Assessing a new approach to verbal autopsy interpretation in a rural Ethiopian community: the InterVA model.
OBJECTIVE
Verbal autopsy (VA) -- the interviewing of family members or caregivers about the circumstances of a death after the event -- is an established tool in areas where routine death registration is non-existent or inadequate. We assessed the performance of a probabilistic model (InterVA) for interpreting community-based VA interviews, in order to investigate patterns of cause-specific mortality in a rural Ethiopian community. We compared results with those obtained after review of the VA by local physicians, with a view to validating the model as a community-based tool.


METHODS
Two-hundred and eighty-nine VA interviews were successfully completed; these included most deaths occurring in a defined community over a 1-year period. The VA interviews were interpreted by physicians and by the model, and cause-specific mortality fractions were derived for the whole community and for particular age groups using both approaches.


RESULTS
The results of the two approaches to interpretation correlated well in this example from Ethiopia. Four major cause groups accounted for over 60% of all mortality, and patterns within specific age groups were consistent with expectations for an underdeveloped high-mortality community in sub-Saharan Africa.


CONCLUSIONS
Compared with interpretation by physicians, the InterVA model is much less labour intensive and offers 100% consistency. It is a valuable new tool for characterizing patterns of cause-specific mortality in communities without death registration and for comparing patterns of mortality in different populations.
Department of Community Health, Addis Ababa University, Ethiopia.
Mesganaw
M
Fantahun
Edward
E
Fottrell
Yemane
Y
Berhane
Stig
S
Wall
Ulf
U
Högberg
Peter
P
Byass
D000293:Adolescent; D000328:Adult; D001344:Autopsy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D012424:Rural Population; D011795:Surveys and Questionnaires