PO 8594 Validation of a verbal autopsy questionnaire applied to a case-control study of cerebral malaria in bandiagara and bamako, mali (original) (raw)
Related papers
PLoS ONE, 2011
Background: Verbal autopsy (VA) procedures can be used to estimate cause of death in settings with inadequate vital registries. However, the sensitivity of VA for determining malaria-specific mortality may be low, and may vary with transmission intensity. We assessed the diagnostic accuracy of VA procedures as compared to hospital medical records for determining cause of death in children under five in three different malaria transmission settings in Uganda, including Tororo (high), Kampala (medium), and Kisoro (low).
Malaria journal, 2007
Background: Although malaria is one of the most important causes of death in Ethiopia, measuring the magnitude of malaria-attributed deaths at community level poses a considerable difficulty. Nevertheless, despite its low sensitivity and specificity, verbal autopsy (VA) has been the most important technique to determine malaria-specific cause of death for community-based studies. The present study was undertaken to assess the magnitude of malaria mortality in a predominantly rural population of Ethiopia using VA technique at Butajira Rural Health Programme (BRHP) Demographic Surveillance Site (DSS). Methods: A verbal autopsy was carried out for a year from August 2003 to July 2004 for all deaths identified at BRPH-DSS. Two trained physicians independently reviewed each VA questionnaire and indicated the most likely causes of death. Finally, all malaria related deaths were identified and used for analysis. Results: A verbal autopsy study was successfully conducted in 325 deaths, of which 42 (13%) were attributed to malaria. The majority of malaria deaths (47.6%) were from the rural lowlands compared to those that occurred in the rural highlands (31%) and urban (21.4%) areas. The proportional mortality attributable to malaria was not statistically significant among the specific age groups and ecological zones. Mortality from malaria was reckoned to be seasonal; 57% occurred during a three-month period at the end of the rainy season between September and November. About 71% of the deceased received some form of treatment before death, while 12 (28.6%) of those who died neither sought care from a traditional healer nor were taken to a conventional health facility before death. Of those who sought treatment, 53.3% were first taken to a private clinic, 40% sought care from public health facilities, and the remaining two (6.7%) received traditional medicine. Only 11.9% of the total malaria-related deaths received some sort of treatment within 24h after the onset of illness. Conclusion: The results of this study suggest that malaria plays a considerable role as a cause of death in the study area. Further data on malaria mortality with a relatively large sample size for at least two years will be needed to substantially describe the burden of malaria mortality in the study area.
American Journal of Computational and Applied Mathematics, 2019
Multivariate analysis was applied to hospital data in this study. The underlying assumptions of MANOVA were verified with the data and were satisfied. The results from the post hoc test showed a positive and significant mean difference between children below the age of five years and patients between the ages of 5 and 19 years (MD=3.333, P<0.05). This means children below the age of five are more vulnerable and prone to hospitalization resulting from malaria infection than patients between the ages of 5 and 19 years. Similarly, there was a positive and significant mean difference (MD=12.933, P<0.05) between children below the age five years and pregnant women. This finding means that once again, children below the age of five are more vulnerable and prone to hospitalization resulting from malaria infection than pregnant women. Also, there was a positive mean difference between patients who were at least 20 years old and pregnant women (MD=10.100, P<0.05) when compared on the basis of hospitalization resulting from malaria infection. This indicated that patients who are at least 20 years old are hospitalized (due to malaria infection) more than pregnant women. With reference to the category of patients who were treated and discharged as a result of malaria infection, there was a positive and significant mean difference between patients who were between the ages of 5 and 19 years and patients who were at least 20 years old (MD=5.833, P<0.05). There was also a positive and significant mean difference between patients who were between the ages of 5 and 19 years and pregnant women (MD=8.833, P<0.05) based on the category of patients who were treated and discharged in relation to malaria infection. The results also showed that in terms of hospitalizations which were not related to malaria infection, children below the age of five were again found to be more vulnerable when compared to pregnant women (MD=5.600, P<0.05) and patients who are at least 20 years old (MD=5.125, P<0.05). The study advocated for reforms that grant free treatment to children below the age of five years since they were found to be the most vulnerable in contracting malaria and non-malaria related diseases and the most vulnerable to hospitalization.
Tanzania Journal of Health Research, 2010
Reliable malaria related mortality data is important for planning appropriate interventions. However, there is scarce information on the pattern of malaria related mortality in epidemic prone districts of Tanzania. This study was carried out to determine malaria related mortality and establish its trend change over time in both epidemic and non-epidemic areas of Muleba District of northwestern Tanzania. A verbal autopsy survey was conducted to obtain data on all deaths of individuals who died in six randomly selected villages from 1997 to 2006. Relatives of the deceased were interviewed using a standardized questionnaire. Communicable diseases accounted for about two thirds (61.9%) of deaths among ≥5 years individuals and 84.8% in ≤5 years. Non-communicable diseases accounted for 28.9% and 14.1% deaths in ≥5 years and ≤5 years, respectively. Malaria was the leading cause of deaths in all age groups (40.3%) and among children <5 years (73.8%). Infants accounted for about two third (64.5%) of all malaria related deaths in children <5 years. Peak of malaria proportional mortality was highest during malaria epidemics. Most of the malaria-related deaths in this group were among 1-12 months (64.5%) followed by 13-24 months (20.9%), and 25-59months (14.8%). Cerebral malaria accounted for 18.9% (N=32) of death related to malaria in all age groups; 12.1% (17/141) were in under-five, 42.9% (6/14) were in 5-14 years and 64.3% (9/14) in 15-70 years old. More than half of malaria related deaths (61.0%) in <5 years children were associated with severe anaemia followed by diarrhoeal disease (24.1%), cerebral malaria (12.5%) and respiratory infection (8.5%) as common conditions. The majority of the deceased caretakers first sought treatment at health facilities within 24hr of the onset of illness. Significantly a higher proportion of caretakers of the underfives in the epidemic area sought treatment within 24hr than in non-epidemic area (39.3% vs. 18.5%; P=0.0385). In conclusion, malaria accounts for majority of deaths in Muleba district, with substantial proportion being attributed to malaria epidemics.
