scholarly journals Age, Period and Cohort Analysis of Young Adult Mortality due to HIV and TB in South Africa: 1997-2015

2021 ◽  
Author(s):  
Tshifhiwa Nkwenika ◽  
Samuel Manda
Keyword(s):  
South Africa ◽  
Young Adult ◽  
Birth Cohort ◽  
Mortality Rates ◽  
Adult Mortality ◽  
Downward Trend ◽  
Mortality Data ◽  
Hiv Mortality ◽  
Related Mortality ◽  
Hiv Aids

Abstract Background: Young adult mortality is very significant in South Africa due to the influence of HIV/AIDS, Tuberculosis (TB), Injuries and Non-Communicable Diseases (NCDs). Previous analyses have mainly focused on assessing the time effect of age and period separately. However, health outcomes often depend on three-time scales, namely age, period, and cohort, which are linearly interlinked. Using Age-Period-Cohort (APC) models, this study estimated the time effects of age, period, and cohort on HIV and TB mortality among young adults in South Africa. Methods: HIV and TB mortality data and mid population estimates were obtained from Statistics South Africa for the period 1997 to 2015. Mortality data are based on deaths reported to the Department of Home Affairs where the underlying cause of death was HIV or TB based on the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) definition. Observed HIV/AIDS deaths were adjusted for under-reporting, misclassification, and systematic proportion from ill-defined natural deaths. Three-year age, period, and birth cohort intervals for 15-64 years, 1997-2015 and 1934-2000 respectively were used. The Age-Period-Cohort (APC) analysis using the Poisson distribution was used to compute the effects of age, period, and cohort on mortality due to TB and HIV. Results: A total of 5, 825,502 adult deaths were recorded from the period 1997 to 2015 of which, 910,731 (15.6%) and 252,101 (4.3%) were attributed to TB and HIV, respectively. For both observed mortality rate and estimated relative effects, concave down associations were found between TB, HIV mortality rates and period, age with peaks, at 36-38 and 30-32 years, respectively. A downward trend and inverted V-shape between TB and HIV mortality by birth cohort was found, respectively. Conclusions: The study found an inverse U-shaped association between TB-related mortality and age, period, and general downward trend with a birth cohort for deaths reported between 1997 and 2015. A concave down relationship between HIV-related mortality and age, period, and inverted V-shaped with birth cohort was found. Our findings have shed more light on HIV and TB mortality rates across different age groups, the effect of changes in the overall TB and HIV management and care on the mortality rates, and whether the mortality rates depend on the year an individual was born.

scholarly journals Young Adult Age-Period-Cohort Analysis of HIV and TB Mortality in South Africa: 1997-2015

2020 ◽  
Author(s):  
Tshifhiwa Nkwenika ◽  
Samuel Manda
Keyword(s):  
South Africa ◽  
Young Adult ◽  
Birth Cohort ◽  
Cohort Analysis ◽  
Mortality Rates ◽  
Downward Trend ◽  
Mortality Data ◽  
Hiv Mortality ◽  
Related Mortality ◽  
Hiv Aids

Abstract Background: Young adult mortality is very significant in South Africa due to the influence of HIV/AIDS, Tuberculosis (TB), Injuries and Non-Communicable Diseases (NCDs). Previous analyses have mainly focused on assessing time effect of age and period separately. However, health outcomes often depend on three-time scales of age, period and cohort, which are linearly interlinked. Using Age-Period-Cohort (APC) models, this study estimated the time effects of age, period and cohort on HIV and TB mortality among young adults in South Africa.Methods: HIV and TB mortality data and mid population estimates were obtained from Statistics South Africa for the period 1997 to 2015. Mortality data are based on deaths reported to the Department of Home Affairs where the underlying cause of death was HIV or TB based on the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) definition. Observed HIV/AIDS deaths were adjusted for under-reporting, misclassification and systematic proportion from ill-defined natural deaths. Three-year age, period, and birth cohort intervals for 15–64 years, 1997–2015 and 1934–2000 respectively were used. The Age-Period-Cohort (APC) analysis using the Poisson distribution was used to compute the effects of age, period and cohort on mortality due to TB and HIV.Results: A total of 5, 825,502 adult deaths were recorded from the period 1997 to 2015 of which, 910,731 (15.6%) and 252,101 (4.3%) were attributed to TB and HIV, respectively. For both observed mortality rate and estimated relative effects, concave down associations were found between TB, HIV mortality rates and period, age with peaks, at 36–38 and 30–32 years, respectively. A downward trend and inverted V-shape between TB and HIV mortality by birth cohort was found, respectively.Conclusions: The study found an inverse U-shaped association between TB-related mortality and age, period, and general downward trend with birth cohort for deaths reported between 1997 and 2015. A concave down relationship between HIV-related mortality and age, period, and inverted V-shaped with birth cohort was found. Our findings have shed more light on HIV and TB mortality rates across different age groups, effect of changes in the overall TB and HIV management and care on the mortality rates and whether or not the mortality rates depended on the year an individual was born.

