#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Child Mortality Estimation: Methods Used to Adjust for Bias due to AIDS in Estimating Trends in Under-Five Mortality


In most low- and middle-income countries, child mortality is estimated from data provided by mothers concerning the survival of their children using methods that assume no correlation between the mortality risks of the mothers and those of their children. This assumption is not valid for populations with generalized HIV epidemics, however, and in this review, we show how the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) uses a cohort component projection model to correct for AIDS-related biases in the data used to estimate trends in under-five mortality. In this model, births in a given year are identified as occurring to HIV-positive or HIV-negative mothers, the lives of the infants and mothers are projected forward using survivorship probabilities to estimate survivors at the time of a given survey, and the extent to which excess mortality of children goes unreported because of the deaths of HIV-infected mothers prior to the survey is calculated. Estimates from the survey for past periods can then be adjusted for the estimated bias. The extent of the AIDS-related bias depends crucially on the dynamics of the HIV epidemic, on the length of time before the survey that the estimates are made for, and on the underlying non-AIDS child mortality. This simple methodology (which does not take into account the use of effective antiretroviral interventions) gives results qualitatively similar to those of other studies.


Vyšlo v časopise: Child Mortality Estimation: Methods Used to Adjust for Bias due to AIDS in Estimating Trends in Under-Five Mortality. PLoS Med 9(8): e32767. doi:10.1371/journal.pmed.1001298
Kategorie: Review
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1001298

Souhrn

In most low- and middle-income countries, child mortality is estimated from data provided by mothers concerning the survival of their children using methods that assume no correlation between the mortality risks of the mothers and those of their children. This assumption is not valid for populations with generalized HIV epidemics, however, and in this review, we show how the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) uses a cohort component projection model to correct for AIDS-related biases in the data used to estimate trends in under-five mortality. In this model, births in a given year are identified as occurring to HIV-positive or HIV-negative mothers, the lives of the infants and mothers are projected forward using survivorship probabilities to estimate survivors at the time of a given survey, and the extent to which excess mortality of children goes unreported because of the deaths of HIV-infected mothers prior to the survey is calculated. Estimates from the survey for past periods can then be adjusted for the estimated bias. The extent of the AIDS-related bias depends crucially on the dynamics of the HIV epidemic, on the length of time before the survey that the estimates are made for, and on the underlying non-AIDS child mortality. This simple methodology (which does not take into account the use of effective antiretroviral interventions) gives results qualitatively similar to those of other studies.


Zdroje

1. StoverJ, JohnsonP, HallettT, MarstonM, BecquetR, et al. (2010) The Spectrum projection package: improvements in estimating incidence by age and sex, mother-to-child transmission, HIV progression in children and double orphans. Sex Transm Infect 86(Suppl 2) ii16–ii21.

2. LopmanBA, BarnabasR, HallettTB, NyamukapaC, MundandiC, et al. (2006) Assessing adult mortality in HIV-1-afflicted Zimbabwe (1998–2003). Bull World Health Organ 84: 189–197.

3. Joint United Nations Programme on HIV/AIDS (2010) UNAIDS report on the global AIDS epidemic: 2010. Geneva: Joint United Nations Programme on HIV/AIDS.

4. BlackerJ, ZabaB (1997) HIV prevalence and lifetime risk of dying of AIDS. Health Transit Rev 7(Suppl 2) 45–62.

5. Mahy M (2003) Measuring child mortality in AIDS-affected countries. New York: United Nations Population Division. Available: http://www.un.org/esa/population/publications/adultmort/UNICEF_Paper15.pdf. Accessed 4 July 2012.

6. Zaba B, Marston M, Floyd S (2003) The effect of HIV on child mortality trends in sub-Saharan Africa. New York: United Nations Population Division. Available: http://www.un.org/esa/population/publications/adultmort/Zaba.pdf. Accessed 4 July 2012.

7. WardP, ZabaB (2008) The effect of HIV on the estimation of child mortality using the children surviving/children ever born technique. South Afr J Demogr 11: 39–73.

8. HallettTB, GregsonS, KurwaF, GarnettGP, DubeS, et al. (2010) Measuring and correcting biased child mortality statistics in countries with generalized epidemics of HIV infection. Bull World Health Organ 88: 761–768.

9. Schneider M, Zwahlen M, Egger M (2004) Natural history and mortality in HIV-positive individuals living in resource-poor settings: a literature review. Bern: Institute of Social and Preventive Medicine, University of Bern. Available: http://www.epidem.org/Publications/unaids%20HQ_03_463871%20final.pdf. Accessed 4 July 2012.

10. ToddJ, GlynnJR, MarstonM, LutaloT, BiraroS, et al. (2007) Time from HIV seroconversion to death: a collaborative analysis of eight studies in six low- and middle-income countries before highly active antiretroviral therapy. AIDS 21(Suppl 6) 555–563.

11. StoverJ, JohnsonP, ZabaB, ZwahlenM, DabisF, et al. (2008) The Spectrum projection package: improvements in estimating mortality, ART needs, PMTCT impact and uncertainty bounds. Sex Transm Infect 84 (Suppl 1) i24–i30.

12. Child Mortality Coordination Group (2006) Tracking progress towards the Millennium Development Goals: reaching consensus on child mortality levels and trends. Bull World Health Organ 84: 225–232.

13. Coale AJ, Demeny P (1983) Regional model life tables and stable populations, 2nd edition. Princeton: Princeton University Press.

14. HillK, YouD, InoueM, OestergaardMZ (2012) Child mortality estimation: accelerated progress in reducing global child mortality, 1990–2010. PLoS Med 9: e1011303 doi:10.1371/journal.pmed.1001303.

15. United Nations Inter-agency Group for Child Mortality Estimation (2010) Levels & trends in child mortality: report 2010. New York: United Nations Children's Fund. Available: http://www.childinfo.org/files/Child_Mortality_Report_2010.pdf. Accessed 4 July 2012.

16. Mutematinga T (2011) Impact of HIV on estimates of child mortality derived using the summary birth history (CEB/CS) method [MPhil thesis]. Cape Town: Centre for Actuarial Research, University of Cape Town.

Štítky
Interné lekárstvo

Článok vyšiel v časopise

PLOS Medicine


2012 Číslo 8
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Kurzy

Zvýšte si kvalifikáciu online z pohodlia domova

Získaná hemofilie - Povědomí o nemoci a její diagnostika
nový kurz

Eozinofilní granulomatóza s polyangiitidou
Autori: doc. MUDr. Martina Doubková, Ph.D.

Všetky kurzy
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#