ArticleJournal of acquired immune deficiency syndromes (1999)2018
A Spatiotemporal Analysis of HIV-Associated Mortality in Rural Western Kenya 2011-2015.
Article in Journal of acquired immune deficiency syndromes (1999), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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10 authors.
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Abstract
backgroundReliable data on the HIV epidemic is critical for the measurement of the impact of HIV response and for the implementation of further interventions.
methodsWe used mortality data from the Kombewa health and demographic surveillance systems (HDSS) from January 1, 2011 to December 31, 2015 to examine the space-time pattern of HIV-associated mortality. HIV mortality rate was calculated per 1000 persons living with HIV (for comparison with regional and national averages) and per 1000 person-years (p-y) for comparison with data from other HDSS sites. We used the Optimized Hot Spot Analysis to examine whether HIV-associated deaths would form statistically significant local aggregation in the 5-year period. P-value of <0.05 and <0.01 was considered significant.
resultsThe HIV-associated mortality rate over the 5-year period was 9.8 per 1000 persons living with HIV (PLHIV). Mortality declined from 11.6 per 1000 PLHIV in 2011 to 7.3 per 1000 PLHIV by the end of 2015. The rates of HIV were highest among infants [hazard ratio (HR) = 2.39 (<0.001)]. Tuberculosis mortality rates were highest in the age group 5-14 years [HR = 2.29 (0.002)] and the age group 50-64 years [HR = 1.18 (0.531)]. The overall trend in HIV-associated mortality showed a decline from 1.8 per 1000 p-y in 2011 to 1.3 per 1000 p-y by the end of 2015. The hotspot analysis showed that 20.0% of the study area (72 km) was detected as hotspots (Z = 2.382-3.143, P ≤ 0.001) and 4.2% of the study area as cold spots (15 km).
conclusionsHIV attributable death in the HDSS population is substantial, although it is lower than both the national and the regional estimates.
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