scholarly journals Early cohort mortality predicts the rate of aging in the cohort: a historical analysis

2012 ◽  
Vol 3 (5) ◽  
pp. 380-386 ◽  
Author(s):  
H. Beltrán-Sánchez ◽  
E. M. Crimmins ◽  
C. E. Finch
Keyword(s):  
20Th Century ◽  
Early Life ◽  
Later Life ◽  
Mortality Rates ◽  
Adult Mortality ◽  
Mortality Data ◽  
Early 20Th Century ◽  
Adult Health ◽  
Mortality Level ◽  
Poor Nutrition

Early environmental influences on later-life health and mortality are well recognized in the doubling of life expectancy since 1800. To further define these relationships, we analyzed the associations between early-life mortality and both the estimated mortality level at age 40 and the exponential acceleration in mortality rates with age characterized by the Gompertz model. Using mortality data from 630 cohorts born throughout the 19th and early 20th century in nine European countries, we developed a multilevel model that accounts for cohort and period effects in later-life mortality. We show that early-life mortality, which is linked to exposure to infection and poor nutrition, predicts both the estimated cohort mortality level at age 40 and the subsequent Gompertz rate of mortality acceleration during aging. After controlling for effects of country and period, the model accounts for the majority of variance in the Gompertz parameters (about 90% of variation in the estimated level of mortality at age 40 and about 78% of variation in the Gompertz slope). The gains in cohort survival to older ages are entirely due to large declines in adult mortality level, because the rates of mortality acceleration at older ages became faster. These findings apply to cohorts born in both the 19th century and the early 20th century. This analysis defines new links in the developmental origins of adult health and disease in which effects of early-life circumstances, such as exposure to infections or poor nutrition, persist into mid-adulthood and remain evident in the cohort mortality rates from ages 40 to 90.

Trends in Melanoma Mortality in the Population Groups of South Africa

Dermatology ◽  
2019 ◽  
Vol 235 (5) ◽  
pp. 396-399 ◽  
Author(s):  
Caradee Yael Wright ◽  
Thandi Kapwata ◽  
Elvira Singh ◽  
Adele C. Green ◽  
Peter Baade ◽  
...  
Keyword(s):  
South Africa ◽  
Regression Models ◽  
Population Group ◽  
Mortality Rates ◽  
Mortality Data ◽  
African Countries ◽  
South Africans ◽  
Awareness Campaigns ◽  
Increasing Trend ◽  
Join Point

The incidence of cutaneous melanoma (CM) is increasing in countries around the world. However, little is known about melanoma trends in African countries by population group. We studied CM mortality in South Africa from 1997 to 2014 to partly address this knowledge gap. Unit record mortality data for all South Africans who died from CM (n = 8,537) were obtained from Statistics South Africa. Join-point regression models were used to assess whether there was a statistically significant change in the direction and/or magnitude of the annual trends in CM mortality. A significant increasing trend of 11% per year was observed in age-adjusted mortality rates in men between 2000 and 2005 (p < 0.01), rising from 2 to 3 per 100,000. There was also a statistically significant increase of 180% per year among White South Africans from 1997 to 1999 (p < 0.05) and of 3% from 1999 to 2014 (p < 0.01). These results may be used to inform CM awareness campaigns and will motivate efforts to improve the collection and analysis of relevant statistics regarding the present burden of CM in South Africa.

