Analysis of impact of HIV / AIDS on deaths certified at Mosvold Hospital, Ingwavuma, Northern KwaZulu-Natal from 2003 to 2006 : original research

Background: Mosvold Hospital is a government district hospital situated in northern KwaZulu-Natal, a province with an antenatal HIV prevalence of 39%. A previous study indicated that 45% of deaths certified at Mosvold Hospital were due to HIV / AIDS. The antiretroviral roll-out programme commenced at Mosvold Hospital on 16 September 2004. Methods: Data from deaths certified at Mosvold Hospital from 1 January 2003 to 31 December 2006 were analysed for trends in diagnosis and age at death. The period included 20 months prior to the start of the antiretroviral roll-out at the hospital in September 2004, and the first 28 months of the programme. Results: Of the deaths between 2003 and 2006, 53% were certified as having HIV/AIDS as the underlying cause of death. Between 2003 and 2005 there was a significant reduction in the average age at death for males and females, with an increase in mortality in the zero to four years age group. In 2006 there was a significant increase in the average age at death of females compared to 2005, although this increase was not demonstrated to be due to an improvement in mortality from HIV/AIDS. Conclusion: HIV / AIDS continues to be the dominant public health concern in the sub-district. To date, public health measures such as the antiretroviral roll-out programme cannot be demonstrated to have affected mortality from the disease.