HIV/Aids facts hard to come by

The majority of the 572673 deaths that year were attributed to natural causes, and 30% occurred at home. Infectious and parasitic diseases were a major contributor. Tuberculosis (TB) was the leading natural cause of death in all provinces except the Free State and Limpopo, where influenza and pneumonia topped the list, according to the Stats SA research.

This contrasts with the findings of the Medical Research Council's (MRC) burden of disease research unit since 2000. The unit ranks HIV/Aids, ischaemic heart disease, stroke and TB as the four main causes of death in the country.

Richard Nethononda, professor of cardiology and consultant to the Chris Hani Baragwanath Academic Hospital and the Wits University Donald Gordon Medical Centre in Johannesburg, says there is no adequate system to monitor the leading causes of death in SA.

He says the lack of accurate and consistent statistical data makes the work of medical specialists difficult.

"There is no central point or information hub where mortality trends in SA can be tracked. The closest we have come is the latest population census, which can be seen as a first attempt in a very long time to address the matter of capturing proper statistics," he says.

MRC burden of disease research unit director Prof Debbie Bradshaw agrees there is no central and accurate database of reliable statistics on SA's mortality rate.

She says there was a time when an estimated half of the deaths occurring in the country were not being registered. However, some improvement has taken place, she says, as government realised how poor the quality of the health profile was.

"In addition to the existence of the communicable diseases HIV/Aids and TB, noncommunicable diseases such as hypertension are increasing, which could be closely linked to the high rate of strokes and heart disease as the causes of death," says Bradshaw.

The council says one problem in gathering statistics is the quality of information on death certificates.

"We have a long way to go to get accurate data on deaths and causes of death," Bradshaw says. She adds that the misreporting can be attributed to the era when "the political climate meant there was a huge stigma attached to HIV/Aids. Many doctors were reluctant to indicate this as the cause of death, and would rather write it was tuberculosis or pneumonia.

"We need to [change this], and must be open as a society [so that we can] gauge the true burden of disease in the country."

To address the problem the MRC and the Western Cape government have started a programme to train doctors to record deaths properly.

Source: Financial Mail