High HIV prevalence among decedents received by two high-volume mortuaries in Kisumu, western Kenya, 2019.

<h4>Background</h4>Accurate data on HIV-related mortality are necessary to evaluate the impact of HIV interventions. In low- and middle-income countries (LMIC), mortality data obtained through civil registration are often of poor quality. Though not commonly conducted, mortuary surveilla...

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Autores principales:	Dickens O Onyango, Marianne A B van der Sande, Paul Musingila, Eunice Kinywa, Valarie Opollo, Boaz Oyaro, Emmanuel Nyakeriga, Anthony Waruru, Wanjiru Waruiru, Mary Mwangome, Teresia Macharia, Peter W Young, Muthoni Junghae, Catherine Ngugi, Kevin M De Cock, George W Rutherford
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/222c9353f2ad444aac9e414e9dfc0a18
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spelling	oai:doaj.org-article:222c9353f2ad444aac9e414e9dfc0a182021-12-02T20:09:47ZHigh HIV prevalence among decedents received by two high-volume mortuaries in Kisumu, western Kenya, 2019.1932-620310.1371/journal.pone.0253516https://doaj.org/article/222c9353f2ad444aac9e414e9dfc0a182021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253516https://doaj.org/toc/1932-6203<h4>Background</h4>Accurate data on HIV-related mortality are necessary to evaluate the impact of HIV interventions. In low- and middle-income countries (LMIC), mortality data obtained through civil registration are often of poor quality. Though not commonly conducted, mortuary surveillance is a potential complementary source of data on HIV-associated mortality.<h4>Methods</h4>During April-July 2019, we assessed HIV prevalence, the attributable fraction among the exposed, and the population attributable fraction among decedents received by two high-volume mortuaries in Kisumu County, Kenya, where HIV prevalence in the adult population was estimated at 18% in 2019 with high ART coverage (76%). Stillbirths were excluded. The two mortuaries receive 70% of deaths notified to the Kisumu East civil death registry; this registry captures 45% of deaths notified in Kisumu County. We conducted hospital chart reviews to determine the HIV status of decedents. Decedents without documented HIV status, including those dead on arrival, were tested using HIV antibody tests or polymerase chain reaction (PCR) consistent with national HIV testing guidelines. Decedents aged less than 15 years were defined as children. We estimated annual county deaths by applying weights that incorporated the study period, coverage of deaths, and mortality rates observed in the study.<h4>Results</h4>The two mortuaries received a total of 1,004 decedents during the study period, of which 95.1% (955/1004) were available for study; 89.1% (851/955) of available decedents were enrolled of whom 99.4% (846/851) had their HIV status available from medical records and post-mortem testing. The overall population-based, age- and sex-adjusted mortality rate was 12.4 per 1,000 population. The unadjusted HIV prevalence among decedents was 28.5% (95% confidence interval (CI): 25.5-31.6). The age- and sex-adjusted mortality rate in the HIV-infected population (40.7/1000 population) was four times higher than in the HIV-uninfected population (10.2/1000 population). Overall, the attributable fraction among the HIV-exposed was 0.71 (95% CI: 0.66-0.76) while the HIV population attributable fraction was 0.17 (95% CI: 0.14-0.20). In children the attributable fraction among the exposed and population attributable fraction were 0.92 (95% CI: 0.89-0.94) and 0.11 (95% CI: 0.08-0.15), respectively.<h4>Conclusions</h4>Over one quarter (28.5%) of decedents received by high-volume mortuaries in western Kenya were HIV-positive; overall, HIV was considered the cause of death in 17% of the population (19% of adults and 11% of children). Despite substantial scale-up of HIV services, HIV disease remains a leading cause of death in western Kenya. Despite progress, increased efforts remain necessary to prevent and treat HIV infection and disease.Dickens O OnyangoMarianne A B van der SandePaul MusingilaEunice KinywaValarie OpolloBoaz OyaroEmmanuel NyakerigaAnthony WaruruWanjiru WaruiruMary MwangomeTeresia MachariaPeter W YoungMuthoni JunghaeCatherine NgugiKevin M De CockGeorge W RutherfordPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0253516 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Dickens O Onyango Marianne A B van der Sande Paul Musingila Eunice Kinywa Valarie Opollo Boaz Oyaro Emmanuel Nyakeriga Anthony Waruru Wanjiru Waruiru Mary Mwangome Teresia Macharia Peter W Young Muthoni Junghae Catherine Ngugi Kevin M De Cock George W Rutherford High HIV prevalence among decedents received by two high-volume mortuaries in Kisumu, western Kenya, 2019.
