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HIV-related deaths in Nairobi, Kenya: Results from a HIV mortuary surveillance study, 2015
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5 01 2019
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Source: J Acquir Immune Defic Syndr. 81(1):18-23
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Details:
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Alternative Title:J Acquir Immune Defic Syndr
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Description:Background:
Death is an important but often unmeasured endpoint in public health HIV surveillance. We sought to describe HIV among deaths using a novel mortuary-based approach in Nairobi, Kenya.
Methods:
Cadavers aged ≥15 years at death at Kenyatta National Hospital (KNH) and City Mortuaries were screened consecutively from January 29th to March 3rd 2015. Cause of death was abstracted from medical files and death notification forms. Cardiac blood was drawn and tested for HIV infection using the national HIV testing algorithm followed by viral load testing of HIV-positive samples.
Results:
Of 807 eligible cadavers, 610 (75.6%) had an HIV test result available. Cadavers from KNH had significantly higher HIV positivity at 23.2% (95% CI 19.3–27.7) compared to City Mortuary at 12.6% (95% CI 8.8–17.8), p<0.001. HIV prevalence was significantly higher among women than men at both City (33.3% versus 9.2%, p=0.008) and KNH Mortuary (28.8% versus 19.0%, p=0.025). Half (53.3%) of HIV infected cadavers had no diagnosis prior to death and an additional 22.2% were only diagnosed during hospitalization leading to death. Although not statistically significant, 61.9% of males had no prior diagnosis compared to 45.8% of females (p=0.144). Half (52.3%) of 44 cadavers at KNH with HIV diagnosis prior to death were on treatment, and one in five (22.7%) with a prior diagnosis had achieved viral suppression.
Conclusions:
HIV prevalence was high among deaths in Nairobi, especially among women, and prior diagnosis among cadavers was low. Establishing routine mortuary surveillance can contribute to monitoring HIV-associated deaths among cadavers sent to mortuaries.
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Pubmed ID:30964803
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Pubmed Central ID:PMC8569897
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