Browsing by Author "Urassa, Mark"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Data Resource Profile: Network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA Network)
    (International journal of epidemiology, 2016) Reniers, Georges; Lutalo, Tom; Wamukoya, Marylene; Urassa, Mark; Nakiyingi-Miiro, Jessica; Hosegood, Vicky; Wringe, Alison; Marston, Milly; Maquins, Sewe; Levira, Francis; Zaba, Basia
    The Network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA Network) was established in 2005 and aims to: (i) broaden the evidence base on HIV epidemiology for informing policy; (ii) strengthen analytical capacity for HIV research; and (iii) foster collaboration between study sites.1 All of the study sites participating in the ALPHA Network are independently managed and have their own scientific agendas and tailored research methodologies, but share a common interest in HIV epidemiology and its interactions with the socio-demographic characteristics of the populations they cover. The ALPHA Network study sites and their institutional affiliations are described in Table 1, and their geographical distribution is shown in Figure 1. Several of the ALPHA Network study sites have published site-specific profiles that contain more detail.2–10 Most of the ALPHA Network study sites are also members of the INDEPTH Network of demographic surveillance sites [http:// www.indepth-network.org/].
  • Thumbnail Image
    Item
    Estimating ‘net’ HIV-related Mortality and the Importance of Background Mortality Rates
    (AIDS, 2007) Marston, Milly; Todd, Jim; Glynn, Judith R.; Nelson, Kenrad E.; Rangsin, Ram; Lutalo, Tom; Urassa, Mark; Biraro, Sam; Paal, Lieve Van der; Sonnenberg, Pam; Żaba, Basia
    To estimate mortality directly attributable to HIV in HIV-infected adults in low and middle income countries and discuss appropriate methodology.Illustrative analysis of pooled data from six studies across sub-Saharan Africa and Thailand with data on individuals with known dates of seroconversion to HIV.Five of the studies also had data from HIV-negative subjects and one had verbal autopsies. Data for HIV-negative cohorts were weighted by the initial age and sex distribution of the seroconverters. Using the survival of the HIV-negative group to represent the background mortality, net survival from HIV was calculated for the seroconverters using competing risk methods. Mortality from all causes and ‘net’ mortality were modelled using piecewise exponential regression. Alternative approaches are explored in the dataset without information on mortality of uninfected individuals.The overall effect of the net mortality adjustment was to increase survivorship proportionately by 2 to 5% at 6 years post-infection. The increase ranged from 2% at ages 15–24 to 22% in those 55 and over. Mortality rate ratios between sites were similar to corresponding ratios for all-cause mortality.Differences between HIV mortality in different populations and age groups are not explained by differences in background mortality, although this does appear to contribute to the excess at older ages. In the absence of data from uninfected individuals in the same population, model life tables can be used to calculate background rates.