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M94A2348.TXT
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Document 2348
DOCN M94A2348
TI Verbal autopsy as a tool for assessing adult HIV-1 attributable
mortality in a rural population.
DT 9412
AU Kamali A; Wagner HU; Kengeya Kayondo JF; Nakiyingi J; Mulder DW; Medical
Research Council AIDS Programme, Entebbe, Uganda.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):324 (abstract no. PC0228). Unique
Identifier : AIDSLINE ICA10/94370227
AB OBJECTIVE: To validate the use of verbal autopsies (VA) for the
assessment of HIV-1 attributable adult mortality in a rural population.
METHODS: A rural population cohort was enrolled in 1989/90 through a
census and serological survey, and kept under surveillance through
annual surveys. In addition, a village based death registration was
established. Sera were tested for HIV-1 antibodies using two independent
EIA systems. A VA questionnaire based on the Bangui AIDS case definition
was administered by paramedical staff within 4-12 weeks of death to
relative(s) of the deceased. Assessment of the VA forms was done by 2
clinicians who, unaware of HIV, status, independently indicated likely
causes of death. The clinicians' assessments were categorised according
to whether HIV was mentioned as the likely cause of death. RESULTS: The
HIV-1 seroprevalence rate in adults (13+ yrs) was 8%. VA assessement are
available for 154 deaths: 76 seropositives (SP) and 78 seronegatives
(SN) deaths. Of these, 82 (61 SP; 21 SN) were aged 13-44 years. In 83%
of SP and 13% of SN the death was attributed to HIV-1. Agreement between
the assessors was high. The table shows the specificity and positive
predictive value (PPV) for the age groups 13-44 and 45+. Also shown are
attributable mortality fractions (AMF) comparing estimates based on the
use of VA with those from the general cohort surveillance. TABULAR DATA,
SEE ABSTRACT VOLUME. CONCLUSION: Comparison of the surveillance and VA
based HIV-1 AMFs suggests that VA is a useful tool to estimate, at low
cost, the HIV-1 AMF among adults in populations with a prevalence rate
of 8% or more.
DE Adolescence Adult Autopsy/*METHODS *Cause of Death Cohort Studies
Human HIV Infections/*MORTALITY HIV Seroprevalence/TRENDS *HIV-1
Middle Age Population Surveillance Rural Population/*STATISTICS &
NUMER DATA Truth Disclosure Uganda/EPIDEMIOLOGY MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).