Poster presented at AIDS 2014.

1. Stanley Kamocha1 ■ Robert Mswia2 ■ Peter Chipimo1 ■ Sheila S. Mudenda3 ■ Palver Sikanyiti3 ■ Fatma Soud1 ■ Melissa A. Marx1
1Centers for Disease Control and Prevention, Zambia ■ 2MEASURE Evaluation, U.S.A ■ 3Central Statistical Office, Zambia.
HIV Remains a Key Killer in Zambia: Results
of Community-Based Mortality Surveillance
Methods
• Mortality data was collected using the Sample Vital
Registration with Verbal Autopsy (SAVVY) methods.
• A census was conducted in 76 clusters chosen by stratified
cluster-sampling in January 2011.
• Data were collected on the number of deaths in the year prior
to the census.
• Subsequently, trained interviewers conducted verbal autopsy
(VA) interviews with close relatives of those deceased.
• Additional deaths were identified prospectively for 12 months
and VA interviews were conducted for those deaths.
• Two physicians independently reviewed each VA
questionnaire to determine probable cause of death using the
ICD-10 coding principles.
Introduction
• Despite a decline in HIV prevalence from 2001 to 2009,
HIV/AIDS is still a burden, affecting the health and wellbeing
of the population in Zambia
• National data on mortality are not available due to a poorly
functioning vital statistics system.
• Among adults, diseases of circulatory system (11.8%) and
tuberculosis (9.3%) were the second and third leading causes
of death, respectively.
• HIV/AIDS was the third leading cause of death, after malaria,
accidents and injuries, among 5-14 year-olds and accounted
for 7.9% of deaths in all age groups.
• Among children under five, HIV/AIDS accounted for 7.3% of
all deaths.
• HIV/AIDS is the leading cause of death in Zambia,
contributing about 20% of all deaths for males and females.
Figure 2: HIV Specific Causes of Death in Zambia 2010-12 (%)
Acknowledgments
We would like to acknowledge the following:
• Central Statistical Office for conducting the survey
• The Centers for Disease Control and Prevention (CDC) for financial and technical support
• MEASURE Evaluation for the technical assistance
Presented at AIDS 2014 – Melbourne, Australia
Conclusions
• HIV/AIDS remains the leading cause of death in Zambian
adults.
• HIV/AIDS is the third leading cause of death for children >5
years of age.
• It accounts for over 7% of deaths in children <5 years of age.
1.6
16.6
33.8
46.6
1.6
14
33.3
51.1
0 10 20 30 40 50 60
HIV disease resulting in other
conditions
Unspecified HIV disease
HIV disease resulting in other specific
diseases
HIV disease resulting in infectious &
parasitic diseases
Urban
Rural
Figure 3: Causes of Death for Indirect HIV Deaths in Zambia
2010-12 (%)
Policy Implications
• Interventions to improve access to ARVs and palliative care
need to continue to receive support throughout Zambia.
• Community-based mortality surveillance can be used to
collect HIV/AIDS mortality data in settings where vital and
particularly death registration is incomplete.
Literature Cited
Central Statistical Office [Zambia], Central Board of Health [Zambia], and ORC Macro. 2003.
Zambia Demographic and Health Survey 2001-2002. Calverton, Maryland, USA: Central
Statistical Office, Central Board of Health, and ORC Macro.
Central Statistical Office (CSO), Ministry of Health (MOH), Tropical Diseases Research Centre
(TDRC), University of Zambia and Macro International Inc. 2009. Zambia Demographic and
Health Survey 2007. Calverton, Maryland, USA: CSO and Macro International Inc.
Central Statistical Office (CSO) 2014 , Sample Vital Registration with Verbal Autopsy, 2010-12.
Lusaka, Zambia.
Figure 1: Leading Causes of Death in Zambia 2010-12 (%)
Contact Information
Sheila S. Mudenda sheila_sms@yahoo.com
Palver Sikanyiti mpalver12000@yahoo.com
Stanley Kamocha hod5@cdc.gov
Objective
• To describe the leading cause of death using community-
based mortality surveillance data.
Results
• The census covered 176,226 residents of whom 48.8% were
male. The mean age was 20.5 years (SE=0.15).
• Of the 2,750 people who died within the reference period
(15.6/1,000), 1,472 (53.5%) were male; 1,705 (62.0%) were
adults (15 years and older), 143 (5.2%) were 5-14 year-olds,
and 902 (32.8%) were 0-4 year olds.
• HIV/AIDS was the leading cause of death among adults
accounting for 484 deaths (28.4% of all deaths).
• Over half of all deaths (245, 50.6%) were among men and
239 deaths (49.4%) were among women.
Poster Number: PE100
5.0
9.9
1.2
1.3
1.5
1.8
2.4
3.1
3.8
5.6
5.7
5.9
6.2
6.5
9.8
10.9
19.3
4.3
10.2
1.5
0.4
1.6
2.3
1.4
3.1
3.2
4.1
4.8
4.9
9.0
5.9
5.3
4.4
12.2
21.5
25 20 15 10 5 0 5 10 15 20 25
Ill-defined & undetermined causes
All other remaining causes
Maternal causes
Disorders of the kidney
Meningitis
Senility/Old age
Diabetes mellitus
Neoplasms
Stillbirth
Diarrhoeal diseases
Perinatal and neonatal conditions
Pneumonia/ARI
Diseases of the circulatory system
Tuberculosis
Malnutrition
Injuries & Accidents
AFI / Malaria
HIV-related diseases
Females
Males
4.2
3.9
4.0
4.0
4.0
4.3
4.3
8.0
8.1
11.1
11.4
11.5
21.3
0 10 20 30
Ill-defined causes
Tuberculosis
Disorders of the kidney
Diarrhoeal diseases
Diseases of oesophagus/stomach/duodenum
Remainder of infect. & parasitic diseases
Other specified perinatal
Pneumonia/ARI
AFI/Malaria
Diseases of the circulatory system
Maternal causes
Injuries & Accidents
Malnutrition