Malaria journal, 2017
Lack of valid and reliable data on malaria deaths continues to be a problem that plagues the global health community. To address this gap, the verbal autopsy (VA) method was developed to ascertain cause of death at the population level. Despite the adoption and wide use of VA, there are many recognized limitations of VA tools and methods, especially for measuring malaria mortality. This study synthesizes the strengths and limitations of existing VA tools and methods for measuring malaria mortality (MM) in low- and middle-income countries through a systematic literature review. The authors searched PubMed, Cochrane Library, Popline, WHOLIS, Google Scholar, and INDEPTH Network Health and Demographic Surveillance System sites' websites from 1 January 1990 to 15 January 2016 for articles and reports on MM measurement through VA. article presented results from a VA study where malaria was a cause of death; article discussed limitations/challenges related to measurement of MM through ...
Malaria …, 2008
Background: Malaria is a leading cause of death in children below five years of age in sub-Saharan Africa. All-cause and malaria-specific mortality rates for children under-five years old in a mesoendemic malaria area (The Gambia) were compared with those from a hyper/holoendemic area (Burkina Faso). Methods: Information on observed person-years (PY), deaths and cause of death was extracted from online search, using key words: "Africa, The Gambia, Burkina Faso, malaria, Plasmodium falciparum, mortality, child survival, morbidity". Missing person-years were estimated and all-cause and malaria-specific mortality were calculated as rates per 1,000 PY. Studies were classified as longitudinal/clinical studies or surveys/censuses. Linear regression was used to investigate mortality trends. Results: Overall, 39 and 18 longitudinal/clinical studies plus 10 and 15 surveys and censuses were identified for The Gambia and Burkina Faso respectively (1960-2004). Model-based estimates for underfive all-cause mortality rates show a decline from 1960 to 2000 in both countries (Burkina Faso: from 71.8 to 39.0), but more markedly in The Gambia (from 104.5 to 28.4). The weighted-average malaria-specific mortality rate per 1000 person-years for Burkina Faso (15.4, 95% CI: 13.0-18.3) was higher than that in The Gambia (9.5, 95% CI: 9.1-10.1). Malaria mortality rates did not decline over time in either country. Conclusion: Child mortality in both countries declined significantly in the period 1960 to 2004, possibly due to socioeconomic development, improved health services and specific intervention projects. However, there was little decline in malaria mortality suggesting that there had been no major impact of malaria control programmes during this period. The difference in malaria mortality rates across countries points to significant differences in national disease control policies and/or disease transmission patterns.
2020
Background The burden of severe malaria is uncertain at the population level because existing estimates rely exclusively on data from the formal healthcare system. Using data from population-based surveys this analysis examines severe malaria cases at the population level, which captures children whose caregivers 1) have taken the child to a healthcare facility but the child’s illness did not resolve, or 2) have not sought care for the child’s illness. Direct inclusion of these children in severe malaria estimates has been an underlying data gap. Methods This analysis examined data from 37 Demographic and Health Surveys and Malaria Indicator Surveys across 19 countries in sub-Saharan Africa collected between 2011 and 2018. The outcome of interest is severe malaria, defined as children age 6–59 months who were positive for malaria with at least one self-reported symptom for severe malaria, including loss of consciousness, rapid breathing, seizures, or severe anemia. The study include...
Global health action, 2014
Background: Malaria continues to be a major cause of infectious disease mortality in tropical regions. However, deaths from malaria are most often not individually documented, and as a result overall understanding of malaria epidemiology is inadequate. INDEPTH Network members maintain population surveillance in Health and Demographic Surveillance System sites across Africa and Asia, in which individual deaths are followed up with verbal autopsies. Objective: To present patterns of malaria mortality determined by verbal autopsy from INDEPTH sites across Africa and Asia, comparing these findings with other relevant information on malaria in the same regions. Design: From a database covering 111,910 deaths over 12,204,043 person-years in 22 sites, in which verbal autopsy data were handled according to the WHO 2012 standard and processed using the InterVA-4 model, over 6,000 deaths were attributed to malaria. The overall period covered was 1992Á2012, but two-thirds of the observations related to 2006Á2012. These deaths were analysed by site, time period, age group and sex to investigate epidemiological differences in malaria mortality. Results: Rates of malaria mortality varied by 1:10,000 across the sites, with generally low rates in Asia (one site recording no malaria deaths over 0.5 million person-years) and some of the highest rates in West Africa (Nouna, Burkina Faso: 2.47 per 1,000 person-years). Childhood malaria mortality rates were strongly correlated with Malaria Atlas Project estimates of Plasmodium falciparum parasite rates for the same locations. Adult malaria mortality rates, while lower than corresponding childhood rates, were strongly correlated with childhood rates at the site level. Conclusions: The wide variations observed in malaria mortality, which were nevertheless consistent with various other estimates, suggest that population-based registration of deaths using verbal autopsy is a useful approach to understanding the details of malaria epidemiology.