Manortey Stephen, Carey Adrienne, Ansong Daniel, Harvey Ryan, Good Brian, Boaheng Joseph, Crookston Benjamin, Dickerson Ty
Department of Family and Preventive Medicine, University of Utah, Salt Lake City.
School of Medicine, University of Utah, Salt Lake City.
J Public Health Afr. 2011 May 13;2(2):e18. doi: 10.4081/jphia.2011.e18. eCollection 2011 Sep 5.
The availability of mortality data for any society plays an essential role in health monitoring and evaluation, as well as in the design of health interventions. However, most resource-poor countries such as Ghana have no reliable vital registration system. In these instances, verbal autopsy (VA) may be used as an alternative method to gather mortality data. In rural Ghana, the research team utilized a VA questionnaire to interview caretakers who were present with a child under the age of five prior to death. The data was given to two physicians who independently assigned the most probable cause of death for the child. A third, blinded physician analyzed the data in the cases where the first two physicians disagreed. When there was agreement between physicians, this was assigned as the cause of death for the individual child. During the study period, we recorded 118 deaths from 92 households. Twenty-nine (24.6%) were neonatal deaths with the leading causes of death being neonatal sepsis, birth asphyxia and pneumonia. The remaining 89 (75.4%) were post-neonatal deaths with the most common causes of death being pneumonia, malaria and malnutrition. While 63/118 (53.4%) deaths occurred in the home, there is no statistically significant relationship between the location of the home and the time of travel to the nearest health facility (P=0.132). VA is an important epidemiological tool for obtaining mortality data in communities that lack reliable vital registration systems. Improvement in health care is necessary to address the large number of deaths occurring in the home.
任何社会的死亡率数据对于健康监测与评估以及健康干预措施的设计都起着至关重要的作用。然而，像加纳这样的大多数资源匮乏国家没有可靠的人口动态登记系统。在这些情况下，口头尸检（VA）可作为收集死亡率数据的替代方法。在加纳农村，研究团队使用一份VA问卷对那些在孩子死亡前陪伴在五岁以下儿童身边的看护人进行访谈。数据交给两位医生，他们各自独立确定孩子最可能的死因。当两位医生意见不一致时，第三位不知情的医生对这些病例的数据进行分析。当医生之间达成一致意见时，就将其确定为该个体儿童的死因。在研究期间，我们记录了来自92个家庭的118例死亡。29例（24.6%）为新生儿死亡，主要死因是新生儿败血症、出生窒息和肺炎。其余89例（75.4%）为新生儿期后死亡，最常见的死因是肺炎、疟疾和营养不良。虽然63/118（53.4%）的死亡发生在家中，但家庭位置与前往最近医疗机构的时间之间没有统计学上的显著关系（P = 0.132）。口头尸检是在缺乏可靠人口动态登记系统的社区获取死亡率数据的重要流行病学工具。改善医疗保健对于解决大量在家中发生的死亡情况是必要的。
