title: Developing a social autopsy tool for dengue mortality: a pilot study.
abstract: BACKGROUND
  Dengue fever is a public health problem in the tropical and sub-tropical world. Dengue cases have grown dramatically in recent years as well as dengue mortality. Colombia has experienced periodic dengue outbreaks with numerous dengue related-deaths, where the Santander department has been particularly affected. Although social determinants of health (SDH) shape health outcomes, including mortality, it is not yet understood how these affect dengue mortality. The aim of this pilot study was to develop and pre-test a social autopsy (SA) tool for dengue mortality.
  
  
  RESULTS
  The tool was developed and pre-tested in three steps. First, dengue fatal cases and 'near misses' (those who recovered from dengue complications) definitions were elaborated. Second, a conceptual framework on determinants of dengue mortality was developed to guide the construction of the tool. Lastly, the tool was designed and pre-tested among three relatives of fatal cases and six near misses in 2013 in the metropolitan zone of Bucaramanga. The tool turned out to be practical in the context of dengue mortality in Colombia after some modifications. The tool aims to study the social, individual, and health systems determinants of dengue mortality. The tool is focused on studying the socioeconomic position and the intermediary SDH rather than the socioeconomic and political context.
  
  
  CONCLUSIONS
  The SA tool is based on the scientific literature, a validated conceptual framework, researchers' and health professionals' expertise, and a pilot study. It is the first time that a SA tool has been created for the dengue mortality context. Our work furthers the study on SDH and how these are applied to neglected tropical diseases, like dengue. This tool could be integrated in surveillance systems to provide complementary information on the modifiable and avoidable death-related factors and therefore, be able to formulate interventions for dengue mortality reduction.
authors: School of Public Health (ESPUM), University of Montreal / University of Montreal Hospital Research Center (CRCHUM), Montreal, Canada.
authors: María José
authors: MJ
authors: Arauz
authors: School of Public Health (ESPUM), University of Montreal / University of Montreal Hospital Research Center (CRCHUM), Montreal, Canada.
authors: Valéry
authors: V
authors: Ridde
authors: Centro de Atención y Diagnóstico de Enfermedades Infecciosas (CDI-APRESIA), Bucaramanga, Colombia.
authors: Libia Milena
authors: LM
authors: Hernández
authors: Centro de Atención y Diagnóstico de Enfermedades Infecciosas (CDI-APRESIA), Bucaramanga, Colombia.
authors: Yaneth
authors: Y
authors: Charris
authors: Dengue Vaccines Initiative / International Vaccines Institute, Seoul, Republic of Korea.
authors: Mabel
authors: M
authors: Carabali
authors: Universidad Industrial de Santander, Bucaramanga, Colombia.
authors: Luis Ángel
authors: LÁ
authors: Villar
mesh_terms: D003715:Dengue / Q000401:mortality*; D004196:Disease Outbreaks; D006801:Humans; D008962:Models, Theoretical; D010865:Pilot Projects; D011634:Public Health; D064890:Social Determinants of Health; D014330:Tropical Medicine