Demographic impact of HIV infection in rural Rakai district, Uganda: Results of a population-based cohort study

Nelson K. Sewankambo, Maria J Wawer, Ronald H Gray, David Serwadda, Chuanjun Li, Rebecca Y. Stallings, Stanley D. Musgrave, Joseph Konde-Lule

Research output: Contribution to journalArticle

Abstract

Objectives: To examine HIV-1-related mortality and demographic impact in a high HIV prevalence rural district of Uganda. Design: One-year follow-up (1990-1991) in a population-based rural cohort. Setting and participants: Annual enumeration of all consenting residents of 1945 households in 31 randomly selected community clusters in Rakai District. Subjects provided yearly HIV serological samples, behavioral and health information. Main outcome measure: Mortality in HIV-infected and uninfected persons. Results: Mortality among HIV-seropositive adults aged ≥ 15 years of 118.4 per 1000 person-years (PY) was substantially higher than in HIV-seronegative adults [12.4 per 1000 PY; relative risk (RR), 9.5; 95% confidence interval (CI), 6.0-14.9]. Infant mortality among offspring of HIV-infected mothers was almost double that for uninfected women (210 compared with 111 per 1000 live births; RR, 1.9; 95% CI, 1.0-3.5). Adult HIV-related mortality was associated with HIV prevalence and, in this cohort, with higher education, non-agricultural occupation and residence in roadside trading centers. We estimate that adult HIV prevalence in the district is 13% and adult HIV attributable mortality 52%. For all ages combined, district HIV attributable mortality is 28%. Conclusion: HIV is the leading cause of adult death in Rakai. Its effects on mortality are particularly marked in the most economically active sectors. However, the overall crude birth rate in the district (45.7 per 1000 population) remains higher than the crude death rate (28.1 per 1000 population), resulting in continued rapid population growth.

Original languageEnglish (US)
Pages (from-to)1707-1713
Number of pages7
JournalAIDS
Volume8
Issue number12
StatePublished - Dec 1994

Fingerprint

Uganda
HIV Infections
Cohort Studies
Demography
HIV
Population
Mortality
Confidence Intervals
Birth Rate
Population Growth
Live Birth
Infant Mortality
Rural Population
Occupations
HIV-1
Cause of Death
Mothers
Outcome Assessment (Health Care)

Keywords

  • AIDS
  • Demographic impact
  • Fertility
  • HIV
  • Mortality
  • Population growth
  • Rural Africa

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Sewankambo, N. K., Wawer, M. J., Gray, R. H., Serwadda, D., Li, C., Stallings, R. Y., ... Konde-Lule, J. (1994). Demographic impact of HIV infection in rural Rakai district, Uganda: Results of a population-based cohort study. AIDS, 8(12), 1707-1713.

Demographic impact of HIV infection in rural Rakai district, Uganda : Results of a population-based cohort study. / Sewankambo, Nelson K.; Wawer, Maria J; Gray, Ronald H; Serwadda, David; Li, Chuanjun; Stallings, Rebecca Y.; Musgrave, Stanley D.; Konde-Lule, Joseph.

In: AIDS, Vol. 8, No. 12, 12.1994, p. 1707-1713.

Research output: Contribution to journalArticle

Sewankambo, NK, Wawer, MJ, Gray, RH, Serwadda, D, Li, C, Stallings, RY, Musgrave, SD & Konde-Lule, J 1994, 'Demographic impact of HIV infection in rural Rakai district, Uganda: Results of a population-based cohort study', AIDS, vol. 8, no. 12, pp. 1707-1713.
Sewankambo, Nelson K. ; Wawer, Maria J ; Gray, Ronald H ; Serwadda, David ; Li, Chuanjun ; Stallings, Rebecca Y. ; Musgrave, Stanley D. ; Konde-Lule, Joseph. / Demographic impact of HIV infection in rural Rakai district, Uganda : Results of a population-based cohort study. In: AIDS. 1994 ; Vol. 8, No. 12. pp. 1707-1713.
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