Introduction The dramatic increase in adult mortality attributable to HIV/AIDS in Sub Saharan Africa may increase the number of households that do not survive as a functional unit in the years to come. This report describes the extent at which these impacts are weathered by a rural community using data from the Rufiji HDSS in rural Tanzania.
Objectives The study describes adult mortality patterns in the area with an emphasis on the HIV/AIDS related adult deaths and the proportion of household members migrating following these deaths.
Methods A total of 32 787 households and 4603 adult deaths from 4019 households were recorded over the study period. Mortality trends and migration rates were computed while the association between adult mortality and out-migration of members assessed using Cox proportional Hazard model.
Results Adult deaths increase by about 9% the chance of a child to migrate within or without the DSA while HIV/AIDS adult deaths increase by a further 19 percentage point the risk of the child to migrate out of the DSA. Non-HIV/AIDS adult deaths also enhance the risk for female internal migration by 5% albeit hardly significantly (adj. HR 1.05; 95% CI 1.0 to 1.10, p value 0.05) but decreases the chance of male internal migration by 13% (adj. HR 0.87; 95% CI 0.81 to 0.93, p-value 0.01). HIV/AIDS adult death is strongly associated with out-migration of adults. The deaths female out-migration to 19% (adj. HR 1.19; 95% CI 1.09 to 1.30, p value <0.001) and male migration to 30% increased risk (adj. HR 1.30; 95% CI 1.16 to 1.45, p value <0.001).
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