Mapoma C Chabila, Munkombwe Brian, Mwango Chomba, Bwalya Bupe Bwalya, Kalindi Audrey, Gona N Philimon
Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
International Statistics Program, Centre for Disease Control and Prevention, Lusaka, Zambia.
BMC Health Serv Res. 2021 May 1;21(1):408. doi: 10.1186/s12913-021-06427-y.
Ascertaining the causes for deaths occurring outside health facilities is a significant problem in many developing countries where civil registration systems are not well developed or non-functional. Standardized and rigorous verbal autopsy methods is a potential solution to determine the cause of death. We conducted a demonstration project in Lusaka District of Zambia where verbal autopsy (VA) method was implemented in routine civil registration system.
About 3400 VA interviews were conducted for bodies "brought-in-dead" at Lusaka's two major teaching hospital mortuaries using a SmartVA questionnaire between October 2017 and September 2018. Probable underlying causes of deaths using VA and cause-specific mortality fractions were determined.. Demographic characteristics were analyzed for each VA-ascertained cause of death.
Opportunistic infections (OIs) associated with HIV/AIDS such as pneumonia and tuberculosis, and malaria were among leading causes of deaths among bodies "brought-in-dead". Over 21.6 and 26.9% of deaths were attributable to external causes and non-communicable diseases (NCDs), respectively. The VA-ascertained causes of death varied by age-group and sex. External causes were more prevalent among males in middle ages (put an age range like 30-54 years old) and NCDs highly prevalent among those aged 55 years and older.
VA application in civil registration system can provide the much-needed cause of death information for non-facility deaths in countries with under-developed or non-functional civil registration systems.
在许多民事登记系统不完善或无法正常运行的发展中国家，确定在医疗机构外发生的死亡原因是一个重大问题。标准化且严格的死因推断方法是确定死亡原因的一种潜在解决方案。我们在赞比亚卢萨卡区开展了一个示范项目，在常规民事登记系统中采用了死因推断（VA）方法。
2017年10月至2018年9月期间，使用SmartVA问卷对卢萨卡两家主要教学医院太平间送来的“死亡送来者”尸体进行了约3400次VA访谈。确定了使用VA得出的可能潜在死亡原因以及特定病因死亡率。对每个通过VA确定的死亡原因的人口统计学特征进行了分析。
与艾滋病毒/艾滋病相关的机会性感染（OIs），如肺炎和结核病，以及疟疾是“死亡送来者”尸体中主要的死亡原因。分别有超过21.6%和26.9%的死亡归因于外部原因和非传染性疾病（NCDs）。通过VA确定的死亡原因因年龄组和性别而异。外部原因在中年男性（如30 - 54岁）中更为普遍，非传染性疾病在55岁及以上人群中高度普遍。
在民事登记系统中应用VA可以为民事登记系统不发达或无法正常运行的国家提供非医疗机构死亡急需的死亡原因信息。
