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Core verbal autopsy procedures with comparative validation results from two countries.

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Verbal autopsy procedures provide reasonable mortality estimates in low-income countries. Validation studies are crucial as performance varies by local disease prevalence.

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Area of Science:

  • Public Health
  • Epidemiology
  • Demography

Background:

  • Cause-specific mortality data are lacking in low-income countries.
  • Existing health information systems and vital registration are inadequate.
  • Sample vital registration with verbal autopsy is a promising solution.

Purpose of the Study:

  • To develop and validate core verbal autopsy forms and coding procedures.
  • To provide reliable mortality statistics for public health initiatives.
  • To adapt and test these methods in diverse settings.

Main Methods:

  • Developed and revised core verbal autopsy forms over 12 years in Tanzania.
  • Applied forms to over 50,000 deaths, comparable to existing procedures.
  • Adapted forms and coding for the International Statistical Classification of Diseases (ICD) in China.

Main Results:

  • Procedures yielded reasonable mortality estimates against performance criteria in Tanzania and China.
  • Specific causes performing well differed between countries due to varying disease prevalence.
  • Validation results for forms, coding, and protocols are presented.

Conclusions:

  • Verbal autopsy procedures can offer valuable mortality estimates.
  • Validation is essential in new epidemiological settings due to differing cause structures.
  • The study highlights the need for context-specific validation of verbal autopsy tools.