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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Creating and validating an algorithm to measure AIDS mortality in the adult population using verbal autopsy
PLoS Medicine, Volume 3, No. 8, Year 2006
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Description
Background: Vital registration and cause of death reporting is incomplete in the countries in which the HIV epidemic is most severe. A reliable tool that is independent of HIV status is needed for measuring the frequency of AIDS deaths and ultimately the impact of antiretroviral therapy on mortality. Methods and Findings: A verbal autopsy questionnaire was administered to caregivers of 381 adults of known HIV status who died between 1998 and 2003 in Manicaland, eastern Zimbabwe. Individuals who were HIV positive and did not die in an accident or during childbirth (74%; n = 282) were considered to have died of AIDS in the gold standard. Verbal autopsies were randomly allocated to a training dataset (n = 279) to generate classification criteria or a test dataset (n = 102) to verify criteria. A rule-based algorithm created to minimise false positives had a specificity of 66% and a sensitivity of 76%. Eight predictors (weight loss, wasting, jaundice, herpes zoster, presence of abscesses or sores, oral candidiasis, acute respiratory tract infections, and vaginal tumours) were included in the algorithm. In the test dataset of verbal autopsies, 69% of deaths were correctly classified as AIDS/non-AIDS, and it was not necessary to invoke a differential diagnosis of tuberculosis. Presence of any one of these criteria gave a post-test probability of AIDS death of 0.84. Conclusions: Analysis of verbal autopsy data in this rural Zimbabwean population revealed a distinct pattern of signs and symptoms associated with AIDS mortality. Using these signs and symptoms, demographic surveillance data on AIDS deaths may allow for the estimation of AIDS mortality and even HIV prevalence. © 2006 Lopman et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC1526767/bin/pmed.0030312.sd001.xls
https://efashare.b-cdn.net/share/pmc/articles/PMC1526767/bin/pmed.0030312.sd002.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC1526767/bin/pmed.0030312.sd003.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC1526767/bin/pmed.0030312.st001.doc
Authors & Co-Authors
Lopman, Benjamin Alan
United Kingdom, London
Imperial College London
Barnabas, Ruanne Vanessa
United Kingdom, Oxford
University of Oxford, Somerville College
Boerma, Ties
Switzerland, Geneva
Organisation Mondiale de la Santé
Chawira, Godwin
Zimbabwe, Harare
Biomedical Research and Training Institute Harare
Gaitskell, Kezia L.
United Kingdom, Oxford
University of Oxford, Somerville College
Harrop, Tara
United Kingdom, Oxford
University of Oxford, Somerville College
Mason, Peter R.
Zimbabwe, Harare
Biomedical Research and Training Institute Harare
Donnelly, Christl A.
United Kingdom, London
Imperial College London
Garnett, Geoff Peter
United Kingdom, London
Imperial College London
Nyamukapa, Constance Anesu
United Kingdom, London
Imperial College London
Zimbabwe, Harare
Biomedical Research and Training Institute Harare
Gregson, Simon A.J.
United Kingdom, London
Imperial College London
Zimbabwe, Harare
Biomedical Research and Training Institute Harare
Statistics
Citations: 109
Authors: 11
Affiliations: 4
Identifiers
Doi:
10.1371/journal.pmed.0030312
ISSN:
15491277
e-ISSN:
15491676
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Locations
Zimbabwe