TUBERCULOSIS SURVEILLANCE USING DEATH CERTIFICATE DATA, NEW-YORK-CITY, 1992

Objective. To determine the accuracy and frequency of reporting tuberc ulosis as either the contributing or underlying cause of death on deat h certificates in New York City during 1992. Methods. Death certificat es from 1992 that listed tuberculosis were matched with the New York C ity tuberculosis registry. For those persons who had tuberculosis list ed as a cause of death, but who were not listed in the registry, medic al records were reviewed. The frequency of reporting tuberculosis on d eath certificates in patients who died with active tuberculosis was ev aluated in the second part of this study. Death certificates of patien ts with active tuberculosis (persons who died within six months of sta rting anti-tuberculosis medications)in 1992 were reviewed. Results. Tu berculosis was listed on 635 death certificates; 377 (59%) were confir med cases based on registry data. Reviews of medical records were poss ible for 230 (89%) of the remaining 258 patients and confirmed only tw o additional tuberculosis cases. Of 310 persons who died with active t uberculosis in 1992 (second part of the study), only 104 (34%) had tub erculosis listed on their death certificates. Conclusion. In New York City, a diagnosis of tuberculosis an death certificates is an inaccura te measure of tuberculosis burden.