{"title":"艾滋病毒感染者的死亡原因：埃斯瓦提尼五个医疗机构的经验教训。","authors":"Yves Mafulu, Sukoluhle Khumalo, Victor Williams, Sandile Ndabezitha, Elisha Nyandoro, Nkosana Ndlovu, Alexander Kay, Khetsiwe Maseko, Hlobsile Simelane, Siphesihle Gwebu, Normusa Musarapasi, Arnold Mafukidze, Pido Bongomin, Nduduzo Dube, Lydia Buzaalirwa, Nkululeko Dube, Samson Haumba","doi":"10.4102/sajhivmed.v25i1.1614","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Eswatini has a high HIV prevalence in adults and, despite being one of the first countries to achieve the UNAIDS 95-95-95 targets, AIDS-related deaths are still high.</p><p><strong>Objectives: </strong>This study describes the causes of death among people living with HIV (PLHIV) receiving care at five clinics in Eswatini.</p><p><strong>Method: </strong>A cross-sectional review of sociodemographic, clinical and mortality data of deceased clients who received care from 01 January 2021 to 30 June 2022, was conducted. Data were extracted from the deceased clients' clinical records, and descriptive and comparative analysis was performed.</p><p><strong>Results: </strong>Of 257 clients, 52.5% (<i>n</i> = 135) were male, and the median age was 47 years (interquartile range [IQR]: 38, 59). The leading causes of death were non-communicable diseases (NCDs) (<i>n</i> = 59, 23.0%), malignancies (<i>n</i> = 37, 14.4%), COVID-19 (<i>n</i> = 36, 14.0%), and advanced HIV disease (AHD) (<i>n</i> = 24, 9.3%). Clients who had been on antiretroviral therapy (ART) for 12-60 months (OR: 0.01; 95% confidence interval [CI]: 0.0006, 0.06) and > 60 months (OR: 0.006; 95% CI: 0.0003, 0.029) had lower odds of death from AHD compared to those on ART for < 12 months. Clients aged ≥ 40 years had higher odds of dying from COVID-19, while female clients (OR: 2.64; 95% CI: 1.29, 5.70) had higher odds of death from malignancy.</p><p><strong>Conclusion: </strong>Most clients who died were aged 40 years and above and died from NCD-related causes, indicating a need to integrate prevention, screening, and treatment of NCDs into HIV services. Specific interventions targeting younger PLHIV will limit their risk for AHD.</p>","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"25 1","pages":"1614"},"PeriodicalIF":0.0000,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538099/pdf/","citationCount":"0","resultStr":"{\"title\":\"Causes of death in people living with HIV: Lessons from five health facilities in Eswatini.\",\"authors\":\"Yves Mafulu, Sukoluhle Khumalo, Victor Williams, Sandile Ndabezitha, Elisha Nyandoro, Nkosana Ndlovu, Alexander Kay, Khetsiwe Maseko, Hlobsile Simelane, Siphesihle Gwebu, Normusa Musarapasi, Arnold Mafukidze, Pido Bongomin, Nduduzo Dube, Lydia Buzaalirwa, Nkululeko Dube, Samson Haumba\",\"doi\":\"10.4102/sajhivmed.v25i1.1614\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Eswatini has a high HIV prevalence in adults and, despite being one of the first countries to achieve the UNAIDS 95-95-95 targets, AIDS-related deaths are still high.</p><p><strong>Objectives: </strong>This study describes the causes of death among people living with HIV (PLHIV) receiving care at five clinics in Eswatini.</p><p><strong>Method: </strong>A cross-sectional review of sociodemographic, clinical and mortality data of deceased clients who received care from 01 January 2021 to 30 June 2022, was conducted. Data were extracted from the deceased clients' clinical records, and descriptive and comparative analysis was performed.</p><p><strong>Results: </strong>Of 257 clients, 52.5% (<i>n</i> = 135) were male, and the median age was 47 years (interquartile range [IQR]: 38, 59). The leading causes of death were non-communicable diseases (NCDs) (<i>n</i> = 59, 23.0%), malignancies (<i>n</i> = 37, 14.4%), COVID-19 (<i>n</i> = 36, 14.0%), and advanced HIV disease (AHD) (<i>n</i> = 24, 9.3%). Clients who had been on antiretroviral therapy (ART) for 12-60 months (OR: 0.01; 95% confidence interval [CI]: 0.0006, 0.06) and > 60 months (OR: 0.006; 95% CI: 0.0003, 0.029) had lower odds of death from AHD compared to those on ART for < 12 months. Clients aged ≥ 40 years had higher odds of dying from COVID-19, while female clients (OR: 2.64; 95% CI: 1.29, 5.70) had higher odds of death from malignancy.</p><p><strong>Conclusion: </strong>Most clients who died were aged 40 years and above and died from NCD-related causes, indicating a need to integrate prevention, screening, and treatment of NCDs into HIV services. Specific interventions targeting younger PLHIV will limit their risk for AHD.</p>\",\"PeriodicalId\":94212,\"journal\":{\"name\":\"Southern African journal of HIV medicine\",\"volume\":\"25 1\",\"pages\":\"1614\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-10-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538099/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Southern African journal of HIV medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4102/sajhivmed.v25i1.1614\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Southern African journal of HIV medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4102/sajhivmed.v25i1.1614","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
Causes of death in people living with HIV: Lessons from five health facilities in Eswatini.
Background: Eswatini has a high HIV prevalence in adults and, despite being one of the first countries to achieve the UNAIDS 95-95-95 targets, AIDS-related deaths are still high.
Objectives: This study describes the causes of death among people living with HIV (PLHIV) receiving care at five clinics in Eswatini.
Method: A cross-sectional review of sociodemographic, clinical and mortality data of deceased clients who received care from 01 January 2021 to 30 June 2022, was conducted. Data were extracted from the deceased clients' clinical records, and descriptive and comparative analysis was performed.
Results: Of 257 clients, 52.5% (n = 135) were male, and the median age was 47 years (interquartile range [IQR]: 38, 59). The leading causes of death were non-communicable diseases (NCDs) (n = 59, 23.0%), malignancies (n = 37, 14.4%), COVID-19 (n = 36, 14.0%), and advanced HIV disease (AHD) (n = 24, 9.3%). Clients who had been on antiretroviral therapy (ART) for 12-60 months (OR: 0.01; 95% confidence interval [CI]: 0.0006, 0.06) and > 60 months (OR: 0.006; 95% CI: 0.0003, 0.029) had lower odds of death from AHD compared to those on ART for < 12 months. Clients aged ≥ 40 years had higher odds of dying from COVID-19, while female clients (OR: 2.64; 95% CI: 1.29, 5.70) had higher odds of death from malignancy.
Conclusion: Most clients who died were aged 40 years and above and died from NCD-related causes, indicating a need to integrate prevention, screening, and treatment of NCDs into HIV services. Specific interventions targeting younger PLHIV will limit their risk for AHD.
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