| Background:Death is an important indicator reflecting the effectiveness of the implementation of AIDS policy.China collects HIV/AIDS death information through the national HIV/AIDS case report database,but some HIV/AIDS patients can not report death information to the case report database in time after death,which leads to the delay in reporting HIV/AIDS deaths in China.Therefore,the annual death situation is reviewed according to the time of death,and the annual death situation of HIV/AIDS patients and the difference between actual death and reported death were described.Also,the late reporting situation of death were described,the impact of late reporting on death data and the reasons of late reporting were analyzed,which is of great significance for formulating relevant measures to improve late reporting and obtain accurate death data every year.Objectives:(1)Describe the actual death situation of HIV/AIDS patients in China from 2011 to 2018.(2)Describe the death delay-reporting situation in China from 2011 to 2018,and analyze the impact of late death report on death data.(3)Through investigation,finding the difference of death reporting process between areas with higher and lower late reporting rates,so as to provide help for HIV/AIDS information reporting.Method:(1)The data of HIV/AIDS patients who reported death from January 1,2011 to December 31,2019 were downloaded from the case report database,and descriptive analysis was made.(2)The Joinpoint regression model is used to describe the trend of death and death late reporting among HIV/AIDS patients in China from 2011 to 2018,and to calculate the Annual Percentage Changes(APCs).(3)Two districts of Guangxi Province and two districts of Tianjin,which have higher late reporting rate,and two districts of Zhejiang Province and two districts of Hunan Province,which have lower late reporting rate,were selected as research sites.One-on-one interviews were conducted with the staff of CDC responsible for national HIV/AIDS reporting in eight research sites,and relevant information on late reporting of death was collected and analyzed by inductive argumentation.Results:(1)From 2011 to 2018,205,582 HIV/AIDS patients died in China,the average death age was 50.92±6.16 years old,among all the death patients,79.28%were male;74.99%were Hans;59.35%had not taken ART,50.95%were Non-AIDS related deaths.The proportion of male HIV/AIDS patients,death age over 60 years old,received national free antiviral treatment,survived for more than 1 year,and received CD4+T test after diagnosis for less than 1 year showed an obvious increasing trend(p<0.01).Female,death age were 0-25 and 25-40 years old,who did not receive national free antiviral treatment,did not receive CD4+T cell test,and a survival time of less than 1 year showed a downward trend(p?0.01),There is a turning point in the change trend of the proportion of the dead patients who received and did not receive free antiviral treatment,receiving CD4+T cell test within 1 year after diagnosed,receiving CD4+T cell test more than 1 year after diagnosed.(2)From 2011 to 2018,205582 cases of HIV/AIDS patients reported dead in China,and 205581 cases were included in the study.The rate of delay-reporting between 2011 to 2018 were 11.47%,8.32%,8.96%,9.43%,9.62%,11.09%,14.63%and 12.56%,respectively,and the trend of rate had no significant change in 8 years(p=0.06).Those whose occupation is domestic work,housework and unemployed,whose education level is high school or above,whose infection route is injecting drug,who has been diagnosed for more than 6 months and whose last follow-up before death is lost have higher reporting delay rate.The reporting delay rate between those who received antiviral treatment and those who died in medical institutions was lower,and there were significant differences(p<0.05).Comparing the actual mortality with the reported mortality,it was found that there was no significant difference between them,and the turning point of the reported mortality was one year later than the actual mortality(p<0.05).(3)Among the 8 survey areas,except for two CDC in Guangxi Province,only untreated and treatment-losing patients were followed up,and the rest of the CDC followed up all HIV/AIDS patients in the jurisdiction.Getting to knowing the deaths of HIV/AIDS patients in 8 regions were mainly through follow-up.Except for CDC in Yuyao City and Taoyuan County,CDC in other regions will inquire the death cause system to find out whether the patients who lost the follow-up were dead.Except for two CDC in Guangxi Province,other CDC will communicate with the treatment points in time.After knowing the death of patients,the staff of 8 CDC all reported that information to the database immediately.Conclusion:Based on the actual time of death,there were 205,582 deaths of HIV/AIDS patients in China from 2011 to 2018;There are turning points in the proportion of treatment,CD4+T cell test.The proportion of deaths aged 60 years old and over has increased year by year.Late reporting leads to a one-year delay in the turning point of reported mortality trend compared with the actual mortality rate.The results of investigation show that there are differences between areas with high late reporting rate and areas with low late reporting rate in terms of lost follow-up rate,follow-up situation,communication with treatment points and workload. |
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