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Evaluating the performance of interpreting Verbal Autopsy 3.2 model for establishing pulmonary tuberculosis as a cause of death in Ethiopia: a population-based cross-sectional study.

Tadesse S, Tadesse T - BMC Public Health (2012)

Bottom Line: But in addition to being time and energy consuming, the method is liable to produce inconsistent results.The proportion of tuberculosis-specific mortality was established to be 36.0% and 23.0% by the InterVA model and the physicians, respectively.The conclusion is believed to provide policymakers with a highly needed piece of information for allocating resources for health intervention.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Public Health, the University of Gondar, Gondar, Ethiopia.

ABSTRACT

Background: In resource- poor settings, verbal autopsy data are often reviewed by physicians in order to assign the probable cause of death. But in addition to being time and energy consuming, the method is liable to produce inconsistent results. The aim of this study is to evaluate the performance of the InterVA 3.2 model for establishing pulmonary tuberculosis as a cause of death in comparison with physician review of verbal autopsy data.

Methods: A population-based cross-sectional study was conducted from March to April, 2012. All adults aged ≥14 years and died between 01 January 2010 and 15 February 2012 were included in the study. Data were collected by using a pre-tested and modified WHO designed verbal autopsy questionnaire. The verbal autopsy interviews were reviewed by the InterVA model and the physicians. Cohen's kappa statistic, receiver operating characteristic curves, sensitivity, and specificity values were applied to compare the agreement between the InterVA model and the physician review.

Results: A total of 408 adult deaths were studied. The proportion of tuberculosis-specific mortality was established to be 36.0% and 23.0% by the InterVA model and the physicians, respectively. The InterVA model predicted pulmonary tuberculosis as a cause of death with the probability of 0.80 (95% CI: 0.75-0.85). In classifying all deaths as tuberculosis and non-tuberculosis, the sensitivity and specificity values were 0.82 and 0.78, respectively. A moderate agreement was found between the model and physicians in assigning pulmonary tuberculosis as a cause of deaths [kappa= 0.5; 95% CI: (0.4-0.6)].

Conclusions: This study has revealed that the InterVA model showed a more promising result as a community-level tool for generating pulmonary tuberculosis-specific mortality data from verbal autopsy. The conclusion is believed to provide policymakers with a highly needed piece of information for allocating resources for health intervention.

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Related in: MedlinePlus

Map of Ethiopia, Dabat district and Dabat HDSSs.
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Figure 1: Map of Ethiopia, Dabat district and Dabat HDSSs.

Mentions: A population-based cross-sectional study was implemented from 01 March to 30 April, 2012 in Dabat Health and Demographic Surveillance System site (HDSSs) hosted by the University of Gondar. The site is located in a district known as Dabat, northern Ethiopia (See map, Figure1), and has an estimated population of 46,165 living in 7 rural and 3 urban "kebeles" (the smallest administrative units in Ethiopia). The local communities largely depend on subsistence agriculture. It has two health centers providing Directly Observed Treatment Short-course (DOTS) for TB cases. Information on vital events, like birth, death, and migration are collected quarterly[23].


Evaluating the performance of interpreting Verbal Autopsy 3.2 model for establishing pulmonary tuberculosis as a cause of death in Ethiopia: a population-based cross-sectional study.

Tadesse S, Tadesse T - BMC Public Health (2012)

Map of Ethiopia, Dabat district and Dabat HDSSs.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3526415&req=5

Figure 1: Map of Ethiopia, Dabat district and Dabat HDSSs.
Mentions: A population-based cross-sectional study was implemented from 01 March to 30 April, 2012 in Dabat Health and Demographic Surveillance System site (HDSSs) hosted by the University of Gondar. The site is located in a district known as Dabat, northern Ethiopia (See map, Figure1), and has an estimated population of 46,165 living in 7 rural and 3 urban "kebeles" (the smallest administrative units in Ethiopia). The local communities largely depend on subsistence agriculture. It has two health centers providing Directly Observed Treatment Short-course (DOTS) for TB cases. Information on vital events, like birth, death, and migration are collected quarterly[23].

Bottom Line: But in addition to being time and energy consuming, the method is liable to produce inconsistent results.The proportion of tuberculosis-specific mortality was established to be 36.0% and 23.0% by the InterVA model and the physicians, respectively.The conclusion is believed to provide policymakers with a highly needed piece of information for allocating resources for health intervention.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Public Health, the University of Gondar, Gondar, Ethiopia.

ABSTRACT

Background: In resource- poor settings, verbal autopsy data are often reviewed by physicians in order to assign the probable cause of death. But in addition to being time and energy consuming, the method is liable to produce inconsistent results. The aim of this study is to evaluate the performance of the InterVA 3.2 model for establishing pulmonary tuberculosis as a cause of death in comparison with physician review of verbal autopsy data.

Methods: A population-based cross-sectional study was conducted from March to April, 2012. All adults aged ≥14 years and died between 01 January 2010 and 15 February 2012 were included in the study. Data were collected by using a pre-tested and modified WHO designed verbal autopsy questionnaire. The verbal autopsy interviews were reviewed by the InterVA model and the physicians. Cohen's kappa statistic, receiver operating characteristic curves, sensitivity, and specificity values were applied to compare the agreement between the InterVA model and the physician review.

Results: A total of 408 adult deaths were studied. The proportion of tuberculosis-specific mortality was established to be 36.0% and 23.0% by the InterVA model and the physicians, respectively. The InterVA model predicted pulmonary tuberculosis as a cause of death with the probability of 0.80 (95% CI: 0.75-0.85). In classifying all deaths as tuberculosis and non-tuberculosis, the sensitivity and specificity values were 0.82 and 0.78, respectively. A moderate agreement was found between the model and physicians in assigning pulmonary tuberculosis as a cause of deaths [kappa= 0.5; 95% CI: (0.4-0.6)].

Conclusions: This study has revealed that the InterVA model showed a more promising result as a community-level tool for generating pulmonary tuberculosis-specific mortality data from verbal autopsy. The conclusion is believed to provide policymakers with a highly needed piece of information for allocating resources for health intervention.

Show MeSH
Related in: MedlinePlus