Malawi has one of the highest HIV adult prevalence rates in sub-Saharan Africa. However, even at this advanced stage of the AIDS epidemic, remarkably little robust evidence is available on mortality levels and trends among the population as a whole as well as specific occupational groups. Teachers, in particular have been frequently singled out as being a 'high-risk group'. For example, a report by BBC World in November 2002 on the combined impact of AIDS and famine in Malawi concluded with the statement that 'one in seven teachers will die this year (2002) alone'.The most reliable basis for any HIV/AIDS risk assessment is to select representative samples from the particular population or group under investigation and to conduct voluntary, anonymous (blind) testing for HIV using standard protocols. To date, however, no population-based HIV survey of teachers has been conducted in any high prevalence country in Africa. In the absence of this information, reliance has to be placed on an analysis of deaths among teachers. In the context of a mature epidemic with adult HIV prevalence rates in excess of 15 per cent, over 85 per cent of deaths below 50 years old are likely to be AIDS-related. Unfortunately, official statistics on mortality among teachers employed in the 5,000 primary and 700 secondary schools in Malawi are neither reliable nor up to date. The only way, therefore, to assess what the impact of the epidemic has been on teachers is to survey a sample of schools directly. This paper summarises the main findings of a survey of teacher mortality (from all causes) based on 38 schools located in two districts in Malawi, namely Blantyre, the commercial capital and the contiguous, mainly rural district of Chiradzulu. Adult HIV prevalence was 24.0 percent in Blantyre in 2001 and 17.2 per cent in Chiradzulu in 2001. The national adult HIV prevalence rate was estimated to be 14.7 per cent in 2001.
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