Accuracy of physicians in diagnosing HIV and AIDS-related death in the adult population of Addis Ababa, Ethiopia

Araya, Tekebash, Tensou, Biruk, Davey, Gail and Berhane, Yemane (2012) Accuracy of physicians in diagnosing HIV and AIDS-related death in the adult population of Addis Ababa, Ethiopia. World Journal of AIDS, 2. pp. 89-96. ISSN 2160-8814

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Abstract

Background: The lack of cause of death information is the main challenge in monitoring the effectiveness of interventions aimed at reducing HIV and AIDS-related deaths in countries where the majority of deaths occur at home.

Objective: To evaluate the accuracy of physician reviewers of verbal autopsies in diagnosing HIV and AIDS-related deaths in the adult population of Addis Ababa, the capital of Ethiopia.

Methods: This study was done within the context of a burial surveillance system in Addis Ababa. Trained interviewers completed a standard verbal autopsy questionnaire and an independent panel of physicians reviewed the completed form to assign cause of death. Physicians’ review was compared to a reference standard constructed based on prospectively collected HIV-serostatus and patients’ hospital record. Sensitivity and specificity were calculated to validate the physicians’ verbal autopsy diagnoses against reference standards.

Results: Physicians accurately identified AIDS-related deaths with sensitivity and specificity of 0.88 (95% CI: 0.80 - 0.93) and 0.77 (95% CI: 0.64 - 0.87), respectively. Generally, there was high level of agreement (Cohen’s Kappa Statistic (K > 0.6) between the first two physicians with some yearly variations. In 2008 and 2009 there was an almost perfect agreement (K > 0.80).

Conclusion: This study demonstrated the agreement level between two independent physicians in diagnosing AIDS-related death is very high and thus using a single verbal autopsy coder is practical for programmatic purposes in countries where there is critical shortage of doctors.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Global Health and Infection
Subjects: R Medicine > R Medicine (General) > R728 Practice of medicine. Medical practice economics
Depositing User: Gail Davey
Date Deposited: 02 May 2013 10:37
Last Modified: 07 Aug 2017 16:24
URI: http://sro.sussex.ac.uk/id/eprint/44597

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