Background Recent gains in child survival are being threatened by the RN epidemic. Monitoring child mortality rates is essential to understanding the impact of the epidemic, but is constrained by a lack of data. A community-based survey was used to determine child mortality rates in a rural area with high RN prevalence, located in the Rlabisa subdistrict of the KwaZulu-Natal Province, South Africa. ii. Methods The study was conducted between 1 January 2000 and 31 December 2002 on deaths in children under the age of 15 years. Children were followed up through 4-monthly home visits. Cause of death was ascertained by verbal autopsy. Rates were calculated using Poisson methods. iii. Results Infant and under-5 mortality ratios were respectively, 59.6 and 97.1 deaths per 1000 live births. Infant and under-5 mortality rates were, respectively, 67.5 and 21.1 deaths per 1000 child-years. RN/AIDS was attributed to 41% of deaths in the under-5 age group, with a mortality rate of 8.6 per 1000 person years. Lower respiratory infections caused an estimated 24.9 deaths per 1000 person years in children under 1 year of age. iv. Discussion In rural South Africa, infant and child mortality levels are high, with RN/AIDS estimated as the single largest cause ofdeath. Improving the coverage of interventions known to impact on child mortality is required urgently.

Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2007.