Age-specific mortality patterns in Central Mozambique during and after the end of the Civil War

Data was collected from the death register at Beira's Central Hospital between 1985 and 2003 and descriptively analyzed.The data show two distinct periods: before and after the peace agreements in 1992. Before 1992 (during the civil war), the main impact of mortality was on children below 5 years of age, including still births, accounting for 58% of all deaths. After the war ended in 1992, the pattern shifted dramatically and rapidly to the 15-49 year old age group which accounted for 49% of all deaths by 2003.As under-5 mortality rates were decreasing at the end of the conflict, rates for 24-49 year old adults began to dramatically increase due to AIDS. This study demonstrates that strategies can be implemented during conflicts to decrease mortality rates in one vulnerable population but post-conflict dynamics can bring together other factors which contribute to the rapid spread of other infectious diseases in other vulnerable populations.In recent years, vigorous debate has developed concerning how conflicts contribute to the spread of infectious diseases, and in particular, the role of post-conflict situations in the epidemiology of HIV/AIDS [1-3]. It has been widely assumed that the disarray accompanying conflicts contributes significantly to the spread of HIV in local population [4]. However, others have shown that the spread of HIV occurs primarily in the post-conflict period when the isolation of the population is removed and the freedom to travel improves [1,4,5]. Central Mozambique is a unique place in which to evaluate the relationship between conflict and mortality related to infectious diseases as an extended civil war ended in 1992. The aim of this retrospective study was to detail the age-specific mortality patterns among the population in the central provincial capital of Beira, Mozambique, during and after the Mozambican civil war.Beira, Mozambique, the provincial capital of the central province of Sofala, is situated on the Indian Ocean. Since the 1