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NEW THIS MONDAY: CHILD MORTALITY ESTIMATION: METHODS USED TO ADJUST FOR BIAS DUE TO AIDS IN ESTIMATING TRENDS IN UNDER-FIVE MORTALITY

Sunday, 30th of June 2013

• CHILD MORTALITY ESTIMATION: METHODS USED TO ADJUST FOR BIAS DUE TO AIDS IN ESTIMATING TRENDS IN UNDER-FIVE MORTALITY

 

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Abstract below; full text is at http://www.ploscollections.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001298;jsessionid=F2DDF3E25ECC5F9C8CCB70221CC99417

In most low- and middle-income countries, child mortality is estimated from data provided by mothers concerning the survival of their children using methods that assume no correlation between the mortality risks of the mothers and those of their children. This assumption is not valid for populations with generalized HIV epidemics, however, and in this review, we show how the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) uses a cohort component projection model to correct for AIDS-related biases in the data used to estimate trends in under-five mortality. In this model, births in a given year are identified as occurring to HIV-positive or HIV-negative mothers, the lives of the infants and mothers are projected forward using survivorship probabilities to estimate survivors at the time of a given survey, and the extent to which excess mortality of children goes unreported because of the deaths of HIV-infected mothers prior to the survey is calculated. Estimates from the survey for past periods can then be adjusted for the estimated bias. The extent of the AIDS-related bias depends crucially on the dynamics of the HIV epidemic, on the length of time before the survey that the estimates are made for, and on the underlying non-AIDS child mortality. This simple methodology (which does not take into account the use of effective antiretroviral interventions) gives results qualitatively similar to those of other studies.

Citation: Walker N, Hill K, Zhao F (2012) Child Mortality Estimation: Methods Used to Adjust for Bias due to AIDS in Estimating Trends in Under-Five Mortality. PLoS Med 9(8): e1001298. doi:10.1371/journal.pmed.1001298

Academic Editor: Peter Byass, Umeå Centre for Global Health Research, Umeå University, Sweden

Published: August 28, 2012

Copyright: © Walker et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: Partial financial support for this work has been received from UNICEF. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Abbreviations: ART, antiretroviral therapy; CME, child mortality estimation; DHS, Demographic and Health Surveys; U5MR, under-five mortality rate; UN IGME, United Nations Inter-agency Group for Child Mortality Estimation; UNAIDS, Joint United Nations Programme on HIV/AIDS

Provenance: Submitted as part of a sponsored Collection; externally reviewed.