OBJECTIVE: To determine whether deaths among Haitian infants born to HIV-1-seronegative women could be distinguished from deaths among children born to HIV-1-seropositive women using the verbal autopsy technique. METHODS: Mothers of 315 Haitian children who died were interviewed about events leading to the child's death. Three physicians independently reviewed interview data and determined the probable cause of death without knowledge of maternal HIV-1 status or hospital records. The underlying causes of death assigned to the infants were analyzed to determine whether maternal HIV status could be predicted. RESULTS: There was good agreement among the physicians (kappa = 0.62) and 90% agreement between hospital records and the verbal autopsy diagnosis. Compared with children born to HIV-1-seronegative women, deaths in children born to HIV-1-seropositive mothers were more likely to be ascribed to a presumptive diagnosis of AIDS (37 versus 21%; P = 0.01). The sensitivity and specificity of verbal autopsies for identifying deaths associated with maternal HIV-1 infection ranged from 37 to 59% and from 69 to 79%, respectively, depending on the classification system used. The predictive positive value of a death believed to be consistent with pediatric HIV-1 infection was 26-30% and the predictive negative value was 85-90%. CONCLUSION: Verbal autopsies may be useful for distinguishing certain causes of death, but have limited utility for distinguishing deaths associated with maternal HIV-1 infection from deaths among children born to HIV-1-seronegative women.
OBJECTIVE: To determine whether deaths among Haitian infants born to HIV-1-seronegative women could be distinguished from deaths among children born to HIV-1-seropositivewomen using the verbal autopsy technique. METHODS: Mothers of 315 Haitian children who died were interviewed about events leading to the child's death. Three physicians independently reviewed interview data and determined the probable cause of death without knowledge of maternal HIV-1 status or hospital records. The underlying causes of death assigned to the infants were analyzed to determine whether maternal HIV status could be predicted. RESULTS: There was good agreement among the physicians (kappa = 0.62) and 90% agreement between hospital records and the verbal autopsy diagnosis. Compared with children born to HIV-1-seronegative women, deaths in children born to HIV-1-seropositive mothers were more likely to be ascribed to a presumptive diagnosis of AIDS (37 versus 21%; P = 0.01). The sensitivity and specificity of verbal autopsies for identifying deaths associated with maternal HIV-1 infection ranged from 37 to 59% and from 69 to 79%, respectively, depending on the classification system used. The predictive positive value of a death believed to be consistent with pediatric HIV-1 infection was 26-30% and the predictive negative value was 85-90%. CONCLUSION: Verbal autopsies may be useful for distinguishing certain causes of death, but have limited utility for distinguishing deaths associated with maternal HIV-1 infection from deaths among children born to HIV-1-seronegative women.
Entities:
Keywords:
Age Factors; Americas; Caribbean; Causes Of Death; Child; Child Mortality; Congenital Abnormalities; Data Collection; Demographic Factors; Developing Countries; Diseases; Family And Household; Family Characteristics; Family Relationships; Haiti; Hiv Infections; Interviews; Latin America; Measurement; Mortality; Mothers; Neonatal Diseases And Abnormalities; North America; Parents; Population; Population Characteristics; Population Dynamics; Research Methodology; Validity; Viral Diseases; Youth
Authors: Kathleen Kahn; Stephen M Tollman; Mark A Collinson; Samuel J Clark; Rhian Twine; Benjamin D Clark; Mildred Shabangu; Francesc Xavier Gómez-Olivé; Obed Mokoena; Michel L Garenne Journal: Scand J Public Health Suppl Date: 2007-08 Impact factor: 3.021
Authors: C Langston; E R Cooper; J Goldfarb; K A Easley; S Husak; S Sunkle; T J Starc; A A Colin Journal: Pediatrics Date: 2001-02 Impact factor: 7.124
Authors: Mary J Hamel; Kubaje Adazu; David Obor; Maquins Sewe; John Vulule; John M Williamson; Laurence Slutsker; Daniel R Feikin; Kayla F Laserson Journal: Am J Trop Med Hyg Date: 2011-10 Impact factor: 2.345
Authors: A Jahn; S Floyd; A C Crampin; H Mvula; V Mwinuka; E Mwaiyeghele; N McGrath; B Zaba; P E M Fine; Judith R Glynn Journal: Bull World Health Organ Date: 2010-05-10 Impact factor: 9.408
Authors: Hooman Khademi; Arash Etemadi; Farin Kamangar; Mehdi Nouraie; Ramin Shakeri; Behrooz Abaie; Akram Pourshams; Mohammad Bagheri; Afshin Hooshyar; Farhad Islami; Christian C Abnet; Paul Pharoah; Paul Brennan; Paolo Boffetta; Sanford M Dawsey; Reza Malekzadeh Journal: PLoS One Date: 2010-06-17 Impact factor: 3.240