English language version - Human Development Reports - United ...

Mozambique National Human Development Report 2007Graph 1.1 HIV prevalence rates (%) in 2004201510302520151050Graph 1.2 Projection of HIV prevalence rates (%)51998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010ProjectionAs with HIV and AIDS, Mozambique is among thecountries most affected by tuberculosis, following therevision of the estimated incidence of this disease in1999. Tuberculosis is the third largest cause of hospitalisation,after acute respiratory infections andmalaria. There are estimated to be around 21,000cases of tuberculosis in the country. (MISAU, PNCSTI/HIV/AIDS 2004-2008)In populations with an average HIV and AIDSprevalence of around 10%, it is estimated that about40% of tuberculosis cases can be attributed to HIVinfection. Likewise, it has been reported that in mostsub-Saharan African countries, 50% of HIV-positivepeople will develop tuberculosis in the course oftheir lives.In Mozambique, the average of HIV-positiveamong patients suffering from tuberculosis hasincreased from 32% in 2002 to 48% in 2004 (Box1.1). The figure varies between 2% and 53% in differentregions of the country.In many referral hospitals, where the HIV andAIDS test is administered on patients hospitalised sufferingfrom diseases related with internal medicine,40-50% of the tests show that the patient is HIV-positive.Furthermore, over 75% of the patients hospitalisedin referral hospitals suffering from tuberculosisare HIV-positive (MISAU, PNC, idem).The increase in AIDS cases is a dramatic humanitariansituation in terms of public and individualhealth within the National Health Service. In healthunits, such as, for example, the Maputo and Beiracentral hospitals, and the Tete and Manica provincialhospitals, in the medical wards, 60%-80% of thepatients have diseases related to AIDS.These figures show the already well-known andbaleful combination between HIV and AIDS andtuberculosis, as one of the main opportunist infections– but that which is largely curable, if strategicinterventions based on DOT (Directly ObservedTreatment), and guidelines for the patients toobserve strictly the drug regime, are properly supportedand adequately funded.Meanwhile, malaria, which has a high incidencein the country, is the main cause of hospitalisationand mortality. Children under five and pregnantwomen are among the groups most vulnerable to thisdisease. Malaria contributes to about 40% of all outpatientconsultations, and 60% of all paediatricadmissions in the rural and general hospitals. It isthe top cause of mortality among patients admittedand hospitalized in Mozambican paediatric wards.Malaria and the anaemia associated with it contributeto the high degree of maternal mortalityrecorded in the country (1,500 per 100,000 livebirths). Due to the anaemia, and the haemorrhagiccomplications associated with it, it becomes the foremostcause of the low weight at birth recordedamong new-born infants.According to the IDS (see Chapter 2) for 2004,the proportion of children under 15 in the populationis 44.5%, with a degree of dependence of about90%. Because HIV and AIDS mostly affects peoplewho are economically active, the degree of dependencewill be worsened by the collateral effects of theepidemic, such as an increase in the number oforphans, an increase in the number of householdsheaded by children, or by elderly people who arethemselves dependent. This list of effects of HIV andAIDS will directly affect the other parameters used incalculating the HDI, such as the level of school attendanceand the purchasing power of individuals andhouseholds.4