Barcelona 2013
Barcelona 2013
Abstract book - Abstract - 69
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Conference Details
International Committee
Plenary Speakers
Presenting Speakers
Scientific Committee
Abstract #69  -  Well Being and Life Expectancy
  25.1: Well Being and Life Expectancy (Parallel) on Tuesday @ 11.00-13.00 in Raval Chaired by Xiaming Li,
Carlos Mur

  Presenting Author:   Mr Harold Gil - University of Miami, United States
  Additional Authors:   
Currently, comprehensive analyses of HIV/AIDS adult mortality at the national level, based on data sources comprising the second-generation surveillance (SGS) system in Guatemala, are not available. Such analyses are recommended as part of SGS, however, underreporting and inconsistent data quality, resulting from stigmatization and discrimination of this disease in Central America, threaten the statistical validity and act as barriers to a reliable and detailed understanding of the state of the HIV/AIDS epidemic in Guatemala. This study applies multiple imputations to SGS data and reports trends of HIV/AIDS adult mortality rates in Guatemala across four demographic variables.
Method / Issue:
Descriptive, serial cross-sectional study for the period of 2005-2009. SGS data from the national vital registry, the AIDS case-reporting system, hospital mortality reports, and clinical monitoring reports of ARV patients were collected and multiple-imputation applied through the Multivariate Imputation by Chained Equations algorithm. We examined death due to all-causes and patients were considered alive if they were not recorded as dead in any of the data sources at the time of data abstraction. Imputed data were stratified and compared across four demographic variables (age-group, sex, ethnicity, and geographical area). Mortality rates were reported as HIV/AIDS-related adult deaths per 100,000 adults per year. Non-residents of Guatemala were excluded from the analysis.
Results / Comments:
Preliminary analyses of the vital registry data indicate that Guatemala?s national HIV/AIDS-related adult mortality rate decreased at an average of 0.6 deaths per 100,000 adults per year. Age-adjusted HIV/AIDS adult mortality rates dropped at an average of 0.84 deaths per 100,000 individuals per year for males and 0.4 deaths per 100,000 individuals per year for females. Among the age-groups 18-24, 25-34, 35-44, and 45-54, HIV/AIDS-related adult mortality rates decreased at an average of: 0.45, 1.07, 0.97, and 0.67 deaths per 100,000 individuals per year, respectively; for the age-group 55 and over, HIV/AIDS adult mortality increased at an average of 0.27 per 100,000 individuals per year. The maximum departmental HIV/AIDS adult mortality rate among all departments of Guatemala decreased from 51.0 to 40.4 deaths per 100,000 individuals from 2005 to 2009, while the minimum decreased from 2.4 to 0.9 deaths per 100,000 individuals or the same time period. Median and mean age at death among adults due to HIV/AIDS-related disease increased at an average of 0.5 years per year. Similar trends were observed in the AIDS case-reporting system.
Findings across several measures suggest that the rate of HIV/AIDS-related deaths in Guatemalan adults was significantly and consistently decreasing during the period 2005-2009. Whether the trends reported in this study also reflect a decrease in the rate of HIV infection in Guatemala prior to the period studied is uncertain and cannot be inferred from these data alone. Results also support the integration of HIV/AIDS mortality analyses into ongoing surveillance. The extent of erroneous/missing data in the SGS system suggests a role for strengthening informatics and data reporting training, as well as improving information system applications in health-surveillance settings in Guatemala.
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