COMPLETENESS OF AIDS REPORTING AND QUALITY OF AIDS DEATH CERTIFICATION IN TUSCANY (ITALY) - A LINKAGE STUDY BETWEEN SURVEILLANCE SYSTEM OF CASES AND DEATH CERTIFICATES

In Italy, the AIDS eases defined according to the CDC criteria are rep orted to the National AIDS Registry (RAIDS, compulsory surveillance sy stem). The aim of the present study is to evaluate the completeness of AIDS cases reported and the quality of AIDS death certification in an Italian Region (Tuscany, about 3,500,000 inhabitants). The 737 AIDS c ases reported to RAIDS as residents in Tuscany (1987-91) were cross-li nked (key link: name and date of birth) with the data of the Mortality Registration system of the Region (RMR). For the residents in Tuscany deceased with a 279.1 death diagnosis (the code for AIDS deaths state d by the Italian Census Bureau) and not reported to RAIDS as AIDS case s, the clinical records were reviewed to check whether the diagnosis f itted the 1987-CDC diagnostic criteria. This study shows that there is a high completeness (97-98%) of the AIDS cases resident in Tuscany, r eported to the RAIDS. The quality of RAIDS data is not as good with re gard to life status assessment (23% of under-reporting of death). In T uscany, the death certification for AIDS (code 279.1 of ICD IX) has a sensitivity of 88% and a specificity around 100% in comparison to RAID S. About 50% of 'false negatives' in death certification are due to ca uses of death presumably unrelated to HIV infection. The evaluation of the quality of AIDS surveillance and mortality data is important in t he assessment of the impact for AIDS epidemic in a target population.