Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems

被引：88

作者：

Cork, Michael A. ^{[1
]}

Henry, Nathaniel J. ^{[1
,2
]}

Watson, Stefanie ^{[1
]}

Croneberger, Andrew J. ^{[1
]}

Baumann, Mathew ^{[1
]}

Letourneau, Ian D. ^{[1
]}

Yang, Mingyou ^{[1
]}

Serfes, Audrey L. ^{[1
]}

Abbas, Jaffar ^{[3
]}

Abbasi, Nooshin ^{[4
]}

Abbastabar, Hedayat ^{[5
]}

Abreu, Lucas G. ^{[6
]}

Abu-Gharbieh, Eman ^{[7
]}

Achappa, Basavaprabhu ^{[8
]}

Adabi, Maryam ^{[9
]}

Adal, Tadele G. ^{[10
]}

Adegbosin, Adeyinka E. ^{[11
]}

Adekanmbi, Victor ^{[12
]}

Adetokunboh, Olatunji O. ^{[13
,14
]}

Agudelo-Botero, Marcela ^{[15
]}

Ahinkorah, Bright O. ^{[16
]}

Ahmadi, Keivan ^{[17
,18
]}

Ahmed, Muktar B. ^{[19
,20
]}

Alhassan, Robert K. ^{[21
]}

Alipour, Vahid ^{[22
,23
]}

Almasi-Hashiani, Amir ^{[24
]}

Alvis-Guzman, Nelson ^{[25
,26
]}

Ancuceanu, Robert ^{[27
]}

Andrei, Tudorel ^{[28
]}

Anvari, Davood ^{[29
,30
]}

Aqeel, Muhammad ^{[31
]}

Arabloo, Jalal ^{[22
]}

Aremu, Olatunde ^{[32
]}

Asaad, Malke ^{[33
]}

Atnafu, Desta D. ^{[34
]}

Atreya, Alok ^{[35
]}

Quintanilla, Beatriz Paulina Ayala ^{[36
]}

Azari, Samad ^{[22
]}

Darshan, B. B. ^{[37
]}

Baig, Atif A. ^{[38
]}

Banach, Maciej ^{[39
,40
]}

Bante, Simachew A. ^{[41
]}

Barboza, Miguel A. ^{[42
,43
]}

Basu, Sanjay ^{[44
,45
]}

Bedi, Neeraj ^{[46
,47
]}

Bejarano Ramirez, Diana F. ^{[48
,49
]}

Bensenor, Isabela M. ^{[50
]}

Beyene, Fentahun Y. ^{[41
]}

Bezabih, Yihienew M. ^{[51
,52
]}

Bhagavathula, Akshaya S. ^{[53
,54
]}

机构：

[1] Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA

[2] Univ Oxford, Big Data Inst, Oxford, England

[3] Shanghai Jiao Tong Univ, Antai Coll Econ, Shanghai, Peoples R China

[4] McGill Univ, Montreal Neurol Inst, Montreal, PQ, Canada

[5] Univ Tehran Med Sci, Adv Diagnost & Intervent Radiol Res Ctr, Tehran, Iran

[6] Univ Fed Minas Gerais, Dept Pediat Dent, Belo Horizonte, MG, Brazil

[7] Univ Sharjah, Dept Clin Sci, Sharjah, U Arab Emirates

[8] Manipal Acad Higher Educ, Dept Internal Med, Mangalore, India

[9] Hamadan Univ Med Sci, Hamadan, Iran

[10] Wolkite Univ, Dept Publ Hlth, Wolkite, Ethiopia

[11] Griffith Univ, Sch Med, Gold Coast, Qld, Australia

[12] Kings Coll London, Dept Populat Hlth Sci, London, England

[13] Stellenbosch Univ, Ctr Excellence Epidemiol Modelin & Anal, Stellenbosch, South Africa

[14] Stellenbosch Univ, Dept Global Hlth, Cape Town, South Africa

[15] Univ Nacl Autonoma Mexico, Ctr Policy Populat & Hlth Res, Mexico City, DF, Mexico

