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Sep 19, 2007Article Details
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Main Article Content
The burden of disease attributable to sexually transmitted infections in South Africa in 2000
Abstract
Objectives. To estimate the burden of disease attributable
to sexually transmitted infections (STIs) in South Africa, to
identify the factors contributing to this burden, and to review
successes and failures in reducing this burden.
Design. Years of life lost (YLL) and years lived with disability
(YLD) were estimated using different approaches for HIV/
AIDS, other STIs and cervical cancer. Burden in respect of HIV/
AIDS was estimated using the ASSA2002 model, and for the
other diseases the revised national burden of disease estimates
for 2000 based on 1996 cause-of-death data were used. The
ASSA2002 model was used to estimate numbers of AIDS deaths
under different prevention and treatment scenarios.
Setting. South Africa.
Outcome measures. Deaths, YLL and disability-adjusted life years
(DALYs) associated with HIV/AIDS, other STIs and cervical
cancer.
Results. STIs accounted for more than 26% of all deaths and
over 5 million DALYs in 2000 and over 98% of this burden was
due to HIV/AIDS. A combination of social, behavioural and
biological conditions contribute to this burden. HIV/AIDS
mortality and morbidity are estimated to have increased
significantly since 2000, and the future change in this burden
is largely dependent on the extent to which antiretroviral
treatment and HIV prevention programmes are introduced. 2.5
million AIDS deaths could be prevented by 2015 if high levels
of access to antiretroviral treatment are achieved.
Conclusion. South Africa faces one of the largest STI epidemics
in the world. A multifaceted strategy to prevent and treat STIs
is needed, and burden of disease assessments should look
beyond the role of ‘unsafe sex' when attributing this disease
burden to risk factors.
South African Medical Journal Vol. 97 (8) Part 2 2007: pp. 658-662
