ArticleGlobal health action2014
Coming home to die? The association between migration and mortality in rural Tanzania before and after ART scale-up.
Article in Global health action, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Leveraging U = U in Interventions for Black Women Living With HIV: A Scoping Review and Call To Action.AIDS and behavior · 2025Review
- Male Fertility and Internal Migration in Rural and Urban Sub-Saharan Africa.European journal of population = Revue europeenne de demographie · 2023Article
- Investigating clinic transfers among HIV patients considered lost to follow-up to improve understanding of the HIV care cascade: Findings from a cohort study in rural north-eastern South Africa.PLOS global public health · 2022Article
- Prevalence of Untreated HIV and Associated Risk Behaviors Among the Sexual Partners of Recent Migrants and Long-term Residents in Rakai, Uganda.Journal of acquired immune deficiency syndromes (1999) · 2021Article
- Migration, hotspots, and dispersal of HIV infection in Rakai, Uganda.Nature communications · 2020Article
- Delayed Disclosure of HIV Status and Lack of Resources Affect Older Persons during Care of Adult Family Members with AIDS-Related Illness in Rural Mpumalanga, South Africa.Current gerontology and geriatrics research · 2020Article
- Association between internal migration and epidemic dynamics: an analysis of cause-specific mortality in Kenya and South Africa using health and demographic surveillance data.BMC public health · 2018Article
- Mortality, Work and Migration. A Consideration of Age-specific Mortality from Tuberculosis in Scotland, 1861-1901.Historical life course studies · 2018Article
- Measuring HIV-related mortality in the first decade of anti-retroviral therapy in sub-Saharan Africa.Global health action · 2014Article
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3 authors.
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Abstract
backgroundPrior to the scale-up of antiretroviral therapy (ART), demographic surveillance cohort studies showed higher mortality among migrants than residents in many rural areas.
objectivesThis study quantifies the overall and AIDS-specific mortality between migrants and residents prior to ART, during ART scale-up, and after widespread availability of ART in Rufiji district in Tanzania.
designIn Health and Demographic Surveillance System (HDSS), the follow-up of individuals aged 15-59 years was categorized into three periods: before ART (1998-2003), during ART scale-up (2004-2007), and after widespread availability of ART (2008-2011). Residents were those who never migrated within and beyond HDSS, internal migrants were those who moved within the HDSS, and external migrants were those who moved into the HDSS from outside. Mortality rates were estimated from deaths and person-years of observations calculated in each time period. Hazard ratios were estimated to compare mortality between migrants and residents. AIDS deaths were identified from verbal autopsy, and the odds ratio of dying from AIDS between migrants and residents was estimated using the multivariate logistic regression model.
resultsInternal and external migrants experienced higher overall mortality than residents before the introduction of ART. After widespread availability of ART overall mortality were similar for internal and external migrants. These overall mortality experiences observed were similar for males and females. In the multivariate logistic regression model, adjusting for age, sex, education, and social economic status, internal migrants had similar likelihood of dying from AIDS as residents (adjusted odds ratio [AOR]=1.14, 95% confidence interval [CI]: 0.70-1.87) while external migrants were 70% more likely to die from AIDS compared to residents prior to the introduction of ART (AOR=1.70, 95% CI: 1.06-2.73). After widespread availability of ART with the same adjustment factors, the odds of dying from AIDS were similar for internal migrants and residents (AOR=1.56, 95% CI: 0.80-3.04) and external migrants and residents (AOR=1.42, 95% CI: 0.76-2.66).
conclusionsAvailability of ART has reduced the number of HIV-infected migrants who would otherwise return home to die. This has reduced the burden on rural communities who had cared for the return external migrants.
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