Effect of HIV infection on pregnancy-related mortality in sub-Saharan Africa: secondary analyses of pooled community-based data from the network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA)
| العنوان: | Effect of HIV infection on pregnancy-related mortality in sub-Saharan Africa: secondary analyses of pooled community-based data from the network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA) |
|---|---|
| المؤلفون: | Milly Marston, Jim Todd, Basia Zaba, Laura Robertson, Kobus Herbst, Peter Byass, Clara Calvert, Carine Ronsmans, Ties Boerma, Marie-Louise Newell, Raphael Isingo, Amelia C. Crampin, Tom Lutalo, Jessica Nakiyingi-Miiro |
| المصدر: | Lancet |
| بيانات النشر: | Lancet Publishing Group, 2013. |
| سنة النشر: | 2013 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, Sub saharan, Adolescent, Population, Human immunodeficiency virus (HIV), Alpha (ethology), HIV Infections, Population based, medicine.disease_cause, Health Services Accessibility, Serology, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Pregnancy, Environmental health, medicine, Humans, 030212 general & internal medicine, Young adult, Pregnancy Complications, Infectious, education, Africa South of the Sahara, reproductive and urinary physiology, Reproductive health, Community based, education.field_of_study, 030219 obstetrics & reproductive medicine, Obstetrics, business.industry, Mortality rate, 1. No poverty, virus diseases, General Medicine, Articles, Middle Aged, medicine.disease, Virology, 3. Good health, Pregnancy Complications, Population Surveillance, Maternal death, Female, Pregnancy related mortality, business |
| الوصف: | Summary Background Model-based estimates of the global proportions of maternal deaths that are in HIV-infected women range from 7% to 21%, and the effects of HIV on the risk of maternal death is highly uncertain. We used longitudinal data from the Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA) network to estimate the excess mortality associated with HIV during pregnancy and the post-partum period in sub-Saharan Africa. Methods The ALPHA network pooled data gathered between June, 1989 and April, 2012 in six community-based studies in eastern and southern Africa with HIV serological surveillance and verbal-autopsy reporting. Deaths occurring during pregnancy and up to 42 days post partum were defined as pregnancy related. Pregnant or post-partum person-years were calculated for HIV-infected and HIV-uninfected women, and HIV-infected to HIV-uninfected mortality rate ratios and HIV-attributable rates were compared between pregnant or post-partum women and women who were not pregnant or post partum. Findings 138 074 women aged 15–49 years contributed 636 213 person-years of observation. 49 568 women had 86 963 pregnancies. 6760 of these women died, 235 of them during pregnancy or the post-partum period. Mean prevalence of HIV infection across all person-years in the pooled data was 17·2% (95% CI 17·0–17·3), but 60 of 118 (50·8%) of the women of known HIV status who died during pregnancy or post partum were HIV infected. The mortality rate ratio of HIV-infected to HIV-uninfected women was 20·5 (18·9–22·4) in women who were not pregnant or post partum and 8·2 (5·7–11·8) in pregnant or post-partum women. Excess mortality attributable to HIV was 51·8 (47·8–53·8) per 1000 person-years in women who were not pregnant or post partum and 11·8 (8·4–15·3) per 1000 person-years in pregnant or post-partum women. Interpretation HIV-infected pregnant or post-partum women had around eight times higher mortality than did their HIV-uninfected counterparts. On the basis of this estimate, we predict that roughly 24% of deaths in pregnant or post-partum women are attributable to HIV in sub-Saharan Africa, suggesting that safe motherhood programmes should pay special attention to the needs of HIV-infected pregnant or post-partum women. Funding Wellcome Trust, Health Metrics Network (WHO). |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1474-547X 0140-6736 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3632a3cd7a31760648b2a3be2778e08bTest http://europepmc.org/articles/PMC4325135Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....3632a3cd7a31760648b2a3be2778e08b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1474547X 01406736 |
|---|