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Deaths from active tuberculosis: can we rely on notification and mortality figures?
E Heldal1, A Naalsund, J Kongerud
1Norwegian National Health Association, Oslo.
Tubercle and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|June 1, 1996
Summary
Tuberculosis (TB) mortality data quality is questionable. While official statistics appear accurate, they under-report and over-report TB deaths, capturing only half of all fatalities. Mentioning TB on death certificates improves accuracy.
Area of Science:
- Epidemiology
- Public Health Surveillance
Background:
- Tuberculosis (TB) mortality and notification rates are key epidemiological indicators.
- The accuracy of TB death data quality is largely unverified, unlike case notification data.
Purpose of the Study:
- To validate the accuracy and completeness of data on deaths attributed to active tuberculosis.
Main Methods:
- Comparison of active TB deaths recorded by Statistics Norway against the National Tuberculosis Register (NTR) and autopsy findings.
- Assessment of diagnostic classification and inclusion criteria for tuberculosis in death records.
Main Results:
- Significant discrepancies were found: 30 patients excluded from Statistics Norway data (inactive TB, minimal lesions).
- Additional cases identified through NTR (20) and autopsies (14), often with different primary diagnoses or not found.
- Tuberculosis was confirmed as the underlying cause in 65 patients, with diagnostic classification altered in 14%.
Conclusions:
- Statistics Norway's tuberculosis mortality rate is only partially correct, with substantial under- and over-reporting.
- The official mortality rate captures less than half of all active TB deaths.
- Utilizing death certificates that mention active tuberculosis offers a more reliable indicator of TB-related mortality.