Iriya N, Manji K P, Mbise R L
Bugando Medical Centre, Mwanza, Tanzania.
East Afr Med J. 2002 Feb;79(2):82-4. doi: 10.4314/eamj.v79i2.8907.
Perinatal mortality is a sensitive indicator of health status of a community and is also highly amenable to intervention. The causes of perinatal deaths in developing countries are often difficult to establish. Verbal autopsy has been used in several countries for children and adults, but seldom for perinatal cause.
To establish the cause of perinatal deaths using verbal autopsy.
Community-based cross-sectional, retrospective study to identify perinatal death over a one year period from July 1996-June 1997. Comparison was made with hospital records. An algorithm of signs and symptoms was used by trained personnel to identify the cause of perinatal death. The duration of collection of data was six months (August 1996-January 1997).
Hai district of Kilimanjaro region in Tanzania.
All perinatal deaths within one year.
The perinatal mortality was 58 per 1000 (121 deaths and 2088 live births). Verbal autopsy could establish the cause of death in 105 of the 121 deaths. Hospital records showed 79 deaths indicating that 42 deaths probably occurred at home. Among the 79 available hospital records, the cause of death could be established in only 30 (38%). The causes of postnatal death were compared between the verbal autopsy and hospital records. There was a good correlation between the same, however only 18 records were available from hospital among the total 31 postnatal deaths. The specificity of determining cause of death using verbal autopsy was 100% and sensitivity 61%.
The commonest causes of perinatal deaths were related to obstetric care, therefore interventions to curb perinatal mortality should be directed to improvement of obstetric care. Verbal autopsy is a simpler and more sensitive tool in establishing the cause of perinatal death than hospital records in a rural district of Tanzania. Large-scale studies are needed to validate this.
围产期死亡率是社区健康状况的一个敏感指标，而且也非常适合进行干预。发展中国家围产期死亡的原因往往难以确定。在一些国家，死因推断已用于儿童和成人，但很少用于围产期死因。
通过死因推断确定围产期死亡的原因。
基于社区的横断面回顾性研究，以确定1996年7月至1997年6月这一年期间的围产期死亡情况。与医院记录进行比较。由经过培训的人员使用症状和体征算法来确定围产期死亡原因。数据收集持续了六个月（1996年8月至1997年1月）。
坦桑尼亚乞力马扎罗地区的海伊区。
一年内所有围产期死亡病例。
围产期死亡率为每1000例中有58例（121例死亡和2088例活产）。死因推断能够确定121例死亡中的105例的死因。医院记录显示有79例死亡，这表明可能有42例死亡发生在家中。在79份可用的医院记录中，仅能确定30例（38%）的死因。对死因推断和医院记录之间产后死亡的原因进行了比较。两者之间存在良好的相关性，然而在总共31例产后死亡中，医院仅有18份记录。使用死因推断确定死亡原因的特异性为100%，敏感性为61%。
围产期死亡最常见的原因与产科护理有关，因此控制围产期死亡率的干预措施应针对改善产科护理。在坦桑尼亚的一个农村地区，死因推断在确定围产期死亡原因方面比医院记录是一种更简单、更敏感的工具。需要进行大规模研究来验证这一点。
