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Temporal trends in death causes in adults attending an urban HIV clinic in Uganda : a retrospective chart review. / Cox, Janneke A; Kiggundu, Daniel; Elpert, Lana; Meintjes, Graeme; Colebunders, Robert; Alamo, Stella.

In: BMJ Open, Vol. 6, Nr. 1, 2016, blz. e008718.

Onderzoeksoutput: Bijdrage aan tijdschriftA1: Web of Science-artikelOnderzoekpeer review

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Cox, Janneke A ; Kiggundu, Daniel ; Elpert, Lana ; Meintjes, Graeme ; Colebunders, Robert ; Alamo, Stella. / Temporal trends in death causes in adults attending an urban HIV clinic in Uganda : a retrospective chart review. In: BMJ Open. 2016 ; Vol. 6, Nr. 1. blz. e008718.

BibTeX

@article{b0d85e5458ef4599a3c6a2ac18375558,
title = "Temporal trends in death causes in adults attending an urban HIV clinic in Uganda: a retrospective chart review",
abstract = "OBJECTIVE: To study temporal trends of mortality in HIV-infected adults who attended an HIV clinic in Kampala, Uganda, between 2002 and 2012.DESIGN: Descriptive retrospective study.METHODS: Two doctors independently reviewed the clinic database that contained information derived from the clinic files and assigned one or more causes of death to each patient >18 years of age with a known date of death. Four cause-of-death categories were defined: 'communicable conditions and AIDS-defining malignancies', 'chronic non-communicable conditions', 'other non-communicable conditions' and 'unknown'. Trends in cause-of-death categories over time were evaluated using multinomial logistic regression with year of death as an independent continuous variable.RESULTS: 1028 deaths were included; 38{\%} of these individuals were on antiretroviral therapy (ART). The estimated mortality rate dropped from 21.86 deaths/100 person years of follow-up (PYFU) in 2002 to 1.75/100 PYFU in 2012. There was a significant change in causes of death over time (p<0.01). Between 2002 and 2012, the proportion of deaths due to 'communicable conditions and AIDS-defining malignancies' decreased from 84{\%} (95{\%} CI 74{\%} to 90{\%}) to 64{\%} (95{\%} CI 53{\%} to 74{\%}) and the proportion of deaths due to 'chronic non-communicable conditions', 'other non-communicable conditions' and a combination of 'communicable and non-communicable conditions' increased. Tuberculosis (TB) was the main cause of death (34{\%}). Death from TB decreased over time, from 43{\%} (95{\%} CI 32{\%} to 53{\%}) in 2002 to a steady proportion of approximately 25{\%} from 2006 onwards (p<0.01).CONCLUSIONS: Mortality rate decreased over time. The proportion of deaths from communicable conditions and AIDS-defining malignancies decreased and from non-communicable diseases, both chronic and non-chronic, increased. Nevertheless, communicable conditions and AIDS-defining malignancies continued to cause the majority of deaths, with TB as the main cause. Ongoing monitoring of cause of death is warranted and strategies to decrease mortality from TB and other common opportunistic infections are essential.",
author = "Cox, {Janneke A} and Daniel Kiggundu and Lana Elpert and Graeme Meintjes and Robert Colebunders and Stella Alamo",
note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/",
year = "2016",
doi = "10.1136/bmjopen-2015-008718",
language = "English",
volume = "6",
pages = "e008718",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "1",

}

RIS

TY - JOUR

T1 - Temporal trends in death causes in adults attending an urban HIV clinic in Uganda

