prime aged adults, in that associated diseases are on the increase." Population growth would account for about 10% of the growth, according to the report.
One of the major challenges facing the statisticians compiling the data was the fact that deaths in South Africa are not always registered and that death certificates, when issued, do not accurately reflect the cause of death. For a variety of reasons (stigma, ignorance, insurance problems) the cause is often not put down by the certifying doctor as HIV or AIDS but is given as one of the common opportunistic infections associated with HIV infection. The number of death registrations has, however, increased in recent years.
The study reports: "It should be noted that the number of deaths which had tuberculosis or influenza and pneumonia as one of the reported causes, increased substantially over the period." (Influenza and pneumonia are treated as one category.)
In 1997, 1999, and 2001 the leading causes of death among people between the ages of 15 and 49 were tuberculosis, HIV, and influenza and pneumonia.
The three leading causes of death in children aged under 4 years were intestinal infectious diseases, malnutrition, and influenza and pneumonia. Medical statisticians say that the trend in these figures is an indication of the effects of the AIDS epidemic.
The focus of news reports in South Africa has been on the AIDS epidemic. But the study also clearly shows an increase in deaths from "lifestyle" diseases, such as heart disease and diabetes.
It is widely believed in South Africa by critics of President Mbeki that the government statistics department, known as Stats SA, was urged to collect the death statistics to prove the government抯 view that the facts of the HIV and AIDS epidemic were overstated. The department famously produced figures about three years ago that the president used to conclude that violence was a leading cause of death in the country rather than AIDS.
Conscious that their figures will be doubted, statisticians at Stats SA are willing to supply the raw data on CD to researchers to study the figures and methods by which the conclusions were reached.(Johannesburg Pat Sidley)