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Tuberculosis mortality and the male survival deficit in rural South Africa: An observational community cohort study

BACKGROUND: Women live on average five years longer than men, and the sex difference in longevity is typically lower in populations with high mortality. South Africa—a high mortality population with a large sex disparity—is an exception, but the causes of death that contribute to this difference are...

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Autores principales: Reniers, Georges, Blom, Sylvia, Lieber, Judith, Herbst, Abraham J., Calvert, Clara, Bor, Jacob, Barnighausen, Till, Zaba, Basia, Li, Zehang R., Clark, Samuel J., Grant, Alison D., Lessells, Richard, Eaton, Jeffrey W., Hosegood, Victoria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5634548/
https://www.ncbi.nlm.nih.gov/pubmed/29016619
http://dx.doi.org/10.1371/journal.pone.0185692
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author Reniers, Georges
Blom, Sylvia
Lieber, Judith
Herbst, Abraham J.
Calvert, Clara
Bor, Jacob
Barnighausen, Till
Zaba, Basia
Li, Zehang R.
Clark, Samuel J.
Grant, Alison D.
Lessells, Richard
Eaton, Jeffrey W.
Hosegood, Victoria
author_facet Reniers, Georges
Blom, Sylvia
Lieber, Judith
Herbst, Abraham J.
Calvert, Clara
Bor, Jacob
Barnighausen, Till
Zaba, Basia
Li, Zehang R.
Clark, Samuel J.
Grant, Alison D.
Lessells, Richard
Eaton, Jeffrey W.
Hosegood, Victoria
author_sort Reniers, Georges
collection PubMed
description BACKGROUND: Women live on average five years longer than men, and the sex difference in longevity is typically lower in populations with high mortality. South Africa—a high mortality population with a large sex disparity—is an exception, but the causes of death that contribute to this difference are not well understood. METHODS: Using data from a demographic surveillance system in rural KwaZulu-Natal (2000–2014), we estimate differences between male and female adult life expectancy by HIV status. The contribution of causes of death to these life expectancy differences are computed with demographic decomposition techniques. Cause of death information comes from verbal autopsy interviews that are interpreted with the InSilicoVA tool. RESULTS: Adult women lived an average of 10.4 years (95% confidence Interval 9.0–11.6) longer than men. Sex differences in adult life expectancy were even larger when disaggregated by HIV status: 13.1 (95% confidence interval 10.7–15.3) and 11.2 (95% confidence interval 7.5–14.8) years among known HIV negatives and positives, respectively. Elevated male mortality from pulmonary tuberculosis (TB) and external injuries were responsible for 43% and 31% of the sex difference in life expectancy among the HIV negative population, and 81% and 16% of the difference among people living with HIV. CONCLUSIONS: The sex differences in adult life expectancy in rural KwaZulu-Natal are exceptionally large, atypical for an African population, and largely driven by high male mortality from pulmonary TB and injuries. This is the case for both HIV positive and HIV negative men and women, signalling a need to improve the engagement of men with health services, irrespective of their HIV status.
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spelling pubmed-56345482017-10-30 Tuberculosis mortality and the male survival deficit in rural South Africa: An observational community cohort study Reniers, Georges Blom, Sylvia Lieber, Judith Herbst, Abraham J. Calvert, Clara Bor, Jacob Barnighausen, Till Zaba, Basia Li, Zehang R. Clark, Samuel J. Grant, Alison D. Lessells, Richard Eaton, Jeffrey W. Hosegood, Victoria PLoS One Research Article BACKGROUND: Women live on average five years longer than men, and the sex difference in longevity is typically lower in populations with high mortality. South Africa—a high mortality population with a large sex disparity—is an exception, but the causes of death that contribute to this difference are not well understood. METHODS: Using data from a demographic surveillance system in rural KwaZulu-Natal (2000–2014), we estimate differences between male and female adult life expectancy by HIV status. The contribution of causes of death to these life expectancy differences are computed with demographic decomposition techniques. Cause of death information comes from verbal autopsy interviews that are interpreted with the InSilicoVA tool. RESULTS: Adult women lived an average of 10.4 years (95% confidence Interval 9.0–11.6) longer than men. Sex differences in adult life expectancy were even larger when disaggregated by HIV status: 13.1 (95% confidence interval 10.7–15.3) and 11.2 (95% confidence interval 7.5–14.8) years among known HIV negatives and positives, respectively. Elevated male mortality from pulmonary tuberculosis (TB) and external injuries were responsible for 43% and 31% of the sex difference in life expectancy among the HIV negative population, and 81% and 16% of the difference among people living with HIV. CONCLUSIONS: The sex differences in adult life expectancy in rural KwaZulu-Natal are exceptionally large, atypical for an African population, and largely driven by high male mortality from pulmonary TB and injuries. This is the case for both HIV positive and HIV negative men and women, signalling a need to improve the engagement of men with health services, irrespective of their HIV status. Public Library of Science 2017-10-10 /pmc/articles/PMC5634548/ /pubmed/29016619 http://dx.doi.org/10.1371/journal.pone.0185692 Text en © 2017 Reniers et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Reniers, Georges
Blom, Sylvia
Lieber, Judith
Herbst, Abraham J.
Calvert, Clara
Bor, Jacob
Barnighausen, Till
Zaba, Basia
Li, Zehang R.
Clark, Samuel J.
Grant, Alison D.
Lessells, Richard
Eaton, Jeffrey W.
Hosegood, Victoria
Tuberculosis mortality and the male survival deficit in rural South Africa: An observational community cohort study
title Tuberculosis mortality and the male survival deficit in rural South Africa: An observational community cohort study
title_full Tuberculosis mortality and the male survival deficit in rural South Africa: An observational community cohort study
title_fullStr Tuberculosis mortality and the male survival deficit in rural South Africa: An observational community cohort study
title_full_unstemmed Tuberculosis mortality and the male survival deficit in rural South Africa: An observational community cohort study
title_short Tuberculosis mortality and the male survival deficit in rural South Africa: An observational community cohort study
title_sort tuberculosis mortality and the male survival deficit in rural south africa: an observational community cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5634548/
https://www.ncbi.nlm.nih.gov/pubmed/29016619
http://dx.doi.org/10.1371/journal.pone.0185692
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