Majority of AIDS deaths in South Africa are misclassified

Liz Clarke:

A bleak and frightening scenario of the huge numbers of people dying from Aids-related diseases was depicted in presentation after presentation at the South African Aids Conference in Durban this week.

But the real numbers remain a mystery, as most of the Aids-related conditions leading to death were not attributed to HIV/Aids in South Africa's official mortality statistics.

"Underreporting and misclassification" of at least 12 potential opportune infections in the official South African death statistics were, according to an updated report, not portraying a true picture.

Presenting the report at the conference, Pam Groenewald, of the Medical Research Council's Burden of Disease Research Unit, said that while the process of death registration had improved (although not for children) natural deaths, which topped the list in the South African mortality statistics, were "ill-defined".

"Our findings," she said, showed that 61% of the HIV/Aids deaths were misclassified on the death notification and were attributed to a number of Aids-related conditions without any reference to HIV/Aids, including tuberculosis (which is known to have a 43%
co-infection rate with HIV), pneumonia and diarrhoea.

When Aids-related deaths were incorporated into the statistics, the actual figure for 2004/5 was 47% and not 12% as officially reported.

"Given the rapid change in mortality in South Africa it is absolutely essential that official cause-specific mortality data is made available," she said.

S.Africa warned of "national wipe-out" from AIDS