VERBAL AUTOPSY VALIDATION STUDY IN UGANDA

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					VERBAL AUTOPSY VALIDATION
     STUDY IN UGANDA


  Presenter: Dr Arthur Mpimbaza

Collaborating institutions: UMSP, LSHTM & CDC
            Sponsored by: CDC/PMI
               Introduction
• In 2005, the US launched PMI to reduce
  malaria deaths by 50% in selected African
  countries

• Impact of PMI activities will be assessed by
  measuring malaria-specific mortality rates
  before and after implementation of activities

• However, data on cause of death (COD) are
  often incomplete or absent

• VA is an alternative method to estimate
  mortality in areas with poor medical records
 What is Verbal Autopsy (VA)??
• An indirect method of determining COD
  based on an interview with the
  caretakers of a deceased person

• Involves 4 steps:
  – Interview, interpretation, COD, coding

• However, use of VA has limitations
  – Few validations studies have been done
  – S/S for malaria varies with transmission
  – Lack of standardized VA procedures
          Study objectives
• We propose to examine the validity of VA
  procedures in three different
  epidemiological settings in Uganda

• A new VA questionnaire developed by the
  WHO will be evaluated

• Hospital medical records will be used as
  the ‘gold standard’
   Medical records            Verbal autopsy
 Originals/ abstraction       VA Questionnaire


   Physician review           Physician review
Establish cause of death   Establish cause of death


Determine cause of death   Determine cause of death


   Cause of death by MR        Cause of death by VA
        Pneumonia                    Malaria
        Meningitis                 Pneumonia
         Malaria                    Meningitis
Study
sites
                Timeline
• Protocol approved by CDC, MU REC,
  LSHTM, and UNCST

• Initial audit of hospital records to begin
  in November

• Training of hospital staff in December

• Recruitment and training of study staff
  in Dec/Jan

• Data collection to begin Jan 2008
                Study team
• Sarah Staedke, UMSP/LSHTM, PI

• Arthur Mpimbaza, UMSP, co-investigator

• Fred Wabwire-Mangen, PI-UMSP, co-
  investigator

• Daniel Chandramohan, LSHTM, co-investigator

• Linda Quick, CDC/PMI/MoH, co-investigator

• Amy Ratcliffe, CDC, collaborator

• Scott Filler, CDC, collaborator