Cc. Mobley et al., VALIDATION-STUDY OF A VERBAL AUTOPSY METHOD FOR CAUSES OF CHILDHOOD MORTALITY IN NAMIBIA, Journal of tropical pediatrics, 42(6), 1996, pp. 365-369
Verbal autopsy uses a caretaker interview to determine the came of dea
th. We conducted a study of the major causes of child death in Namibia
to determine the validity of this method. A questionnaire, including
signs and symptoms of the diagnoses of interest was administered to th
e caretaker in 135 deaths of children <5 years old who were identified
from hospital records. The 243 diagnoses included malnutrition (77),
diarrhoea (73), pneumonia (36), malaria (33), and measles (24). Sensit
ivity and specificity of various algorithms of reported signs and symp
toms were compared to the medical diagnoses. An algorithm for malnutri
tion (very thin or swelling) had 73 per cent sensitivity and 76 per ce
nt specificity. An algorithm for cerebral malaria (fever, loss of cons
ciousness or convulsion) had 72 per cent sensitivity and 85 per cent s
pecificity, while for an malaria deaths the same algorithm had low sen
sitivity (45 per cent) and high specificity (87 per cent). For diarrho
ea, loose or liquid stools had high sensitivity (89 per cent), but low
specificity (61 per cent). Cough with dyspnoea or tachypnoea had 72 p
er cent sensitivity and 64 per cent specificity. An algorithm for meas
les (age greater than or equal to 120 days, rash) had 71 per cent sens
itivity and 85 per cent specificity. The study results suggest verbal
autopsy data can be useful to ascertain the leading causes of death in
childhood, but may have limitations for health impact evaluation.