HIV/AIDS AND PREGNANCY-RELATED DEATHS IN BLANTYRE, MALAWI

Abstract

Background: HIV/AIDS epidemic is one of the major factors affecting women’shealth and impeding national efforts to improve it especially in sub-Saharan Africa.Current evidence indicates that HIV/ AIDS is increasingly becoming a major cause orcontributing factor to pregnancy-related deaths, almost overtaking the “traditional”causes and factors.

Objectives: To survey the contribution of HIV infection and AIDS to pregnancy-relateddeaths in Blantyre, Malawi.

Design: A retrospective, descriptive, facility-based survey.

Setting: The Queen Elizabeth Central Teaching Hospital, Blantyre, Malawi.

Subjects: All women recorded to have had pregnancy-related deaths between January1, 1999 and December 31, 2000.

Results: There were 204 maternal deaths, 154 (75.5%) direct, the top five causes beingpuerperal sepsis (39.0%), postabortion complications (31.2%), obstetric haemorrhage(14.3%), eclampsia (8.4%) and ectopic pregnancy (3.9%). At least 38 (18.6%) of thetotal were HIV positive or had AIDS. The main causes of deaths amongst these weremeningitis (23.7%), pneumonia (18.4%), puerperal sepsis (13.2%), postabortal sepsis(10.5%), severe anaemia (10.5%) and pulmonary tuberculosis (10.5%) Of those who diedof puerperal and postabortal sepsis in the whole study group 8.3% had HIV/AIDS. Ofthe indirect maternal deaths, 50 (58%) were HIV positive or had AIDS.

Conclusion and recommendations: HIV/AIDS contributes to both direct and indirectmaternal deaths in Malawi. National strategies to realise MDG5 targets should includeaddressing the HIV/AIDS epidemic within the entire population as well as scalingup contraceptive uptake and utilisation, especially amongst the most vulnerablegroups.INTRO