description	<h4>Background</h4>Accurate data on HIV-related mortality are necessary to evaluate the impact of HIV interventions. In low- and middle-income countries (LMIC), mortality data obtained through civil registration are often of poor quality. Though not commonly conducted, mortuary surveillance is a potential complementary source of data on HIV-associated mortality.<h4>Methods</h4>During April-July 2019, we assessed HIV prevalence, the attributable fraction among the exposed, and the population attributable fraction among decedents received by two high-volume mortuaries in Kisumu County, Kenya, where HIV prevalence in the adult population was estimated at 18% in 2019 with high ART coverage (76%). Stillbirths were excluded. The two mortuaries receive 70% of deaths notified to the Kisumu East civil death registry; this registry captures 45% of deaths notified in Kisumu County. We conducted hospital chart reviews to determine the HIV status of decedents. Decedents without documented HIV status, including those dead on arrival, were tested using HIV antibody tests or polymerase chain reaction (PCR) consistent with national HIV testing guidelines. Decedents aged less than 15 years were defined as children. We estimated annual county deaths by applying weights that incorporated the study period, coverage of deaths, and mortality rates observed in the study.<h4>Results</h4>The two mortuaries received a total of 1,004 decedents during the study period, of which 95.1% (955/1004) were available for study; 89.1% (851/955) of available decedents were enrolled of whom 99.4% (846/851) had their HIV status available from medical records and post-mortem testing. The overall population-based, age- and sex-adjusted mortality rate was 12.4 per 1,000 population. The unadjusted HIV prevalence among decedents was 28.5% (95% confidence interval (CI): 25.5-31.6). The age- and sex-adjusted mortality rate in the HIV-infected population (40.7/1000 population) was four times higher than in the HIV-uninfected population (10.2/1000 population). Overall, the attributable fraction among the HIV-exposed was 0.71 (95% CI: 0.66-0.76) while the HIV population attributable fraction was 0.17 (95% CI: 0.14-0.20). In children the attributable fraction among the exposed and population attributable fraction were 0.92 (95% CI: 0.89-0.94) and 0.11 (95% CI: 0.08-0.15), respectively.<h4>Conclusions</h4>Over one quarter (28.5%) of decedents received by high-volume mortuaries in western Kenya were HIV-positive; overall, HIV was considered the cause of death in 17% of the population (19% of adults and 11% of children). Despite substantial scale-up of HIV services, HIV disease remains a leading cause of death in western Kenya. Despite progress, increased efforts remain necessary to prevent and treat HIV infection and disease.
format	article
author	Dickens O Onyango Marianne A B van der Sande Paul Musingila Eunice Kinywa Valarie Opollo Boaz Oyaro Emmanuel Nyakeriga Anthony Waruru Wanjiru Waruiru Mary Mwangome Teresia Macharia Peter W Young Muthoni Junghae Catherine Ngugi Kevin M De Cock George W Rutherford
author_facet	Dickens O Onyango Marianne A B van der Sande Paul Musingila Eunice Kinywa Valarie Opollo Boaz Oyaro Emmanuel Nyakeriga Anthony Waruru Wanjiru Waruiru Mary Mwangome Teresia Macharia Peter W Young Muthoni Junghae Catherine Ngugi Kevin M De Cock George W Rutherford
author_sort	Dickens O Onyango
title	High HIV prevalence among decedents received by two high-volume mortuaries in Kisumu, western Kenya, 2019.
title_short	High HIV prevalence among decedents received by two high-volume mortuaries in Kisumu, western Kenya, 2019.
title_full	High HIV prevalence among decedents received by two high-volume mortuaries in Kisumu, western Kenya, 2019.
title_fullStr	High HIV prevalence among decedents received by two high-volume mortuaries in Kisumu, western Kenya, 2019.
title_full_unstemmed	High HIV prevalence among decedents received by two high-volume mortuaries in Kisumu, western Kenya, 2019.
title_sort	high hiv prevalence among decedents received by two high-volume mortuaries in kisumu, western kenya, 2019.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/222c9353f2ad444aac9e414e9dfc0a18
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High HIV prevalence among decedents received by two high-volume mortuaries in Kisumu, western Kenya, 2019.

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