OBJECTIVE: To determine the incidence of HIV-1 infection and HIV-1-associated mortality in a rural Ugandan population. DESIGN: A prospective cohort study. METHODS: A cohort consisting of the population (de jure census 9820) of a cluster of 15 villages in Masaka District, south-west Uganda was enrolled between 1989 and 1990 through a demographic and medical survey. The HIV-1 seroprevalence rate was 4.8% for all ages combined and 8.2% for those aged 13 years or more. The survey was repeated after 1 year. RESULTS: The 1-year HIV-1 incidence rate among adults was 1% [9.2 per 1000 person-years of observation; 95% confidence interval (CI), 5.5-12.9). A total of 84 deaths were observed. In adults, half of all deaths (31 out of 60) were in HIV-1-seropositive individuals. The age-adjusted overall mortality rate ratio for HIV-positive adults compared with HIV-negatives was 20.8 (95% CI, 12.0-35.7). In the 13-44 age group the corresponding rate ratios for men, women and both sexes combined were 16.3, 108.9 and 58.7, respectively. The HIV-attributable mortality fractions, i.e., the proportion of deaths that would have been avoided in the absence of HIV, were 44, 50 and 89% for adult men, adult women and adults aged 25-34 years (both sexes combined), respectively. The 1-year progression to death among HIV-1-seropositive adults was 10.3%. CONCLUSION: These results demonstrate the profound impact that the HIV-1 epidemic has on adult mortality in a rural area of Uganda where the HIV-1 prevalence and incidence rates in adults are 8 and 1%, respectively.
OBJECTIVE: To determine the incidence of HIV-1 infection and HIV-1-associated mortality in a rural Ugandan population. DESIGN: A prospective cohort study. METHODS: A cohort consisting of the population (de jure census 9820) of a cluster of 15 villages in Masaka District, south-west Uganda was enrolled between 1989 and 1990 through a demographic and medical survey. The HIV-1 seroprevalence rate was 4.8% for all ages combined and 8.2% for those aged 13 years or more. The survey was repeated after 1 year. RESULTS: The 1-year HIV-1 incidence rate among adults was 1% [9.2 per 1000 person-years of observation; 95% confidence interval (CI), 5.5-12.9). A total of 84 deaths were observed. In adults, half of all deaths (31 out of 60) were in HIV-1-seropositive individuals. The age-adjusted overall mortality rate ratio for HIV-positive adults compared with HIV-negatives was 20.8 (95% CI, 12.0-35.7). In the 13-44 age group the corresponding rate ratios for men, women and both sexes combined were 16.3, 108.9 and 58.7, respectively. The HIV-attributable mortality fractions, i.e., the proportion of deaths that would have been avoided in the absence of HIV, were 44, 50 and 89% for adult men, adult women and adults aged 25-34 years (both sexes combined), respectively. The 1-year progression to death among HIV-1-seropositive adults was 10.3%. CONCLUSION: These results demonstrate the profound impact that the HIV-1 epidemic has on adult mortality in a rural area of Uganda where the HIV-1 prevalence and incidence rates in adults are 8 and 1%, respectively.
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Keywords:
Africa; Africa South Of The Sahara; Cohort Analysis; Demographic Factors; Developing Countries; Diseases; Eastern Africa; English Speaking Africa; Examinations And Diagnoses; Hiv Infections; Incidence; Laboratory Examinations And Diagnoses; Measurement; Mortality; Population; Population Characteristics; Population Dynamics; Prospective Studies; Research Report; Rural Population; Studies; Uganda; Viral Diseases
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Authors: Fredrick E Makumbi; Gertrude Nakigozi; Joseph Sekasanvu; Ivan Lukabwe; Joseph Kagaayi; Tom Lutalo; Maria Wawer; Ronald Gray Journal: Trop Med Int Health Date: 2012-06-21 Impact factor: 2.622
Authors: Z Chen; A Luckay; D L Sodora; P Telfer; P Reed; A Gettie; J M Kanu; R F Sadek; J Yee; D D Ho; L Zhang; P A Marx Journal: J Virol Date: 1997-05 Impact factor: 5.103
Authors: Gershim Asiki; Georgina Murphy; Jessica Nakiyingi-Miiro; Janet Seeley; Rebecca N Nsubuga; Alex Karabarinde; Laban Waswa; Sam Biraro; Ivan Kasamba; Cristina Pomilla; Dermot Maher; Elizabeth H Young; Anatoli Kamali; Manjinder S Sandhu Journal: Int J Epidemiol Date: 2013-01-30 Impact factor: 7.196
Authors: L Buonaguro; E Del Guadio; M Monaco; D Greco; P Corti; E Beth-Giraldo; F M Buonaguro; G Giraldo Journal: J Virol Date: 1995-12 Impact factor: 5.103