Ngalula J, Urassa M, Ng'weshemi J, Boerma JT; International Conference on AIDS.

Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. WeOrD566.

J. Ngalula, TANESA Project, P.O. Box 434, Mwanza, Tanzania, United Republic of, Tel.: +255 68 500 236, Fax: +255 68 502 458, E-mail: nimr.mwanza@twiga.com

Background: Adult mortality is increasing rapidly in populations affected by the AIDS epidemic, but limited data exist on the medical care utilization during terminal illness and household impact. Methods: A demographic surveillance system with ten rounds during 1994-98 provided data on mortality and households. Verbal autopsies were done for 358 deaths 15-59 years, including HIV status data for 40% of deaths. 205 in-depth interviews were held on a subsample to inquire about expenditure for medical care and funeral. Results: Out of 4,956 households that were registered in Kisesa ward during 1994-98, 563 (11.4%) experienced a death of a person aged 15 years and over. If the head died, a large proportion of households dissolved within one year (38%). Among persons 15-59, AIDS was the leading cause of death (32% of deaths). Among those who had died of AIDS 82% were at least three months ill prior to death; 54% suspected witchcraft to be involved; 52% were admitted to a hospital at least once; and 69% visited a traditional healer during the terminal illness and 8% died in hospital. The median expenditure on medical care was about US$50 and on the funeral about US$ 34. In 62% of AIDS deaths the patient or the patient's spouse needed outside financial help. Property was sold off in 28% of cases. Comparison of AIDS deaths with adult deaths due to other causes (N = 133) showed that medical care utilization among AIDS patients did not differ much from that by other patients, when controlling for other factors in an ordered logit model. Conclusion: AIDS was associated with higher medical care utilization than other terminal illnesses, mainly because of its longer duration. The financial burden of medical and funeral expenditure on the family is substantial in this poor rural setting in Tanzania where the annual household income is below $100.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Adult
• Disease Outbreaks
• Family
• Family Characteristics
• HIV Infections
• Health Expenditures
• Humans
• Population
• Poverty
• Rural Population
• Tanzania
• economics
• mortality
• utilization

Other ID:

• GWAIDS0003274

UI: 102240770

From Meeting Abstracts