Abstract:
Study design. A retrospective descriptive study of the mortality trend among inpatients at Motebang district hospital in
Lesotho.
Aim. To assess the impact of HIV/AIDS on the mortality of Motebang Hospital inpatients from 1989 to 2003.
Rationale. If the hypothesis that AIDS had modified the mortality in a unique way could be confirmed, mortality trends
could be used to supplement other methods of estimating the impact of HIV/AIDS such as antenatal and sexually
transmitted infections sentinel surveillance.
Methodology. Inpatients’ data were collected from January 1989 to December 2003. The 15-year period was split into
three 5-year periods (1989 - 1993, 1994 - 1998, and 1999 - 2003) and the diagnoses were grouped into Global Burden
of Disease groups I, II, and III. The data were analysed to establish time, gender and age trends.
Results. The mortality rate and number of deaths increased over the 15-year period. Group I (communicable diseases,
maternal, perinatal, and nutritional conditions) contributed 69% of all deaths. The rise in mortality was most pronounced
in the 15 - 49-year age range, progressively forming a ‘bulge’ on the death incidence by age curve, with the female peak
occurring at the 25 - 29-year age category, 5 years earlier than males. The study found that AIDS-related deaths
accounted for 51 - 65% of total deaths and 70 - 80% of group I deaths. Although the number of the inpatients in group
II was low, there was evidence of increasing burden from non-communicable diseases. However, the burden from group
III (injuries) remained stable.
Conclusion. AIDS modified the mortality trend of the Motebang Hospital inpatients by raising the deaths of younger
adults, thereby deviating from the expected natural trend. This implied that mortality data of the hospital provenance
can provide information necessary for, inter alia, evaluation of the impact of current and future interventions, for
instance, the impact of the proposed provision of antiretroviral drugs.
