Browsing by Subject "morbidity"

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    The influences of AIDS-related morbidity and mortality on change in urban households: An ethnographic study
    (2008) Bray, Rachel
    Drawing on qualitative panel data collected in a poor township on the edge of Cape Town, this paper provides a fine-grained analysis of the residential decision-making of five HIV positive women and some of their children. HIV status and illness are found to add to the pressures exerted by income and asset poverty in ways that further incline women to seek residential security for themselves and their children. The presence of HIV intensifies the mental health implications of pre-existing socio-economic burdens and efforts to respond to these. Much of the resultant mobility cannot therefore be considered AIDS specific. At the same time, being HIV positive and unwell (or anticipating illhealth) prompts women to organise particular domestic arrangements for themselves and their children. Previously non-resident children are moved from distant relatives to join the urban household, incurring financial and social strain on the domestic group and on infected women in particular. Infected mothers want to live with all their children so that they can nurture them, have opportunity to disclose and familiarise their children with the everyday implications of being positive and on treatment, and to ensure they have the skills to survive on their own should they themselves die. Such moves can be made without raising suspicion of HIV within the family because there is a well established pattern of moving teenagers from the Eastern Cape to schools in Masiphumelele for reasons of improving education.
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    Initial burden of disease estimates for South Africa, 2000
    (2003) Bradshaw, Debbie; Groenewald, Pam; Laubscher, Ria; Nannan, Nadine; Nojilana, Beatrice; Rosana, Norman; Pieterse, Desiréé; Schneider, Michelle; Bourne, David E; Timæus, Ian M; Dorrington, Rob; Johnson, Leigh
    Background. This paper describes the first national burden of disease study for South Africa. The main focus is the burden due to premature mortality, i.e. years of life lost (YLLs). In addition, estimates of the burden contributed by morbidity, i.e. the years lived with disability (YLDs), are obtained to calculate disability-adjusted life years (DALYs); and the impact of AIDS on premature mortality in the year 2010 is assessed. Method. Owing to the rapid mortality transition and the lack of timely data, a modelling approach has been adopted. The total mortality for the year 2000 is estimated using a demographic and AIDS model. The non-AIDS cause-of-death profile is estimated using three sources of data: Statistics South Africa, the National Department of Home Affairs, and the National Injury Mortality Surveillance System. A ratio method is used to estimate the YLDs from the YLLestimates. Results. The top single cause of mortality burden was HIV/AIDS followed by homicide, tuberculosis, road traffic accidents and diarrhoea. HIV/AIDS accounted for 38% of total YLLs, which is proportionately higher for females (47%) than for males (33%). Pre-transitional diseases, usually associated with poverty and underdevelopment, accounted for 25%, non-communicable diseases 21% and injuries 16% of YLLs. The DALY estimates highlight the fact that mortality alone underestimates the burden of disease, especially with regard to unintentional injuries, respiratory disease, and nervous system, mental and sense organ disorders. The impact of HIV/AIDS is expected to more than double the burden of premature mortality by the year 2010. Conclusion. This study has drawn together data from a range of sources to develop coherent estimates of premature mortality by cause. South Africa is experiencing a quadruple burden of disease comprising the pre-transitional diseases, the emerging chronic diseases, injuries, and HIV/AIDS. Unless interventions that reduce morbidity and delay morbidity become widely available, the burden due to HIV/AIDS can be expected to grow very rapidly in the next few years. An improved base of information is needed to assess the morbidity impact more accurate.