Comparative Retrospective Analysis of Communicable versus Non-Communicable Disease Mortality in HIV-Uninfected Patients at a Tertiary Care Facility, South Africa

Abstract

Background and study aim: The global health sector is deeply impacted by both infectious diseases and non-communicable diseases (NCDs). Despite considerable advances in combating infections such as HIV/AIDS and TB, there is a persistent need for detailed mortality data among HIV-negative individuals. This research examined the prevalence of infectious diseases and NCDs, along with their mortality contributions, in HIV-negative patients at King Edward VIII Hospital, Durban, South Africa. Patients and Methods: A retrospective cross-sectional study was carried out, analysing medical records of HIV-negative patients aged ≥ 12 years who died in 2018. Data analysis was performed to compute descriptive statistics, univariate Chi-Square tests for distribution assessment, and bivariate analyses for categorical variable associations (gender, age, and ethnicity). Logistic regression evaluated the effects of multiple variables on mortality outcomes. Results: The study included 183 of the 588 deaths recorded. The demographic distribution was nearly even between females (49.7%) and males (50.3%), primarily of Black African descent (73.2%). Age was predominantly in the 55–64 (29.5%) and 65–74 (25.7%) ranges. The leading NCD was hypertension (56 cases). NCDs were responsible for 72.1% of the deaths, infectious diseases for 18.6%, and both for 9.3%. There was a significant gender-based disparity in mortality causes, with males being more likely to die from infectious diseases (OR: 2.383; 95% CI 1.042 to 5.452; p=0.040). Conclusion: The data highlights a higher mortality rate due to NCDs compared to infectious diseases in non-HIV-infected patients in KwaZulu-Natal. This calls for more longitudinal studies to track trends in this population.