The Accuracy of HIV/AIDS Reporting on Death Certificates

Name: Jayanton Patumanond

Organization : Chiang Mai University. Faculty of Medicine. Department of Community Medicine. Division of Epidemiology and Statistics

Name: Chamaiporn Tawichasri

Organization : Chiang Mai University. Faculty of Medicine. Department of Community Medicine. Division of Epidemiology and Statistics

Name: Pakpoom Thawong

Organization : Mae Wang District Health Office, Chiang Mai

keyword: HIV/AIDS related death

MeSH: Death Certificates

; Specificity

MeSH: HIV

; Agreement

MeSH: Acquired Immunodeficiency Syndrome

MeSH: Sensitivity and Specificity

Abstract: Background: Mortality data are important tools for public health planning. Inaccuracy in the actual cause of death may wrongly suggest differences in magnitude of health problems, which is important for health planning and policy. HIV/AIDS is the leading cause of death in Chiang MaL Studies on the accuracy of HIVI AIDS reporting on death certificates in Thailand were not widely available. ObJective: To quantify the accuracy of HIV/AIDS reporting on death certificates. Design: A population-based cross-sectional study. Setting: Four subdistricts of Mae Wang, Chiang MaL Subjects and methods: Names and addresses of the decedents on a death registration database between 1 st January 1997 and 31 st December 1998 were searched for. The next of kin or the closest relatives of those decedents were interviewed using a standard and validated questionnaire, which included general and demographic information. Past illnesses and any illnesses occurring 1 year before and at the time of death were discussed in detail using an in-depth interview. The information was reviewed by a physician review panel blinded to the information and independent of the actual death certificates. Causes of death reported on death certificates were sought from the demographic registration computer system of the district. The cause of death on death certificates and the cause of death agreed upon by the physician review panel were compared. Consistency of the data was analysed using kappa coefficients. Differences between kappa coefficients were analysed using Fisher's ztransformation test. Results: A total of 201 deaths were registered during the defined period. The death certificates listed HIV/AIDS in only 42 (sensitivity = 65.6%) of 64 instances where the physician review panel identified HIV/AIDS as the underlying cause of death. HIV/AIDS was not recorded on the death certificates of those who were likely to have died from/of HIV/AIDS in 22 cases. The causes of death reported on the official death certificates among these were recorded as disease of cardiovascular, respiratory, gastrointestinal, neurological and urinary systems, allergy and suicide. The death certificates, however had a high specificity (1 00%). Overall observed agreement between the death certificates and the physician review panel was 89.1 % (kappa = 0.72). The validity and agreement did not appear to be affected by age, gender, presence of detailed history of illnesses from governmental hospitals, location and time of death, or the persons who gave opinion on the cause of death. Conclusions: An increase in the HIV/AIDS related mortality trend is not likely to be caused by false positive diagnoses of HIV/AIDS deaths because of its high specificity. HIV/AIDS mortality rate, determined from death certificate information, may underestimate the actual HIV/AIDS related mortality in view of its low sensitivity. Results of the study indicated that the death certification process needs some improvement to ascertain that the mortality statistics of the nation are accurate.

Mahidol University. Mahidol University Library and Knowledge Center

Address: NAKHONPATHOM

Email: liwww@mahidol.ac.th

Created: 2013

Modified: 2013-03-19

Issued: 1999-07/12

บทความ/Article

application/pdf

Mahidol Journal. 6, 2 (July-Dec. 1999) 131-135

eng

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