Applying the InterVA-4 model to determine causes of death in rural Ethiopia.
BACKGROUND
In Ethiopia, most deaths take place at home and routine certification of cause of death by physicians is lacking. As a result, reliable cause of death (CoD) data are often not available. Recently, a computerized method for interpretation of verbal autopsy (VA) data, called InterVA, has been developed and used. It calculates the probability of a set of CoD given the presence of circumstances, signs, and symptoms reported during VA interviews. We applied the InterVA model to describe CoD in a rural population of Ethiopia.


OBJECTIVE
VA data for 436/599 (72.7%) deaths that occurred during 2010-2011 were included. InterVA-4 was used to interpret the VA data into probable cause of death. Cause-specific mortality fraction was used to describe frequency of occurrence of death from specific causes.


RESULTS
InterVA-4 was able to give likely cause(s) of death for 401/436 of the cases (92.0%). Overall, 35.0% of the total deaths were attributed to communicable diseases, and 30.7% to chronic non-communicable diseases. Tuberculosis (12.5%) and acute respiratory tract infections (10.4%) were the most frequent causes followed by neoplasms (9.6%) and diseases of circulatory system (7.2%).


CONCLUSIONS
InterVA-4 can produce plausible estimates of the major public health problems that can guide public health interventions. We encourage further validation studies, in local settings, so that InterVA can be integrated into national health surveys.
Department of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; INDEPTH Network, Accra, Ghana; berheph@gmail.com.
Berhe
B
Weldearegawi
Department of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; INDEPTH Network, Accra, Ghana.
Yohannes Adama
YA
Melaku
Department of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Mark
M
Spigt
CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Geert Jan
GJ
Dinant
D000293:Adolescent; D000328:Adult; D000368:Aged; D001344:Autopsy; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003625:Data Collection / Q000379:methods*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D011159:Population Surveillance; D012424:Rural Population; D012984:Software
Ethiopia; Health and Demographic Surveillance System; InterVA; cause of death; chronic non-communicable