Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands

Abstract Background Good quality cause of death (COD) information is fundamental for formulating and evaluating public health policy; yet most deaths in developing countries, including the Solomon Islands, occur at home without medical certification of cause of death (MCCOD). As a result, COD data i...

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Autores principales:	Matthew Reeve, Hafizur Chowdhury, Pasyodun Koralage Buddhika Mahesh, Gregory Jilini, Rooney Jagilly, Baakai Kamoriki, Rodley Ruskin, Deirdre McLaughlin, Alan D. Lopez
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Verbal autopsy Solomon Islands Civil registration and vital statistics SmartVA Tariff method Causes of death Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/9ac43f87a0cb480e8e88c1fa78b5e2aa
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spelling	oai:doaj.org-article:9ac43f87a0cb480e8e88c1fa78b5e2aa2021-11-14T12:14:32ZGenerating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands10.1186/s12889-021-12180-y1471-2458https://doaj.org/article/9ac43f87a0cb480e8e88c1fa78b5e2aa2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12180-yhttps://doaj.org/toc/1471-2458Abstract Background Good quality cause of death (COD) information is fundamental for formulating and evaluating public health policy; yet most deaths in developing countries, including the Solomon Islands, occur at home without medical certification of cause of death (MCCOD). As a result, COD data in such contexts are often of limited use for policy and planning. Verbal autopsies (VAs) are a cost-effective way of generating reliable COD information in populations lacking comprehensive MCCOD coverage, but this method has not previously been applied in the Solomon Islands. This study describes the establishment of a VA system to estimate the cause specific mortality fractions (CSMFs) for community deaths that are not medically certified in the Solomon Islands. Methods Automated VA methods (SmartVA) were introduced into the Solomon Islands in 2016. Trained data collectors (nurses) conducted VAs on eligible deaths to December 2020 using electronic tablet devices and VA responses were analysed using the Tariff 2.0 automated diagnostic algorithm. CSMFs were generated for both non-inpatient deaths in hospitals (i.e. ‘dead on/by arrival’) and community deaths. Results VA was applied to 914 adolescent-and-adult deaths with a median (IQR) age of 62 (45–75) years, 61% of whom were males. A specific COD could be diagnosed for more than 85% of deaths. The leading causes of death for both sexes combined were: ischemic heart disease (16.3%), stroke (13.5%), diabetes (8.1%), pneumonia (5.7%) and chronic-respiratory disease (4.8%). Stroke was the top-ranked cause for females, and ischaemic heart disease the leading cause for males. The CSMFs from the VAs were similar to Global Burden of Disease (GBD) estimates. Overall, non-communicable diseases (NCDs) accounted for 73% of adult deaths; communicable, maternal and nutritional conditions 15%, and injuries 12%. Six of the ten leading causes reported for facility deaths in the Solomon Islands were also identified as leading causes of community deaths based on the VA diagnoses. Conclusions NCDs are the leading cause of adult deaths in the Solomon Islands. Automated VA methods are an effective means of generating reliable COD information for community deaths in the Solomon Islands and should be routinely incorporated into the national mortality surveillance system.Matthew ReeveHafizur ChowdhuryPasyodun Koralage Buddhika MaheshGregory JiliniRooney JagillyBaakai KamorikiRodley RuskinDeirdre McLaughlinAlan D. LopezBMCarticleVerbal autopsySolomon IslandsCivil registration and vital statisticsSmartVATariff methodCauses of deathPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Verbal autopsy Solomon Islands Civil registration and vital statistics SmartVA Tariff method Causes of death Public aspects of medicine RA1-1270
spellingShingle	Verbal autopsy Solomon Islands Civil registration and vital statistics SmartVA Tariff method Causes of death Public aspects of medicine RA1-1270 Matthew Reeve Hafizur Chowdhury Pasyodun Koralage Buddhika Mahesh Gregory Jilini Rooney Jagilly Baakai Kamoriki Rodley Ruskin Deirdre McLaughlin Alan D. Lopez Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands
description	Abstract Background Good quality cause of death (COD) information is fundamental for formulating and evaluating public health policy; yet most deaths in developing countries, including the Solomon Islands, occur at home without medical certification of cause of death (MCCOD). As a result, COD data in such contexts are often of limited use for policy and planning. Verbal autopsies (VAs) are a cost-effective way of generating reliable COD information in populations lacking comprehensive MCCOD coverage, but this method has not previously been applied in the Solomon Islands. This study describes the establishment of a VA system to estimate the cause specific mortality fractions (CSMFs) for community deaths that are not medically certified in the Solomon Islands. Methods Automated VA methods (SmartVA) were introduced into the Solomon Islands in 2016. Trained data collectors (nurses) conducted VAs on eligible deaths to December 2020 using electronic tablet devices and VA responses were analysed using the Tariff 2.0 automated diagnostic algorithm. CSMFs were generated for both non-inpatient deaths in hospitals (i.e. ‘dead on/by arrival’) and community deaths. Results VA was applied to 914 adolescent-and-adult deaths with a median (IQR) age of 62 (45–75) years, 61% of whom were males. A specific COD could be diagnosed for more than 85% of deaths. The leading causes of death for both sexes combined were: ischemic heart disease (16.3%), stroke (13.5%), diabetes (8.1%), pneumonia (5.7%) and chronic-respiratory disease (4.8%). Stroke was the top-ranked cause for females, and ischaemic heart disease the leading cause for males. The CSMFs from the VAs were similar to Global Burden of Disease (GBD) estimates. Overall, non-communicable diseases (NCDs) accounted for 73% of adult deaths; communicable, maternal and nutritional conditions 15%, and injuries 12%. Six of the ten leading causes reported for facility deaths in the Solomon Islands were also identified as leading causes of community deaths based on the VA diagnoses. Conclusions NCDs are the leading cause of adult deaths in the Solomon Islands. Automated VA methods are an effective means of generating reliable COD information for community deaths in the Solomon Islands and should be routinely incorporated into the national mortality surveillance system.
format	article
author	Matthew Reeve Hafizur Chowdhury Pasyodun Koralage Buddhika Mahesh Gregory Jilini Rooney Jagilly Baakai Kamoriki Rodley Ruskin Deirdre McLaughlin Alan D. Lopez
author_facet	Matthew Reeve Hafizur Chowdhury Pasyodun Koralage Buddhika Mahesh Gregory Jilini Rooney Jagilly Baakai Kamoriki Rodley Ruskin Deirdre McLaughlin Alan D. Lopez
author_sort	Matthew Reeve
title	Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands
title_short	Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands
title_full	Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands
title_fullStr	Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands
title_full_unstemmed	Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands
title_sort	generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the solomon islands
publisher	BMC
publishDate	2021
url	https://doaj.org/article/9ac43f87a0cb480e8e88c1fa78b5e2aa
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Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands

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