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. 2024 Jul 29;4(7):e0003065.
doi: 10.1371/journal.pgph.0003065. eCollection 2024.

Comparison of causes of stillbirth and child deaths as determined by verbal autopsy and minimally invasive tissue sampling

Nega Assefa  1 , Anthony Scott  2 , Lola Madrid  2 , Merga Dheresa  1 , Gezahegn Mengesha  1 , Shabir Mahdi  3 , Sana Mahtab  3 , Ziyaad Dangor  3 , Nellie Myburgh  4 , Lesego Kamogelo Mothibi  4 , Samba O Sow  4 , Karen L Kotloff  5 , Milagritos D Tapia  5 , Uma U Onwuchekwa  4 , Mahamane Djiteye  4 , Rosauro Varo  6   7 , Inacio Mandomando  7   8 , Ariel Nhacolo  7 , Charfudin Sacoor  7 , Elisio Xerinda  7 , Ikechukwu Ogbuanu  9 , Solomon Samura  10 , Babatunde Duduyemi  11 , Alim Swaray-Deen  12 , Abdulai Bah  13 , Shams El Arifeen  14 , Emily S Gurley  15 , Mohammed Zahid Hossain  16 , Afruna Rahman  17 , Atique Iqbal Chowdhury  16 , Bassat Quique  6   7   8 , Portia Mutevedzi  18 , Solveig A Cunningham  19 , Dianna Blau  19 , Cyndy Whitney  18
Affiliations

Comparison of causes of stillbirth and child deaths as determined by verbal autopsy and minimally invasive tissue sampling

Nega Assefa et al. PLOS Glob Public Health. .

Abstract

In resource-limited settings where vital registration and medical death certificates are unavailable or incomplete, verbal autopsy (VA) is often used to attribute causes of death (CoD) and prioritize resource allocation and interventions. We aimed to determine the CoD concordance between InterVA and CHAMPS's method. The causes of death (CoDs) of children <5 were determined by two methods using data from seven low- and middle-income countries (LMICs) enrolled in the Child Health and Mortality Prevention Surveillance (CHAMPS) network. The first CoD method was from the DeCoDe panel using data from Minimally Invasive Tissue Sampling (MITS), whereas the second method used Verbal Autopsy (VA), which utilizes the InterVA software. This analysis evaluated the agreement between the two using Lin's concordance correlation coefficient. The overall concordance of InterVA4 and DeCoDe in assigning causes of death across surveillance sites, age groups, and causes of death was poor (0.75 with 95% CI: 0.73-0.76) and lacked precision. We found substantial differences in agreement by surveillance site, with Mali showing the lowest and Mozambique and Ethiopia the highest concordance. The InterVA4 assigned CoD agrees poorly in assigning causes of death for U5s and stillbirths. Because VA methods are relatively easy to implement, such systems could be more useful if algorithms were improved to more accurately reflect causes of death, for example, by calibrating algorithms to information from programs that used detailed diagnostic testing to improve the accuracy of COD determination.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flowchart of deaths included in the analysis.
Fig 2
Fig 2. Concordance of cause-specific mortality fractions of the underlying causes of death between InterVA4 and DeCoDe for CHAMPS surveillance sites.
Fig 3
Fig 3. Concordance of cause-specific mortality fractions of the underlying causes of death between InterVA4 and DeCoDe for CHAMPS surveillance sites by age group.
See this image and copyright information in PMC

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