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The unfolding counter-transition in rural South Africa: mortality and cause of death, 1994-2009
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. (Centre for Global Health Research)
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2014 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 6, e100420- p.Article in journal (Refereed) Published
Abstract [en]

The HIV pandemic has led to dramatic increases and inequalities in adult mortality, and the diffusion of antiretroviral treatment, together with demographic and socioeconomic shifts in sub-Saharan Africa, has further changed mortality patterns. We describe all-cause and cause-specific mortality patterns in rural South Africa, analyzing data from the Agincourt health and socio-demographic surveillance system from 1994 to 2009 for those aged 5 years and older. Mortality increased during that period, particularly after 2002 for ages 30-69. HIV/AIDS and TB deaths increased and recently plateaued at high levels in people under age 60. Noncommunicable disease deaths increased among those under 60, and recently also increased among those over 60. There was an inverse gradient between mortality and household SES, particularly for deaths due to HIV/AIDS and TB and noncommunicable diseases. A smaller and less consistent gradient emerged for deaths due to other communicable diseases. Deaths due to injuries remained an important mortality risk for males but did not vary by SES. Rural South Africa continues to have a high burden of HIV/AIDS and TB mortality while deaths from noncommunicable diseases have increased, and both of these cause-categories show social inequalities in mortality.

Place, publisher, year, edition, pages
Public Library of Science , 2014. Vol. 9, no 6, e100420- p.
Keyword [en]
sub-saharan africa; antiretroviral therapy; epidemiologic transition; adult mortality; health-care; surveillance system; agincourt health; life expectancy; scale-up; population
National Category
Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:umu:diva-91763DOI: 10.1371/journal.pone.0100420ISI: 000338633900046OAI: diva2:738426
Available from: 2014-08-18 Created: 2014-08-15 Last updated: 2016-02-26Bibliographically approved

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Kahn, KathleenTollman, Stephen M
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