scholarly journals The development of a localised HIV epidemic and the associated excess mortality burden in a rural area of South Africa

2016 ◽  
Vol 1 ◽  
Author(s):  
P. Mee ◽  
K. Kahn ◽  
C.W. Kabudula ◽  
R.G. Wagner ◽  
F. X. Gómez-Olivé ◽  
...  
Keyword(s):  
South Africa ◽  
Rural Area ◽  
Migrant Workers ◽  
Mortality Rates ◽  
Host Community ◽  
Healthcare Provision ◽  
South Africans ◽  
Hiv Epidemic ◽  
Hiv Mortality ◽  
Immunodeficiency Virus

The human immunodeficiency virus (HIV) epidemic in South Africa rapidly developed into a major pandemic. Here we analyse the development of the epidemic in a rural area of the country. The data used were collected between 1992 and 2013 in a longitudinal population survey, the Agincourt Health and Demographic Surveillance Study, in the northeast of the country. Throughout the period of study mortality rates were similar in all villages, suggesting that there were multiple index cases evenly spread geographically. These were likely to have been returning migrant workers. For those aged below 39 years the HIV mortality rate was higher for women, above this age it was higher for men. This indicates the protective effect of greater access to HIV testing and treatment among older women. The recent convergence of mortality rates for Mozambicans and South Africans indicates that the former refugee population are being assimilated into the host community. More than 60% of the deaths occurring in this community between 1992 and 2013 could be attributed directly or indirectly to HIV. Recently there has been an increasing level of non-HIV mortality which has important implications for local healthcare provision. This study demonstrates how evidence from longitudinal analyses can support healthcare planning.

scholarly journals Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: panel data study

BMJ ◽  
2021 ◽  
pp. m4957 ◽  
Author(s):  
Greta Hsu ◽  
Balázs Kovács
Keyword(s):  
United States ◽  
Confidence Interval ◽  
The United States ◽  
Mortality Rates ◽  
Mortality Data ◽  
Panel Regression ◽  
County Level ◽  
Regression Methods ◽  
Synthetic Opioids ◽  
Related Mortality

Abstract Objective To examine county level associations between the prevalence of medical and recreational cannabis stores (referred to as dispensaries) and opioid related mortality rates. Design Panel regression methods. Setting 812 counties in the United States in the 23 states that allowed legal forms of cannabis dispensaries to operate by the end of 2017. Participants The study used US mortality data from the Centers for Disease Control and Prevention combined with US census data and data from Weedmaps.com on storefront dispensary operations. Data were analyzed at the county level by using panel regression methods. Main outcome measure The main outcome measures were the log transformed, age adjusted mortality rates associated with all opioid types combined, and with subcategories of prescription opioids, heroin, and synthetic opioids other than methadone. The associations of medical dispensary and recreational dispensary counts with age adjusted mortality rates were also analyzed. Results County level dispensary count (natural logarithm) is negatively related to the log transformed, age adjusted mortality rate associated with all opioid types (β=−0.17, 95% confidence interval −0.23 to −0.11). According to this estimate, an increase from one to two storefront dispensaries in a county is associated with an estimated 17% reduction in all opioid related mortality rates. Dispensary count has a particularly strong negative association with deaths caused by synthetic opioids other than methadone (β=−0.21, 95% confidence interval −0.27 to −0.14), with an estimated 21% reduction in mortality rates associated with an increase from one to two dispensaries. Similar associations were found for medical versus recreational storefront dispensary counts on synthetic (non-methadone) opioid related mortality rates. Conclusions Higher medical and recreational storefront dispensary counts are associated with reduced opioid related death rates, particularly deaths associated with synthetic opioids such as fentanyl. While the associations documented cannot be assumed to be causal, they suggest a potential association between increased prevalence of medical and recreational cannabis dispensaries and reduced opioid related mortality rates. This study highlights the importance of considering the complex supply side of related drug markets and how this shapes opioid use and misuse.

