A community based cross sectional study on feasibility of lay interviewers in ascertaining causes of adult deaths by using verbal autopsy in rural Wardha
Dongre, A.R.; Singh, A.; Deshmukh, P.R. and Garg, B.S. (2009) A community based cross sectional study on feasibility of lay interviewers in ascertaining causes of adult deaths by using verbal autopsy in rural Wardha. Online Journal of Health And Allied Sciences, 7 (4). ISSN 0972-5997
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Background & objectives: 1) To study the causes of adult (15 years and above) deaths using verbal autopsy (VA) and its sociodemographic characteristics. 2) To study the feasibility of use of the lay interviewer to ascertain causes of adult death using verbal autopsy and a simple algorithm. Methods: The present study was done in Wardha district, Maharashtra, India. Taking into account feasibility, out of 23 villages of Primary Health Centre, Anji, 15 villages were chosen having total population of 14,590. Out of 273 estimated adult deaths during the study period, 209 (77%) could be traced by house to house visit and a lay interviewer, interviewed the close caretakers of the deceased. Both lay interviewer and a physician individually derived their diagnosis using verbal autopsy report and a simplified algorithm. The data was entered and analyzed by using Epi_info 6.04. The inter-observer reliability between the lay interviewer and a physician for each possible diagnosis was assessed by using the Kappa statistics. Considering the diagnosis made by a physician as a gold standard, the diagnostic and predictive accuracy for each diagnosis made by the lay interviewer was calculated. Results: The communicable diseases accounted for 52 percent of the adult deaths while non-communicable for 32 percent and injuries for nine percent deaths. The overall agreement between the lay interviewer and a physician for communicable diseases was found to be good (k = 0.65 + 0.06) and for non-communicable diseases it was found to be excellent (k = 0.80 + 0.06). The lay interviewer using VA performed adequately for individual conditions of public health importance like acute febrile illness, diarrheal diseases, tuberculosis and injuries. Interpretation & conclusions: The present study has been successful to demonstrate feasibility of use of the lay interviewer to provide useful information on population-level estimation of broad causes of adult deaths and its socio-demographic characteristics that are reasonably reliable. The study suggests the possible utility of the method for rural India, where the majority of deaths occur at home. Further research work on development of sensitive and specific yet simple algorithms for lay interviewers to ascertain causes of adult deaths is required.
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