Independent On-line, 21 November 2002, HIV/Aids death ratio doubles over four years

The proportion of South African deaths because of HIV/Aids has nearly doubled from 4,6 to 8,7 percent between 1997 and 2001, Statistics South Africa revealed on Thursday.

It said women aged between 15 and 39 died primarily as a result of HIV/Aids over this period. Men in this age group mostly died from unspecified unnatural causes.

Overall, the five leading underlying causes of death were of an unnatural kind, such as injuries, suicides, car accidents and drowning. They accounted for 40,9 percent of deaths.

Next in line was what Stats SA described as ill-defined causes, followed by tuberculosis, HIV/Aids and influenza and pneumonia.

Releasing the results of a study on the topic in
Pretoria, Stats SA deputy director-general Gugu Gule noted that there had been a change in mortality patterns over the period concerned.

Deaths due to unspecified unnatural causes declined from 15,3 to 8,7 percent among women as well as men in the age group between 15 and 39.

"By contrast, the proportion dying from tuberculosis, HIV/Aids and influenza and pneumonia increased significantly," Gule told reporters.

The study was commissioned after the Medical Research Council (MRC) released a report last year - conducted with Stats SA - which showed that 40 percent of deaths of those aged between 15 and 49 in 2000 were due to Aids.

Stats SA later repudiated this finding, and undertook its own study at the instruction of cabinet.

The MRC's conclusion contradicted assertions by the government that violent crime was the major cause of death. President Thabo Mbeki at the time also maintained that the impact of Aids was being exaggerated.

Stats SA's report was initially scheduled to be released on Monday. The event was postponed on Monday morning with the explanation that the document had to be submitted to cabinet first.

MRC consultant David Bourne, who took part in Thursday's briefing, said the two reports were not really inconsistent.

"Measuring mortality because of Aids will always be an inexact science, and there will be different findings by different studies," he said.

"The results of both reports are in line with broad trends emerging. HIV as an underlying cause of death is certainly rising and is predominant among the young."

Bourne said Stats SA reported precisely what it found on death certificates, while there was an interpretive element in the MRC study.

"To put it in simple terms - Stats SA merely counted while we went further and modelled our findings on the knowledge we had about HIV/Aids."

Many deaths formally attributed to influenza could, for example, have been caused by Aids.

"What is written on a death certificate does not necessarily give the true picture," Bourne explained.

"The only way to be sure would be to test every corpse for HIV, which is practically not possible."

Stats SA found that 22,5 percent of women aged between 15 and 29 died of Aids in the period studied. Among men in this age group the figure was 8,5 percent.

"The highest prevalence of HIV deaths is among African females (13,5 percent), females aged 15 to 29 (24,3 percent) and females aged 30 to 39 (20,5 percent).

The lowest incidence of deaths because of HIV/Aids (0,7 percent) was among white women.

In a statement distributed at the briefing, the Department of Health said the change in mortality patterns underlined the need to step up the country's strategy against the Aids pandemic.

Statistician-General Pali Lehotla sought to assure reporters that the document released on Thursday was the same one he submitted to cabinet.

"There was no way in which we could have had it reprinted," he quipped. - Sapa