scholarly journals Mortality in Tonga over three triennia, 2010–2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Carah Figueroa ◽  
Christine Linhart ◽  
Latu Fusimalohi ◽  
Sioape Kupu ◽  
Gloria Mathenge ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Mortality Rates ◽  
Adult Mortality ◽  
Statistical Testing ◽  
International Agency ◽  
Mortality Data ◽  
Local Health ◽  
Mortality Trends ◽  
Substantial Impact ◽  
International Agencies

Abstract Background Tonga is a South Pacific Island country with a population of 100,651 (2016 Census). This study examines Tongan infant mortality rates (IMR), under-five mortality rates (U5MR), adult mortality and life expectancy (LE) at birth from 2010 to 2018 using a recent collation of empirical mortality data over the past decade for comparison with other previously published mortality estimates. Methods Routinely collected mortality data for 2010–2018 from the Ministry of Health, national (Vaiola) hospital, community nursing reports, and the Civil Registry, were consolidated by deterministic and probabilistic linkage of individual death records. Completeness of empirical mortality reporting was assessed by capture-recapture analysis. The reconciled data were aggregated into triennia to reduce stochastic variation, and used to estimate IMR and U5MR (per 1000 live births), adult mortality (15–59, 15–34, 35–59, and 15–64 years), and LE at birth, employing the hypothetical cohort method (with statistical testing). Mortality trends and differences were assessed by Poisson regression. Mortality findings were compared with published national and international agency estimates. Results Over the three triennia in 2010–2018, levels varied minimally for IMR (12–14) and U5MR (15–19) per 1000 births (both ns, p > 0.05), and also for male LE at birth of 64–65 years, and female LE at birth 69–70 years. Cumulated risks of adult mortality were significantly higher in men than women; period mortality increases in 15–59-year women from 18 to 21% were significant (p < 0.05). Estimated completeness of the reconciled data was > 95%. International agencies reported generally comparable estimates of IMR and U5MR, with varying uncertainty intervals; but they reported significantly lower adult mortality and higher LE than the empirical estimates from this study. Conclusions Life expectancy in Tonga over 2010–2018 has remained relatively low and static, with low IMR and U5MR, indicating the substantial impact from premature adult mortality. This analysis of empirical data (> 95% complete) indicates lower LE and higher premature adult mortality than previously reported by international agencies using indirect and modelled methods. Continued integration of mortality recording and data systems in Tonga is important for improving the completeness and accuracy of mortality estimation for local health monitoring and planning.

scholarly journals Primary malignant brain tumor-related mortality in the Belgrade population

2003 ◽  
Vol 60 (5) ◽  
pp. 565-568
Author(s):  
Tatjana Pekmezovic ◽  
Mirjana Jarebinski ◽  
Darija Kisic ◽  
Milen Pavlovic ◽  
Marina Nikitovic ◽  
...  
Keyword(s):  
Linear Trend ◽  
Population Data ◽  
Mortality Rates ◽  
Mortality Data ◽  
World Population ◽  
Age Group ◽  
Test Results ◽  
Female Population ◽  
Specific Mortality ◽  
Related Mortality

Background. The aim of this investigation was the analysis of primary malignant brain tumors (PMBT)-related mortality in the Belgrade population during the period 1983?2000. Methods. Mortality data (based on death records) for the period observed, as well as population data, were obtained from the unpublished material of the Municipal Institute of Statistics, Belgrade. The data analysis was adjusted to specific and standardized mortality rates and linear trend, using the world population as a standard. Regression coefficient was determined by Fisher?s test. Results. During the period 1983?2000, in the Belgrade population standardized mortality rates from PMBT were 6.29/100 000 (95%CI-confidence interval 5.33?7.24) for males, 4.50/100 000 (95%CI 3.84?5.17) for females, and 5.91/100 000 (95%CI 5.20?6.63) for total population. The age-specific mortality rates increased with age up to the age group 65?74, with the highest value of 21.21/100 000 (95%CI 16.03?26.39), and decreased in persons of 75 and more years of age. Conclusion. Mortality rates from PMBT in Belgrade had slightly increasing tendency in male (5.725+0.0592x, p=0.545), and decreasing tendency in female population (y=4.703-0.0213x, p=0.756), while statistically significant increasing mortality rate was registered only in the age group 65?74 (y=435+1.7707x, p=0.0001).

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