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根据艾滋病毒/艾滋病患者群体的母亲孤儿情况估计成年死亡率
Bruno Masquelier1, Ian M Timæus2,3
1Louvain University.
Population studies
|November 21, 2024
概括
使用孤儿方法估计成人死亡率在艾滋病毒流行期间具有挑战性. 新的系数提高了准确性,提供可靠的成年死亡率估计,即使在高患病率的国家.
科学领域:
- 人口统计学 人口统计学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 基于孤儿的方法对于在缺乏强大的死亡登记系统的国家估计成人死亡率至关重要.
- 人类免疫缺陷病毒 (HIV) 的流行使这些方法复杂化,因为它改变了生存相关性,例如母亲和孩子之间的生存相关性.
- 现有的孤儿方法可能会低估严重流行病 (如获得性免疫缺陷综合征 (艾滋病)) 期间的成人死亡率.
研究的目的:
- 评估基于孤儿的不同方法在估计艾滋病毒流行期间成年人死亡率的表现.
- 开发和验证在高艾滋病毒患病率环境中基于孤儿的死亡率估计的改进系数.
- 评估这些精细方法在填补受影响地区成年死亡率数据缺口时的有用性.
主要方法:
- 微型模拟模型生成了1,152个经历HIV流行病的人口,以测试各种估计技术.
- 通过将生存概率与母亲生存比例联系起来,调整HIV血清流行率和抗逆转录病毒治疗覆盖率,利用回归分析推导出新的系数.
- 精细的方法被应用到16个非洲国家的调查和人口普查数据,这些国家的艾滋病毒流行率很高,用于验证.
主要成果:
- 最初的孤儿方法显著低估了艾滋病流行期间的成年人死亡率.
- 将新系数应用于合成孕产妇存活率指标,可以大幅改善成年人死亡率估计.
- 修订后的估计显示出与联合国人口部门已建立的数据有很强的一致性.
结论:
- 基于孤儿的估计方法需要调整,以准确反映艾滋病毒大流行影响的成年死亡率动态.
- 开发的系数为估计艾滋病毒/艾滋病严重影响的国家的成人死亡率提供了更可靠的方法.
- 这些改进的方法是解决成人死亡率的关键数据缺口的有价值的工具,特别是在高发病率的非洲国家.
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