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Trop Med Int Health. 2014 Apr;19(4):407-12. doi: 10.1111/tmi.12268. Epub 2014 Mar 12.

Validating a verbal autopsy tool to assess pre-hospital trauma mortality burden in a resource-poor setting.

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  • 1Department of Surgery, University of North Carolina, Chapel Hill, NC, USA.

Abstract

OBJECTIVES:

To present the validation of a verbal autopsy (VA) tool using inpatient deaths in order to ultimately assess the burden of adult pre-hospital trauma mortality in Lilongwe, Malawi.

METHODS:

A WHO VA tool was administered at the Kamuzu Central Hospital (KCH) morgue in Lilongwe to family members of inpatient deceased. Two physicians assigned cause of death as 'trauma' or 'non-trauma' as well as a standard VA cause of death based on the VA tool. These assignments were compared to the 'gold standard' of physician review of hospital records using a kappa statistic.

RESULTS:

The VA method had near-perfect agreement with the hospital record in determining 'trauma' vs. 'non-trauma'. There was moderate agreement when comparing types of death, for example cardiovascular vs. infectious disease, and limited agreement when comparing specific causes of death.

CONCLUSION:

This VA tool can accurately ascertain trauma-related mortality with almost perfect agreement. The next step is to assess pre-hospital trauma mortality burden using the VA tool to determine whether hospital records underestimate the burden of trauma in the community.

© 2014 John Wiley & Sons Ltd.

KEYWORDS:

Africa; Malawi; trauma; vital statistics registration

PMID:
24617322
[PubMed - indexed for MEDLINE]
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