Original Research
Causes of death in people living with HIV: Lessons from five health facilities in Eswatini
Submitted: 28 May 2024 | Published: 28 October 2024
About the author(s)
Yves Mafulu, Department of Care and Treatment, AIDS Healthcare Foundation, Manzini, EswatiniSukoluhle Khumalo, Department of Care and Treatment, AIDS Healthcare Foundation, Manzini, Eswatini
Victor Williams, Center for Global Health Practice and Impact, Georgetown University, Mbabane, Eswatini; and, Department of Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, the Netherlands
Sandile Ndabezitha, Baylor College of Medicine Children’s Foundation, Mbabane, Eswatini
Elisha Nyandoro, Center for Global Health Practice and Impact, Georgetown University, Mbabane, Eswatini
Nkosana Ndlovu, Department of Care and Treatment, AIDS Healthcare Foundation, Manzini, Eswatini
Alexander Kay, Baylor College of Medicine Children’s Foundation, Mbabane, Eswatini
Khetsiwe Maseko, Department of Care and Treatment, AIDS Healthcare Foundation, Manzini, Eswatini
Hlobsile Simelane, Department of Care and Treatment, AIDS Healthcare Foundation, Manzini, Eswatini
Siphesihle Gwebu, Department of Care and Treatment, AIDS Healthcare Foundation, Manzini, Eswatini
Normusa Musarapasi, Center for Global Health Practice and Impact, Georgetown University, Mbabane, Eswatini
Arnold Mafukidze, Center for Global Health Practice and Impact, Georgetown University, Mbabane, Eswatini
Pido Bongomin, Center for Global Health Practice and Impact, Georgetown University, Mbabane, Eswatini
Nduduzo Dube, Department of Care and Treatment, AIDS Healthcare Foundation, Manzini, Eswatini
Lydia Buzaalirwa, AIDS Healthcare Foundation Africa Bureau, Kampala, Uganda
Nkululeko Dube, AIDS Healthcare Foundation Africa Bureau, Kampala, Uganda
Samson Haumba, Center for Global Health Practice and Impact, Georgetown University, Mbabane, Eswatini; and, Center for Global Health Practice and Impact, Georgetown University Medical Center, Washington DC, Washington, United States of America
Abstract
Background: Eswatini has a high HIV prevalence in adults and, despite being one of the first countries to achieve the UNAIDS 95-95-95 targets, AIDS-related deaths are still high.
Objectives: This study describes the causes of death among people living with HIV (PLHIV) receiving care at five clinics in Eswatini.
Method: A cross-sectional review of sociodemographic, clinical and mortality data of deceased clients who received care from 01 January 2021 to 30 June 2022, was conducted. Data were extracted from the deceased clients’ clinical records, and descriptive and comparative analysis was performed.
Results: Of 257 clients, 52.5% (n = 135) were male, and the median age was 47 years (interquartile range [IQR]: 38, 59). The leading causes of death were non-communicable diseases (NCDs) (n = 59, 23.0%), malignancies (n = 37, 14.4%), COVID-19 (n = 36, 14.0%), and advanced HIV disease (AHD) (n = 24, 9.3%). Clients who had been on antiretroviral therapy (ART) for 12–60 months (OR: 0.01; 95% confidence interval [CI]: 0.0006, 0.06) and > 60 months (OR: 0.006; 95% CI: 0.0003, 0.029) had lower odds of death from AHD compared to those on ART for < 12 months. Clients aged ≥ 40 years had higher odds of dying from COVID-19, while female clients (OR: 2.64; 95% CI: 1.29, 5.70) had higher odds of death from malignancy.
Conclusion: Most clients who died were aged 40 years and above and died from NCD-related causes, indicating a need to integrate prevention, screening, and treatment of NCDs into HIV services. Specific interventions targeting younger PLHIV will limit their risk for AHD.
Keywords
Sustainable Development Goal
Metrics
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