Evidence map›Paper›PMID 38589045›Full record

ArticleBMJ global health2024

Mortality variability and differentials by age and causes of death in rural South Africa, 1994-2018.

Brian Houle, Chodziwadziwa Kabudula, Sanyu A Mojola, Nicole Angotti, Francesc Xavier Gómez-Olivé, Dickman Gareta, Kobus Herbst, Samuel J Clark, Jane Menken, Vladimir Canudas-Romo

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
4.4field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. The Strength of Long-Distance Ties for Aging Healthy With HIV: The Case of Rural South Africa.The journals of gerontology. Series B, Psychological sciences and social sciences · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 3 countries.

Brian HouleSchool of Demography, The Australian National University, Acton, Australian Capital Territory, Australia brian.houle@anu.edu.au.ORCID http://orcid.org/0000-0003-2157-3118
Chodziwadziwa KabudulaMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.ORCID http://orcid.org/0000-0002-5867-0336
Sanyu A MojolaMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Nicole AngottiMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Francesc Xavier Gómez-OlivéMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Dickman GaretaAfrica Health Research Institute, Durban, KwaZulu-Natal, South Africa.ORCID http://orcid.org/0000-0002-4004-5655
Kobus HerbstAfrica Health Research Institute, Durban, KwaZulu-Natal, South Africa.
Samuel J ClarkMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Jane MenkenMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Vladimir Canudas-RomoSchool of Demography, The Australian National University, Acton, Australian Capital Territory, Australia.ORCID http://orcid.org/0000-0001-6532-0089
University of the Witwatersrand · ZAAfrica Health Research Institute · ZAAustralian National University · AUAmerican University · USUniversity of Colorado Boulder · US

Funding

Partnership for Social Science AIDS Research in South African's Era of ART RollouR24AG032112 · NIA · UNIVERSITY OF COLORADO · PI MENKEN, JANE A · 2007 to 2011
$1.6M
HIV after 40 in Rural South Africa: Aging in the Context of an HIV/AIDS EpidemicR01AG049634 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MOJOLA, SANYU AMIMO · 2016 to 2020
$1.3M
Predicting Impacts of Infectious Disease on Structure and Dynamics of PopulationsK01HD057246 · NICHD · UNIVERSITY OF WASHINGTON · PI CLARK, SAMUEL J · 2008 to 2012
$620k
NIA NIH HHS R01 AG049634NIA NIH HHS R24 AG032112NICHD NIH HHS K01 HD057246Wellcome Trust
6 · The paper itself

Abstract

introductionUnderstanding mortality variability by age and cause is critical to identifying intervention and prevention actions to support disadvantaged populations. We assessed mortality changes in two rural South African populations over 25 years covering pre-AIDS and peak AIDS epidemic and subsequent antiretroviral therapy (ART) availability.

methodsUsing population surveillance data from the Agincourt Health and Socio-Demographic Surveillance System (AHDSS; 1994-2018) and Africa Health Research Institute (AHRI; 2000-2018) for 5-year periods, we calculated life expectancy from birth to age 85, mortality age distributions and variation, and life-years lost (LYL) decomposed into four cause-of-death groups.

resultsThe AIDS epidemic shifted the age-at-death distribution to younger ages and increased LYL. For AHDSS, between 1994-1998 and 1999-2003 LYL increased for females from 13.6 years (95% CI 12.7 to 14.4) to 22.1 (95% CI 21.2 to 23.0) and for males from 19.9 (95% CI 18.8 to 20.8) to 27.1 (95% CI 26.2 to 28.0). AHRI LYL in 2000-2003 was extremely high (females=40.7 years (95% CI 39.8 to 41.5), males=44.8 years (95% CI 44.1 to 45.5)). Subsequent widespread ART availability reduced LYL (2014-2018) for women (AHDSS=15.7 (95% CI 15.0 to 16.3); AHRI=22.4 (95% CI 21.7 to 23.1)) and men (AHDSS=21.2 (95% CI 20.5 to 22.0); AHRI=27.4 (95% CI 26.7 to 28.2)), primarily due to reduced HIV/AIDS/TB deaths in mid-life and other communicable disease deaths in children. External causes increased as a proportion of LYL for men (2014-2018: AHRI=25%, AHDSS=17%). The share of AHDSS LYL 2014-2018 due to non-communicable diseases exceeded pre-HIV levels: females=43%; males=40%.

conclusionsOur findings highlight shifting burdens in cause-specific LYL and persistent mortality differentials in two populations experiencing complex epidemiological transitions. Results show high contributions of child deaths to LYL at the height of the AIDS epidemic. Reductions in LYL were primarily driven by lowered HIV/AIDS/TB and other communicable disease mortality during the ART periods. LYL differentials persist despite widespread ART availability, highlighting the contributions of other communicable diseases in children, HIV/AIDS/TB and external causes in mid-life and non-communicable diseases in older ages.

Indexed as

Acquired Immunodeficiency SyndromeHIV InfectionsNoncommunicable DiseasesAged, 80 and overCause of DeathChildFemaleHumansMaleSouth AfricaAIDSChild healthEpidemiologyHIVPublic Health

Identifiers

PMID38589045
PMCPMC11015189
OpenAlexW4394565962

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.