T2 - BMJ Open

AU - Cox, Janneke A

AU - Kiggundu, Daniel

AU - Elpert, Lana

AU - Meintjes, Graeme

AU - Colebunders, Robert

AU - Alamo, Stella

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

PY - 2016

Y1 - 2016

N2 - OBJECTIVE: To study temporal trends of mortality in HIV-infected adults who attended an HIV clinic in Kampala, Uganda, between 2002 and 2012.DESIGN: Descriptive retrospective study.METHODS: Two doctors independently reviewed the clinic database that contained information derived from the clinic files and assigned one or more causes of death to each patient >18 years of age with a known date of death. Four cause-of-death categories were defined: 'communicable conditions and AIDS-defining malignancies', 'chronic non-communicable conditions', 'other non-communicable conditions' and 'unknown'. Trends in cause-of-death categories over time were evaluated using multinomial logistic regression with year of death as an independent continuous variable.RESULTS: 1028 deaths were included; 38% of these individuals were on antiretroviral therapy (ART). The estimated mortality rate dropped from 21.86 deaths/100 person years of follow-up (PYFU) in 2002 to 1.75/100 PYFU in 2012. There was a significant change in causes of death over time (p<0.01). Between 2002 and 2012, the proportion of deaths due to 'communicable conditions and AIDS-defining malignancies' decreased from 84% (95% CI 74% to 90%) to 64% (95% CI 53% to 74%) and the proportion of deaths due to 'chronic non-communicable conditions', 'other non-communicable conditions' and a combination of 'communicable and non-communicable conditions' increased. Tuberculosis (TB) was the main cause of death (34%). Death from TB decreased over time, from 43% (95% CI 32% to 53%) in 2002 to a steady proportion of approximately 25% from 2006 onwards (p<0.01).CONCLUSIONS: Mortality rate decreased over time. The proportion of deaths from communicable conditions and AIDS-defining malignancies decreased and from non-communicable diseases, both chronic and non-chronic, increased. Nevertheless, communicable conditions and AIDS-defining malignancies continued to cause the majority of deaths, with TB as the main cause. Ongoing monitoring of cause of death is warranted and strategies to decrease mortality from TB and other common opportunistic infections are essential.

AB - OBJECTIVE: To study temporal trends of mortality in HIV-infected adults who attended an HIV clinic in Kampala, Uganda, between 2002 and 2012.DESIGN: Descriptive retrospective study.METHODS: Two doctors independently reviewed the clinic database that contained information derived from the clinic files and assigned one or more causes of death to each patient >18 years of age with a known date of death. Four cause-of-death categories were defined: 'communicable conditions and AIDS-defining malignancies', 'chronic non-communicable conditions', 'other non-communicable conditions' and 'unknown'. Trends in cause-of-death categories over time were evaluated using multinomial logistic regression with year of death as an independent continuous variable.RESULTS: 1028 deaths were included; 38% of these individuals were on antiretroviral therapy (ART). The estimated mortality rate dropped from 21.86 deaths/100 person years of follow-up (PYFU) in 2002 to 1.75/100 PYFU in 2012. There was a significant change in causes of death over time (p<0.01). Between 2002 and 2012, the proportion of deaths due to 'communicable conditions and AIDS-defining malignancies' decreased from 84% (95% CI 74% to 90%) to 64% (95% CI 53% to 74%) and the proportion of deaths due to 'chronic non-communicable conditions', 'other non-communicable conditions' and a combination of 'communicable and non-communicable conditions' increased. Tuberculosis (TB) was the main cause of death (34%). Death from TB decreased over time, from 43% (95% CI 32% to 53%) in 2002 to a steady proportion of approximately 25% from 2006 onwards (p<0.01).CONCLUSIONS: Mortality rate decreased over time. The proportion of deaths from communicable conditions and AIDS-defining malignancies decreased and from non-communicable diseases, both chronic and non-chronic, increased. Nevertheless, communicable conditions and AIDS-defining malignancies continued to cause the majority of deaths, with TB as the main cause. Ongoing monitoring of cause of death is warranted and strategies to decrease mortality from TB and other common opportunistic infections are essential.

U2 - 10.1136/bmjopen-2015-008718

DO - 10.1136/bmjopen-2015-008718

M3 - A1: Web of Science-article

VL - 6

SP - e008718

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 1

ER -

ID: 1408051