Although HIV and Aids is gaining acceptance as a cause of death in South Africa, the leading causes are tuberculosis, influenza and pneumonia, according to a report released by the South African Institute for Race Relations on Tuesday.

"This should not be taken to mean that HIV and Aids was not a direct contributor to a very large proportion of observed mortality, but rather it should be noted that these statistics track, for the most part, direct causes of death," the researchers said.

Close to 70 percent of all people diagnosed with tuberculosis (TB) in South Africa were also HIV-positive, the report found.

There were 353 879 TB cases in 2007 compared with 73 917 in 1995.

"It is thus reasonable to assume that at least 70 percent of observed mortality from tuberculosis, and by extension a comparable percentage of deaths from influenza/pneumonia, also has HIV and Aids as an underlying cause," the report noted.

A person did not die from HIV and Aids directly, as it was a syndrome which caused immune system deficiency.

"Rather, mortality from Aids-related infections will be observed," the researchers said.

"It is possible that a person who is immuno-compromised enough to be classified as having reached 'full-blown' Aids would succumb to a great many infections that a person with a healthy immune system would never suffer from."

This meant that people infected with HIV and Aids could die from a vast range of secondary infections.

"It is impossible to say with certainty how much mortality is directly attributable to HIV and Aids, although the Actuarial Society of South Africa estimates that by 2009 some 2.9 million people will have died from HIV and Aids-related disease in South Africa," according to the South Africa Survey 2008/9.

It records 382 521 HIV and Aids related deaths for 2009.

The report found that the "actual" figure of people living with HIV and Aids was 5 728 711, or 11,7 percent of the population.

Researchers said that when analysing causes of death by race, a very clear pattern of mortality emerged for each different race group.

For Africans, the leading causes of death were TB and influenza/pneumonia - the diseases most closely associated with HIV and Aids-related mortality.

Coloureds were likely to die of TB, but also suffered from cerebrovascular disease and diabetes; Indians were most likely to die of diabetes or heart disease; and whites were most likely to die of heart disease.

"These causes of death are closely related to socio-economic status."

There had also been an unprecedented spike in deaths between the ages of 25 and 45, but antiretroviral treatment seemed to be having a positive effect. The researchers estimated that there were 497 756 new infections in 2009.

Other statistics the report identified were:

  • An increase in the deaths of children up to the age of four from 32 468 in 1997, to 63 596 in 2006.

  • A decline in malnutrition of children up to the age of six from 25 percent in 2001, to 5,7 percent in 2006.

    The report found that there were five recorded malaria deaths in 1971, but this spiked to 459 in 2000 and declined to 48 in 2007.

    It also found that there were 81 900 terminations of pregnancy in 2007.

    Researchers projected life expectancy for people born in 2008 as 50,5 years. - Sapa