title: Agreement on underlying causes of infant death between original records and after investigation: analysis of two biennia in the years 2000.
abstract: OBJECTIVE
  To analyze the agreement between underlying causes of infant deaths obtained from Death Certificates (DC) with those defined after investigation by the Municipal Committee for the Prevention of Maternal and Infant Mortality (CMPMMI), in Londrina, Paraná State, in the biennia 2000-2001 and 2007-2008.
  
  
  METHODS
  DC of infants and records of investigations were obtained from the CMPMMI. The causes of death registered in both sources were coded according to the International Classification of Diseases, tenth revision (ICD-10), and the underlying causes of deaths were selected. Agreement between underlying causes of deaths was verified by Kappa's (k) test and analyzed according to ICD-10 chapters and blocks of categories in both biennia.
  
  
  RESULTS
  In 2000/2001, according to ICD-10 chapters, high agreement rates were observed for conditions originated in the perinatal period (k = 0.85) and for external causes (k = 0.84), while, for congenital malformations, there was a substantial agreement (k = 0.71). In 2007/2008, agreement was considered poor for all analyzed chapters. For blocks of categories, high or substantial agreement rates were observed only in the first biennium for "congenital malformations of the circulatory system" (k = 0.78) and for "other external causes of accidental injury" (k = 0.91).
  
  
  CONCLUSIONS
  A decrease in agreement between the sources during the study period indicates either an improvement in the process of investigation of infant death by the CMPMMI and/or a worsening in the quality of the DC information.
authors.affiliation: Universidade Estadual de Londrina, Londrina, PR, Brazil.
authors.forename: Hellen Geremias
authors.initials: HG
authors.lastname: dos Santos
authors.affiliation: Universidade Estadual de Londrina, Londrina, PR, Brazil.
authors.forename: Selma Maffei
authors.initials: SM
authors.lastname: de Andrade
authors.affiliation: Universidade Estadual de Londrina, Londrina, PR, Brazil.
authors.forename: Ana Maria Rigo
authors.initials: AM
authors.lastname: Silva
authors.affiliation: Universidade Estadual de Londrina, Londrina, PR, Brazil.
authors.forename: Wladithe Organ
authors.initials: WO
authors.lastname: de Carvalho
authors.affiliation: Universidade Estadual de Londrina, Londrina, PR, Brazil.
authors.forename: Arthur Eumann
authors.initials: AE
authors.lastname: Mesas
authors.affiliation: Universidade Estadual de Londrina, Londrina, PR, Brazil.
authors.forename: Alberto Durán
authors.initials: AD
authors.lastname: González
mesh_terms: D001938:Brazil; D002423:Cause of Death; D003644:Death Certificates; D006801:Humans; D007223:Infant; D066088:Infant Death / Q000209:etiology*; D007231:Infant, Newborn; D013997:Time Factors