Hardy A M, Starcher E T, Morgan W M, Druker J, Kristal A, Day J M, Kelly C, Ewing E, Curran J W
Public Health Rep. 1987 Jul-Aug;102(4):386-91.
To assess the level of reporting of acquired immunodeficiency syndrome (AIDS) cases, the authors reviewed death certificates for periods of 3 months during July through December 1985 in each of four cities: Washington, DC, New York City, Boston, and Chicago. Since reporting began in 1981, these cities have reported 38 percent of all AIDS cases in the United States. Death certificates were selected and matched to the AIDS surveillance registries in each city, and medical records of those not on the AIDS registry were reviewed to determine if AIDS had been diagnosed. The estimated completeness of AIDS case reporting to AIDS surveillance systems was high in all four cities (ranging from 83 percent to 100 percent). The unreported cases were similar to reported cases with respect to sex, race, risk factor, and specific diagnosis. Of the causes of death examined, AIDS, Pneumocystis carinii pneumonia, and Kaposi's sarcoma were predictive of AIDS as defined by the CDC case definition. However, 77 of 588 deaths (13 percent) attributed to 1 of these 3 causes occurred in cases that were presumptively AIDS but did not meet the diagnostic requirements to be classified as AIDS for reporting purposes. A review of death certificates provides an easy and rapid means of evaluating surveillance efforts and can be a useful adjunct to other methods of surveillance for AIDS.
为评估获得性免疫缺陷综合征（艾滋病）病例的报告水平，作者回顾了1985年7月至12月期间四个城市（华盛顿特区、纽约市、波士顿和芝加哥）中每个城市为期3个月的死亡证明。自1981年开始报告以来，这些城市报告了美国所有艾滋病病例的38%。选取死亡证明并与每个城市的艾滋病监测登记处进行匹配，对未在艾滋病登记处登记的人员的病历进行审查，以确定是否已诊断出艾滋病。所有四个城市向艾滋病监测系统报告艾滋病病例的估计完整性都很高（从83%到100%不等）。未报告的病例在性别、种族、危险因素和具体诊断方面与报告的病例相似。在所检查的死亡原因中，艾滋病、卡氏肺孢子虫肺炎和卡波西肉瘤可预测符合美国疾病控制与预防中心病例定义的艾滋病。然而，在588例归因于这三种原因之一的死亡病例中，有77例（13%）发生在推定患有艾滋病但不符合报告目的分类为艾滋病的诊断要求的病例中。回顾死亡证明提供了一种评估监测工作的简便快捷方法，并且可以作为艾滋病其他监测方法的有用辅助手段。
