Objective: To measure the impact of HIV on mortality in Addis Ababa, Ethiopia. Design: A retrospective review of burials at three cemeteries, 1987-2001 and a prospective surveillance of burials at all (n = 70) cemeteries, February-May, 2001. Methods: The age, sex, and date of burial were recorded; in the absence of denominators, we compared the ratio of deaths of persons 25-49 versus 5-14 years of age per calendar year, using logistic regression, adjusting for sex and site. The age- and sex- specific mortality were calculated and compared with pre-HIV mortality in 1984. Results: Of 17 519 deaths, retrospectively reviewed, complete data were available for 6342 (47%) females and 7269 (53%) males. During 1987-2001, the '25-49' versus '5-14' group all-cause mortality ratio increased by 8.5% per calendar year (P < 0.05). A total of 5101 deaths were recorded in the prospective surveillance. Crude mortality rates were 9.5/1000 per year (men) and 7.1/1000 per year (women). In comparison with 1984, 5.0-times as many men and 5.3-times as many women died in the age group 35-39 years. Attributing the increase in mortality in ages 15-60 to HIV in the period 1984-2001, Ethiopian men and women have a probability of 18.8 and 17.8%, respectively, of dying of HIV before age 60. Conclusion: Burials increased significantly among the '25-49', versus the '5-14' group, during the period 1987-2001. This trend, and a five-times higher mortality in 2001 than in 1984 in those aged 35-39 years demonstrate a severe impact of HIV on mortality. Continuing surveillance of burials is recommended.

Africa, AIDS mortality, Burial, Cemetery, Ethiopia, HIV, Population surveillance
dx.doi.org/10.1097/00002030-200305230-00013, hdl.handle.net/1765/64976
AIDS
Erasmus MC: University Medical Center Rotterdam

Sanders, E.J, Araya, R, Kebede, D, Schaap, A, Nagelkerke, N.J.D, & Coutinho, R.A. (2003). Mortality impact of AIDS in Addis Ababa, Ethiopia. AIDS, 17(8), 1209–1216. doi:10.1097/00002030-200305230-00013