Anwar Jasim, Torvaldsen Siranda, Sheikh Mohamud, Taylor Richard
School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, Australia.
Department of Community Medicine, Women Medical and Dental College, Abbottabad, Pakistan.
Matern Child Health J. 2018 Dec;22(12):1743-1750. doi: 10.1007/s10995-018-2571-5.
Objectives An enhanced surveillance system that integrated health information systems and extended surveillance to previously uncovered areas to capture all births, perinatal and maternal deaths in a rural district of Pakistan was established in 2015, and this study uses capture-recapture methodology to assess completeness. Methods Births and deaths collected by the survey were matched with the data captured by the enhanced surveillance system. Capture-recapture methodology was used to estimate the total number of births and deaths, measure the degree of underestimation, and adjust mortality rates. Results Of all births, 99% were captured by the enhanced surveillance system. Ninety percent of neonatal deaths and 86% of early neonatal deaths were recorded. The recorded neonatal mortality rate was 40 per 1000 live births (95% CI 35-44), and after adjustment for under-enumeration was 42 per 1000 live births (95% CI 37-46). Recorded rates underestimated neonatal mortality by 5% and perinatal mortality by 7%. Five stillbirths were recorded by the survey and all were matched to recorded stillbirths. The one maternal death recorded by the survey was matched with the maternal death captured by the enhanced surveillance system. The maternal mortality ratio prior to adjustment for under-enumeration was 247 per 100,000 live births (95% CI 147-391), whereas after adjustment it was 246 per 100,000 live births (95% CI 146-389). Conclusion Application of capture-recapture methods to the enhanced surveillance system indicated a high completeness of birth and death recording by the surveillance system.
目的 2015 年在巴基斯坦一个农村地区建立了一个强化监测系统，该系统整合了卫生信息系统，并将监测范围扩大到以前未覆盖的地区，以记录所有出生、围产期和孕产妇死亡情况。本研究采用捕获再捕获方法评估完整性。方法 将调查收集的出生和死亡数据与强化监测系统捕获的数据进行匹配。采用捕获再捕获方法估计出生和死亡总数，衡量低估程度，并调整死亡率。结果 在所有出生中，99% 被强化监测系统记录。记录了 90% 的新生儿死亡和 86% 的早期新生儿死亡。记录的新生儿死亡率为每 1000 例活产 40 例（95% 置信区间 35 - 44），在调整漏报后为每 1000 例活产 42 例（95% 置信区间 37 - 46）。记录的比率低估新生儿死亡率 5%，围产期死亡率 7%。调查记录了 5 例死产，所有死产均与记录的死产相匹配。调查记录的 1 例孕产妇死亡与强化监测系统捕获的孕产妇死亡相匹配。在调整漏报之前，孕产妇死亡率为每 100,000 例活产 247 例（95% 置信区间 147 - 391），调整后为每 100,000 例活产 246 例（95% 置信区间 146 - 389）。结论 将捕获再捕获方法应用于强化监测系统表明，监测系统对出生和死亡记录的完整性较高。
