Calling a spade a spade: deaths due to HIV moves into top 5

The 2013 Mortality and Causes of Death release shows that HIV disease has moved from being ranked sixth in 2012 to being ranked third in 2013. Of the 458 933 deaths registered at the Department of Home Affairs in 2013 and processed by Statistics South Africa (Stats SA), 5,1% were due to HIV disease, an increase from the 3,9% in 2012.

The change in the ranking of HIV disease was driven by increases in the number of deaths due to HIV reported by three provinces: Western Cape, KwaZulu Natal and Northern Cape. In addition, the age groups 15 – 44 and 45 – 64 showed clear signs of increasing proportions in HIV deaths compared to HIV-related deaths[1]. Trend analysis between HIV deaths and HIV-related deaths suggest that the decline in tuberculosis, influenza and pneumonia, intestinal infectious diseases and other viral diseases could have also contributed to the rising numbers and proportions in HIV deaths. Without a detailed study looking into this pattern and additional time points to assess the pattern, we can only speculate that there seems to be a decline in the stigma or discomfort of reporting HIV as a cause of death. Thus moving to the era of calling a spade a spade!

The production of mortality and causes of death information from civil registration depends on the quality of input data. Thus better reporting of causes of death will lead to an improvement in the quality of statistics. Additional improvements have been observed in 2013. There were 75% of deaths registered within the legislative period of 72 hours. Ill-defined causes of death are also an indicator of the quality of causes of death statistics. The analysis of causes of death shows that in 2013, 12,7% of deaths were attributable to ill-defined causes, which is a decline from 13,6% in 2012. Further improvement in assigning correct causes of death will ensure better utilisation of mortality and causes of death statistics in monitoring and developing public health interventions.

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[1] HIV related diseases refer to deaths due to tuberculosis, influenza and pneumonia, intestinal infectious diseases, Kaposi’s sarcoma, certain disorders involving the immune system, meningitis due to other and unspecified causes and other viral diseases.