Is HIV the leading cause of death in south Africa?
- September 26, 2024
- Health
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What’s the leading cause of death in South Africa? That depends on who you ask. According to health minister Dr Aaron Motsoaledi, HIV/AIDS is the biggest killer in our country. But the most recent mortality and causes of death report compiled by Statistics South Africa (Stats SA) lists COVID-19 as the leading cause of death. This report was published earlier this year and looks at deaths reported in 2020. According to the Stats SA report tuberculosis (TB) was the leading cause of death between 2012-2018. In 2019 it was diabetes. Zanele Taylor Mtsweni, Stats SA’s principal statistician: Health and Vital Statistics tells Health-e News that the statistics presented in the mortality and causes of death reports are based solely on administrative records from death notification forms obtained from the Department of Home Affairs. “It is true that the most recent publication is from 2020 deaths and in the publication we describe how the processing of death notification is conducted. These are paper forms (above 500 000) which are physically collected from Home Affairs by Stats SA and are then individually and manually captured, but prior to that there are other processes such as sorting of the forms by year of death, pasting a unique identifier label on each form,” she says. She adds that Stats SA also manually codes socio-demographic and causes of death variables before they can begin to analyse the data. “This is a very lengthy process hence the lag time between occurrence of death and publication,” she explains. Extensive misclassification in Stats SA mortality reporting The South African Medical Research Council ( SAMRC) agrees with Motsoaledi: HIV is the leading cause of death in South Africa. According to the SAMRC, there is extensive misclassification in Statistics South Africa mortality reporting, which renders these data unsuitable for health resource allocation decisions. Dr Nadine Nannan, specialist scientist in the SAMRC’s Burden of Disease Research Unit tells Health-e News that HIV-related deaths are a huge problem for South Africa and have been for decades. She says the minister is actually right. “When someone dies, by law there is a requirement for the death to be certified by a doctor. However, doctors are not certifying HIV as the underlying cause of death but they are certifying symtoms of HIV. Doctors look at the immediate cause of death. The World Health Organisation (WHO) considers the underlying cause of death as the most effective method as the best information is received from it,” she says. She says there are also various ways that the scientific community looks at death and they get reports from model-based information. She shares that they look at all effective data. Importance of reporting causes of death Researchers from SAMRC’s Burden of Disease Research Unit recently undertook a rapid assessment to identify the challenges related to the collection, reporting and use of cause of death statistics in South Africa to identify how these may be addressed. According to the study, South Africa has a well established civil registration and vital statistics system. However, there are indications that the cause of death data is poor. “Of concern is the misclassification of HIV/AIDS deaths as other causes. The COVID-19 pandemic profoundly highlighted shortcomings of the current civil registration and vital statistics system, which could not provide timely cause of death information, with limited access by the Department of Health to enable public health follow-up actions,” reads the study report. Nannan says reporting on causes of deaths is essential information for formulating public health policy. “This also helps preventative measures to be put in place to prevent deaths if they are preventable. It is also important information for planning health services to address public health problems. Policy makers can use the information for public health policies. It helps the government to know how many deaths have been recorded in a year and what were the causes of those deaths,” she says. – Health-e News
Health-e News
