Publication:

Trends in mortality associated with infectious diseases in European Union, 2000-2010

Background: To conduct a systematic and updated analysis of the evolution of the trends in Tuberculosis (TB) and Human lmmunodeficiency Virus infections (HIV) mortality rates and the association between them and a factors such as underlying cause of death, economic situation, econoroic recession, health inequalities, immigration and Highly Active Antiretroviral Therapies (HAAR1). Methods: Data (age-standardised roortality rates) were extracted for Tuberculosis deaths during 2000-2010 for TB and during 2000-2014 for HIV for the 28 countries of the European Union, from the World Health Organization (WHO) European detailed mortality database (DMDB), using the Mortality tabulation list 1 (MTLl) cedes for men and woroen separately for one age group (20 - 85+). Socioeconomic data were extracted froro Eurostat for different years. We estimated age-standardised roortallty rates, and analyzed data using Joinpoint Regression programme for roen and women separately in European Union overall and by individual country for each year. Also we tested if there was a correlation between age-standardised mortality rates and the mentioned factors by using SPSS programme. Results: For TB, between 2000-2010, there were 68,771 recorded Tuberculosis deaths in European Union and the mortality rates were higher in men than in women across the zone of study. Overall, the TB mortality rates declined linearly in both genders, but more so in women than men (from 5.43/100,000 in 2000 to 2.59/100,000 in 2010 in men and froro 1.37/100,000 in 2000 to 0.51/100,000 in 2010 in women). There was decline in both genders for the whole period of study, by a significant Estimated Annual Percentage Change (EAPC) -8.1for women and -7 for men when (Alpha < 0.05) and with 95% confidence interval (CI). A higher tuberculosis mortality was associated with lower economic resources and more inequalities. For HIV, between 2000-2014,there were 53518 deaths due to HIV infection in European Union, (41294 for roen and 12224 for women), with 3.38:1of ratio. The mortality rates were higher in men than in women. In European Union overall, the HIV mortality rates rose linearly in both genders, but more so in women than men (from 1.72/ 100,000 in 2000 to 1.83/100,000 in 2014 in men and from 0.45/ 100,000 in 2000 to 0.54/100,000 in 2014 in women). There was a significant rise ju st in women for the whole period of study, by a significant Estimated Annual Percentage Change (EAPC) 2.1 for women when (Alpha < 0.05) and with 95% confidence interval (CI). There was a significant positive correlation between HIV age-standardised mortality rates and each of Unemployment and GINI index of EU countries. Conclusions: TB mortality rates in European Union decreased overall during 2000-2010 in both genders. Men have a higher TB mortality rates than women in ali countries. Our findings were consistent with the downward TB mortality trend in many other countries globally. HIV mortality trend s rose in Europe over ali (not al! countries) in both genders during 2000-2014; these trends are not consenting with the global downward trends. HIV mortality rates rose significantly more in women than men during 2000-2014.