Changes in the epidemiological transition in Thailand due to HIV/AIDS: implications for population and health policies

Abstract

This study aims to estimate the impact of the re-emergence of tuberculosis and pneumonia on Thai mortality and explores how it challenges the epidemiological transition theory. The 1970 to 2000 national, annual age-sex death rates by cause of death were calculated using Ministry of Public Health death registration data. The results indicated that death rates from infectious diseases in Thailand declined until 1986(4.5 per 1,000 population),only to start rising in 1987. There was a sharp increase after 1994, when reported deaths from tuberculosis and pneumonia was almost double that of 1990.The increased mortality occurred predominately among those aged 20-44 and affected males more than females. Even though only a small number of deaths were reported to be HIV/AIDS,mostly being attributed to tuberculosis and pneumonia,HIV/AIDS has been the underlining cause of death. This study concluded that the epidemiological transition theory has overstated the decline in infectious diseases as cause of death. The emergence of HIV/AIDS and re-emergence of tuberculosis are forcing us to re-think both population and public heath policies. Effort to improve access by people living with HIV/AIDS to ention and treatment tuberculosis andpneumonia warrants immediate attention.