[16] Univ Technol Sydney, Australian Ctr Publ & Populat Hlth Res ACPP HR, Sydney, NSW, Australia

[17] Univ Nottingham, Lincoln Med Sch, Lincoln, England

[18] Univ Lincoln, Lincoln Med Sch, Lincoln, England

[19] Jimma Univ, Dept Epidemiol, Jimma, Ethiopia

[20] Univ South Australia, Australian Ctr Precis Hlth, Adelaide, SA, Australia

[21] Univ Hlth & Allied Sci, Inst Hlth Res, Ho, Ghana

[22] Iran Univ Med Sci, Hlth Management & Econ Res Ctr, Tehran, Iran

[23] Iran Univ Med Sci, Hlth Econ Dept, Tehran, Iran

[24] Arak Univ Med Sci, Dept Epidemiol, Arak, Iran

[25] Univ Cartagena, Res Grp Hlth Econ, Cartagena, Colombia

[26] ALZAK Fdn, Res Grp Hosp Management & Hlth Policies, Cartagena, Colombia

[27] Carol Davila Univ Med & Pharm, Bucharest, Romania

[28] Bucharest Univ Econ Studies, Stat & Econometr Dept, Bucharest, Romania

[29] Mazandaran Univ Med Sci, Dept Parasitol, Sari, Iran

[30] Iranshahr Univ Med Sci, Dept Parasitol, Iranshahr, Iran

[31] Fdn Univ Islamabad, Dept Psychol, Rawalpandi, Pakistan

[32] Birmingham City Univ, Dept Publ Hlth, Birmingham, W Midlands, England

[33] Univ Texas Houston, Dept Plast Surg, Houston, TX USA

[34] Bahir Dar Univ, Dept Hlth Syst & Hlth Econ, Bahir Dar, Ethiopia

[35] Lumbini Med Coll, Dept Forens Med, Palpa, Nepal

[36] La Trobe Univ, Judith Lumley Ctr, Melbourne, Vic, Australia

[37] Manipal Acad Higher Educ, Dept Community Med, Manipal, India

[38] Sultan Zainal Abidin Univ, Unit Biochem, Kuala Terengganu, Malaysia

[39] Med Univ Lodz, Dept Hypertens, Lodz, Poland

[40] Polish Mothers Mem Hosp, Res Inst, Lodz, Poland

[41] Bahir Dar Univ, Dept Midwifery, Bahir Dar, Ethiopia

[42] Costa Rican Dept Social Secur, Dept Neurosci, San Jose, Costa Rica

[43] Univ Costa Rica, Sch Med, San Pedro, Costa Rica

[44] Harvard Univ, Ctr Primary Care, Boston, MA 02115 USA

[45] Imperial Coll London, Sch Publ Hlth, London, England

[46] Gandhi Med Coll Bhopal, Dept Community Med, Bhopal, India

[47] Jazan Univ, Jazan, Saudi Arabia

[48] El Bosque Univ, Dept Med, Bogota, Colombia

[49] Univ Hosp Fdn Santa Fe Bogota, Transplant Serv, Bogota, Colombia

[50] Univ Sao Paulo, Dept Internal Med, Sao Paulo, Brazil

来源：

BMC MEDICINE | 2021年 / 19卷 / 01期

基金：

英国惠康基金;

关键词：

HIV; AIDS; Latin America; HIV mortality; Vital registration; Small area estimation; Mapping; Spatial statistics; ANTIRETROVIRAL THERAPY; GLOBAL BURDEN; LOW-INCOME; TRENDS; HIV/AIDS; BRAZIL; SEX; PEOPLE; HEALTH; DEATH;

D O I：

10.1186/s12916-020-01876-4

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundHuman immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico.MethodsWe performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017.ResultsAll countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries-apart from Ecuador-across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups-the median age group among decedents ranged from 30 to 45years of age at the municipality level in Brazil, Colombia, and Mexico in 2017.ConclusionsOur subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths.

引用

页数：25

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