CC BY-NC-ND 4.0 · Appl Clin Inform 2022; 13(03): 583-591
DOI: 10.1055/s-0042-1749118
Research Article

Comparison of the Causes of Death Identified Using Automated Verbal Autopsy and Complete Autopsy among Brought-in-Dead Cases at a Tertiary Hospital in Sub-Sahara Africa

Yuta Yokobori
1   National Center for Global Health and Medicine, Shinjuku-ku, Japan
2   Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
,
Jun Matsuura
1   National Center for Global Health and Medicine, Shinjuku-ku, Japan
,
Yasuo Sugiura
1   National Center for Global Health and Medicine, Shinjuku-ku, Japan
,
Charles Mutemba
3   Ministry of Health, Lusaka, Zambia
4   Adult Hospital, University Teaching Hospital, Lusaka, Zambia
,
Peter Julius
3   Ministry of Health, Lusaka, Zambia
5   Department of Pathology and Microbiology, School of Medicine, The University of Zambia, Lusaka, Zambia
,
Cordelia Himwaze
3   Ministry of Health, Lusaka, Zambia
5   Department of Pathology and Microbiology, School of Medicine, The University of Zambia, Lusaka, Zambia
,
Martin Nyahoda
6   Department of National Registration of Home Passport & Citizenship, Ministry Affairs, Lusaka, Zambia
,
Chomba Mwango
7   Bloomberg Data for Health Initiative, Lusaka, Zambia
,
Lloyd Kazhumbula
3   Ministry of Health, Lusaka, Zambia
,
Motoyuki Yuasa
2   Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
,
Brian Munkombwe
8   National Center for Health Statistics, Center for Disease Control and Prevention, Atlanta, United States
,
Luchenga Mucheleng'anga
9   Office of the State Forensic Pathologist, Ministry of Home Affairs and Internal Security, Lusaka, Zambia
› Author Affiliations
Funding This research was supported by NCGM Intramural research Fund (19A03) for the study design, collection, analysis, and interpretation of data, and the necessary publication procedures.

Abstract

Background Over one-third of deaths recorded at health facilities in Zambia are brought in dead (BID) and the causes of death (CODs) are not fully analyzed. The use of automated verbal autopsy (VA) has reportedly determined the CODs of more BID cases than the death notification form issued by the hospital. However, the validity of automated VA is yet to be fully investigated.

Objectives To compare the CODs identified by automated VA with those by complete autopsy to examine the validity of a VA tool.

Methods The study site was the tertiary hospital in the capital city of Zambia. From September 2019 to January 2020, all BID cases aged 13 years and older brought to the hospital during the daytime on weekdays were enrolled in this study. External COD cases were excluded. The deceased's relatives were interviewed using the 2016 World Health Organization VA questionnaire. The data were analyzed using InterVA, an automated VA tool, to determine the CODs, which were compared with the results of complete autopsies.

Results A total of 63 cases were included. The CODs of 50 BID cases were determined by both InterVA and complete autopsies. The positive predictive value of InterVA was 22%. InterVA determined the CODs correctly in 100% cases of maternal CODs, 27.5% cases of noncommunicable disease CODs, and 5.3% cases of communicable disease CODs. Using the three broader disease groups, 56.0% cases were classified in the same groups by both methods.

Conclusion While the positive predictive value was low, more than half of the cases were categorized into the same broader categories. However, there are several limitations in this study, including small sample size. More research is required to investigate the factors leading to discrepancies between the CODs determined by both methods to optimize the use of automated VA in Zambia.

Protection of Human and Animal Subjects

Ethical approval was obtained from the University of Zambia's Biomedical Research Ethics Committee (ref: 018–12–16) and the Ethics Committee of the National Center for Global Health and Medicine in Japan (ref: NCGM-G-003244–00). Written informed consent was obtained from the closest relatives of the deceased.


Supplementary Material



Publication History

Received: 22 August 2021

Accepted: 24 March 2022

Article published online:
15 June 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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