Can routine inpatient mortality data improve HIV mortality estimates? Inpatient mortality at an urban hospital in South Africa

By  Lawrence Long  Denise Evans  Sydney Rosen  Alana Brennan  Professor Ian Sanne  Matthew Fox  |  | 

South Africa (SA) has one of the world’s largest HIV treatment programmes, to which a dramatic increase in life expectancy
has been attributed. However, there continue to be concerns regarding the reporting of HIV-related mortality in SA, which varies by
source. As accurate HIV mortality estimates are key to measuring the success of the national programme as well as identifying areas for
improvement, we propose a complementary approach to monitoring changes in HIV-related mortality using routine inpatient records to
examine trends in causes of death and HIV status over time.
Objectives. To investigate the feasibility of this approach by calculating mortality due to natural causes in the medical ward of a hospital
during 2010 by HIV status.
Methods. We conducted a cross-sectional study of inpatient mortality at a regional hospital in Johannesburg, SA, analysing all deaths due
to natural causes among adult medical ward inpatients. Cause of death was recorded from the mortuary register. HIV status was ascertained
directly from the mortuary register or from laboratory tests specific for HIV diagnosis or monitoring.

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SAMJ Research