Tuberculosis surveillance using death certificate data, New York City, 1992.
OBJECTIVE
To determine the accuracy and frequency of reporting tuberculosis as either the contributing or underlying cause of death on death certificates in New York City during 1992.


METHODS
Death certificates from 1992 that listed tuberculosis were matched with the New York City tuberculosis registry. For those persons who had tuberculosis listed as a cause of death, but who were not listed in the registry, medical records were reviewed. The frequency of reporting tuberculosis on death certificates in patients who died with active tuberculosis was evaluated in the second part of this study. Death certificates of patients with active tuberculosis (persons who died within six months of starting anti-tuberculosis medications) in 1992 were reviewed.


RESULTS
Tuberculosis was listed on 635 death certificates; 377 (59%) were confirmed cases based on registry data. Reviews of medical records were possible for 230 (89%) of the remaining 258 patients and confirmed only two additional tuberculosis cases. Of 310 persons who died with active tuberculosis in 1992 (second part of the study), only 104 (34%) had tuberculosis listed on their death certificates.


CONCLUSIONS
In New York City, a diagnosis of tuberculosis on death certificates is an inaccurate measure of tuberculosis burden.
Washko
R M
RM
Bureau of Tuberculosis Control, New York City Department of Health, USA. rmw8@niords1.em.cdc.gov
Frieden
T R
TR
D000293:Adolescent; D000328:Adult; D000368:Aged; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003644:Death Certificates; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D012042:Registries; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000401:mortality*