Fewer South Africans dying of HIV/AIDS, but more of diabetes

Released in the Free State yesterday morning (THURSDAY), the Statistics SA report Mortality and causes of death in South Africa, 2010: Findings from death notification, records and analyses deaths reported in 2010 as it is written on death certificates completed by doctors and others certified to do so. The findings were released in Thabo Mofutsanyane district in Phuthaditjhaba, which recorded the highest death rate in the country.

KwaZulu-Natal and Gauteng had the highest overall number of deaths in 2010.

In summary, the number of deaths processed by Stats SA in 2010 was 543 856, a 6.2% decline from the year before with the highest number of deaths among those aged 35-39 and 30-34. Overall, there were slightly more male than female deaths.

In 2010, the average age at death was estimated at around 48 years, which has increased by about five years since 2004.

Tuberculosis was the leading cause of death (11.6%), a spot it has held for a number of years. Influenza and pneumonia is in second spot followed by intestinal infectious diseases. However, the number of deaths attributed to these three conditions has consistently and significantly decreased, while those due to diabetes are increasing ‘€“ 3,8% in 2010.

Looking at the report from an HIV point-of-view, University of Cape Town (UCT) actuary and epidemiologist Leigh Johnson, says the report shows evidence of continued declines in HIV-related mortality, which is likely to be a reflection of the success of the antiretroviral treatment programme. ‘€œAlthough there has been a slight increase in the number of deaths that are recorded as being due to HIV when comparing 2010 to 2009, there have been very substantial reductions in deaths reported as being due to TB, pneumonia, influenza and intestinal infectious diseases,’€ says Johnson.

These three diseases are causes to which HIV deaths are most frequently mis-attributed, in other words they are recorded as such on death certificates instead of being noted as HIV deaths.

Johnson notes that there have also been relatively large reductions in mortality in young adults (roughly 30% reduction in overall mortality rates in the 30-39 age group between 2006 and 2010). ‘€œAll of this is consistent with what we would expect with declining AIDS mortality,’€ Johnson adds.

Rob Dorrington, Professor of Actuarial Science at UCT says it is ‘€œgood’€ that the report has been released because mortality rates and patterns are changing quite rapidly, particularly due to the huge increase in the provision of antiretrovirals.

In addition estimates of mortality rates are important for checking the sensibleness of the 2011 census results.

However, he expressed concern that the report is almost five months late. ‘€œThis is only acknowledged deep within the report and the explanation for the delay (as ‘€œimprovements in data processing methodology and processing systems’€) leaves one worrying about when future reports will become available.’€

Dorrington agrees with Johnson that it is ‘€œhugely apparent’€ that HIV/AIDS deaths are hidden as a cause of death, which distorts the interpretation of rankings of the causes of deaths hugely ‘€“ not only contributing to the ranking of TB at the top of the causes, but also contributing to the high ranking of some other causes.

Dorrington said that although the total number of deaths has fallen, much as expected, the numbers of deaths have increased in the 1-14 age range and the 80-84 age group (particularly for females).

‘€œAlthough the report acknowledges that not all deaths in South Africa are captured by the system, the estimate of 93% completeness that they cite applies only to adults. A higher percentage of child deaths, particularly those under age 5 go unregistered,’€ Dorrington points out.

The report also reveals that almost half of the deaths took place in health facilities. Free States and North West had the highest proportion of children dying in infancy while Western Cape and Eastern Cape had the highest proportions of deaths occurring in old ages. ‘€“ Health-e News Service


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