子どもの生存率とHIV/AIDSに関する国際的な目標を達成すること
Neff Walker1, Bernhard Schwartländer, Jennifer Bryce
1Joint United Nations Programme on HIV/AIDS, 20 Avenue Appia, 1211 Geneva, Switzerland. walkern@unaids.org
Lancet (London, England)
|July 31, 2002
まとめ
ヒト免疫不全ウイルスと獲得免疫不全症候群 (HIV/AIDS) は,1990年から1999年の間にサハラ以南のアフリカで5歳未満の死亡率を大幅に増加させた. HIV/AIDSは懸念が高まっていますが,世界の死亡率削減目標を達成するために,他の子どもを殺害する病気にも注意が必要です.
科学分野:
- グローバル・ヘルス グローバル・ヘルス
- エピデミオロジー エピデミオロジー
- 小児科は小児科です.
背景:
- 5歳未満の死亡率を減らすための取り組みは,過去10年間にわたり,さまざまな結果をもたらしました.
- ヒト免疫不全ウイルスと獲得免疫不全症候群 (HIV/AIDS) の流行は,進展の停滞の理由としてしばしば挙げられます.
- この研究は,サハラ以南のアフリカにおける5歳未満の死亡傾向に対するHIV/エイズの影響を調査しています.
研究 の 目的:
- サハラ以南のアフリカ39カ国でHIVに起因する5歳未満の死亡率を推定する.
- 1990年から1999年の間,HIVに起因する死亡率と5歳未満の死亡率を比較する.
- 幼児死亡率の傾向を逆転させる上でHIV/AIDSの役割を評価する.
主な方法:
- 産前クリニックのHIV血清発生率データを用いて4段階の推定プロセスを利用しました.
- HIVに感染した母親から生まれた子供の数を推定した.
- 計算された母から子への感染率と,その後の5歳未満の死亡率,競合する原因に調整した.
主要な成果:
- 1999年,サハラ以南のアフリカで,HIV感染で5歳未満の子供が約33万人死亡したと推定されています.
- HIV感染は1999年の5歳未満の死亡の7.7%を占め,1990年の2%から増加しました.
- 5カ国は1000人当たりHIVによる5歳未満の死亡者数で30人を超え,さらに16カ国は1000人当たり10~25人を超えた.
結論:
- HIV/AIDSは,アフリカにおける5歳未満の死亡率の重要な要因であり,増加しています.
- HIV/AIDSだけでは,多くのアフリカ諸国における幼児死亡率の停滞や逆転を説明できない.
- HIV/AIDSと共に他の主要な小児疾患に対処するための保健システムの強化は,国際的な死亡率削減目標を達成するために不可欠です.
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