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Child mortality in rural Malawi: HIV closes the survival gap between the socio-economic strata.
PLoS One. 2010 Jun 28; 5(6):e11320.Plos

Abstract

BACKGROUND

As HIV-related deaths increase in a population the usual association between low socioeconomic status and child mortality may change, particularly as death rates from other causes decline.

METHODS/PRINCIPAL FINDINGS

As part of a demographic surveillance system in northern Malawi in 2002-6, covering a population of 32,000, information was collected on socio-economic status of the households. Deaths were classified as HIV/AIDS-related or not by verbal autopsy. Poisson regression models were used to assess the association of socio-economic indicators with all-cause mortality, AIDS-mortality and non-AIDS mortality among children. There were 195 deaths in infants, 109 in children aged 1-4 years, and 38 in children aged 5-15. All-cause child mortality in infants and 1-4 year olds was similar in households with higher and lower socio-economic status. In infants 13% of deaths were attributed to AIDS, and there were no clear trends with socio-economic status for AIDS or non-AIDS causes. For 1-4 year olds 27% of deaths were attributed to AIDS. AIDS mortality was higher among those with better built houses, and lowest in those with income from farming and fishing, whereas non-AIDS mortality was higher in those with worse built houses, lowest in those with income from employment, and decreased with increasing household assets.

CONCLUSIONS/SIGNIFICANCE

In this population, since HIV infection among adults was initially more common among the less poor, childhood mortality patterns have changed. The usual gap in survival between the poor and the less poor has been lost, but because the less poor have been disproportionately affected by HIV, rather than because of relative improvement in the survival of the poorest.

Authors+Show Affiliations

Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20596521

Citation

Jahn, Andreas, et al. "Child Mortality in Rural Malawi: HIV Closes the Survival Gap Between the Socio-economic Strata." PloS One, vol. 5, no. 6, 2010, pp. e11320.
Jahn A, Floyd S, McGrath N, et al. Child mortality in rural Malawi: HIV closes the survival gap between the socio-economic strata. PLoS ONE. 2010;5(6):e11320.
Jahn, A., Floyd, S., McGrath, N., Crampin, A. C., Kachiwanda, L., Mwinuka, V., Zaba, B., Fine, P. E., & Glynn, J. R. (2010). Child mortality in rural Malawi: HIV closes the survival gap between the socio-economic strata. PloS One, 5(6), e11320. https://doi.org/10.1371/journal.pone.0011320
Jahn A, et al. Child Mortality in Rural Malawi: HIV Closes the Survival Gap Between the Socio-economic Strata. PLoS ONE. 2010 Jun 28;5(6):e11320. PubMed PMID: 20596521.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Child mortality in rural Malawi: HIV closes the survival gap between the socio-economic strata. AU - Jahn,Andreas, AU - Floyd,Sian, AU - McGrath,Nuala, AU - Crampin,Amelia C, AU - Kachiwanda,Lackson, AU - Mwinuka,Venance, AU - Zaba,Basia, AU - Fine,Paul E M, AU - Glynn,Judith R, Y1 - 2010/06/28/ PY - 2010/03/15/received PY - 2010/05/31/accepted PY - 2010/7/3/entrez PY - 2010/7/3/pubmed PY - 2010/9/2/medline SP - e11320 EP - e11320 JF - PloS one JO - PLoS ONE VL - 5 IS - 6 N2 - BACKGROUND: As HIV-related deaths increase in a population the usual association between low socioeconomic status and child mortality may change, particularly as death rates from other causes decline. METHODS/PRINCIPAL FINDINGS: As part of a demographic surveillance system in northern Malawi in 2002-6, covering a population of 32,000, information was collected on socio-economic status of the households. Deaths were classified as HIV/AIDS-related or not by verbal autopsy. Poisson regression models were used to assess the association of socio-economic indicators with all-cause mortality, AIDS-mortality and non-AIDS mortality among children. There were 195 deaths in infants, 109 in children aged 1-4 years, and 38 in children aged 5-15. All-cause child mortality in infants and 1-4 year olds was similar in households with higher and lower socio-economic status. In infants 13% of deaths were attributed to AIDS, and there were no clear trends with socio-economic status for AIDS or non-AIDS causes. For 1-4 year olds 27% of deaths were attributed to AIDS. AIDS mortality was higher among those with better built houses, and lowest in those with income from farming and fishing, whereas non-AIDS mortality was higher in those with worse built houses, lowest in those with income from employment, and decreased with increasing household assets. CONCLUSIONS/SIGNIFICANCE: In this population, since HIV infection among adults was initially more common among the less poor, childhood mortality patterns have changed. The usual gap in survival between the poor and the less poor has been lost, but because the less poor have been disproportionately affected by HIV, rather than because of relative improvement in the survival of the poorest. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/20596521/Child_mortality_in_rural_Malawi:_HIV_closes_the_survival_gap_between_the_socio_economic_strata_ L2 - http://dx.plos.org/10.1371/journal.pone.0011320 DB - PRIME DP - Unbound Medicine ER -