Impact of HIV/AIDS on Mortality among the Inpatients at Motebang Hospital, Lesotho

Abstract

Study design. A retrospective descriptive study of the mortality trend among inpatients at Motebang district hospital in Lesotho. Aim. To assess the impact of HIV/AIDS on the mortality of Motebang Hospital inpatients from 1989 to 2003. Rationale. If the hypothesis that AIDS had modified the mortality in a unique way could be confirmed, mortality trends could be used to supplement other methods of estimating the impact of HIV/AIDS such as antenatal and sexually transmitted infections sentinel surveillance. Methodology. Inpatients’ data were collected from January 1989 to December 2003. The 15-year period was split into three 5-year periods (1989 - 1993, 1994 - 1998, and 1999 - 2003) and the diagnoses were grouped into Global Burden of Disease groups I, II, and III. The data were analysed to establish time, gender and age trends. Results. The mortality rate and number of deaths increased over the 15-year period. Group I (communicable diseases, maternal, perinatal, and nutritional conditions) contributed 69% of all deaths. The rise in mortality was most pronounced in the 15 - 49-year age range, progressively forming a ‘bulge’ on the death incidence by age curve, with the female peak occurring at the 25 - 29-year age category, 5 years earlier than males. The study found that AIDS-related deaths accounted for 51 - 65% of total deaths and 70 - 80% of group I deaths. Although the number of the inpatients in group II was low, there was evidence of increasing burden from non-communicable diseases. However, the burden from group III (injuries) remained stable. Conclusion. AIDS modified the mortality trend of the Motebang Hospital inpatients by raising the deaths of younger adults, thereby deviating from the expected natural trend. This implied that mortality data of the hospital provenance can provide information necessary for, inter alia, evaluation of the impact of current and future interventions, for instance, the impact of the proposed provision of antiretroviral drugs.