scholarly journals Overview and Development of the Child Health and Mortality Prevention Surveillance Determination of Cause of Death (DeCoDe) Process and DeCoDe Diagnosis Standards

2019 ◽  
Vol 69 (Supplement_4) ◽  
pp. S333-S341 ◽  
Author(s):  
Dianna M Blau ◽  
J Patrick Caneer ◽  
Rebecca P Philipsborn ◽  
Shabir A Madhi ◽  
Quique Bassat ◽  
...  
Keyword(s):  
Child Health ◽  
Cause Of Death ◽  
Sub Saharan Africa ◽  
World Health ◽  
Mortality Data ◽  
Sequence Of Events ◽  
Decode Process ◽  
Clinical Records ◽  
Health And Mortality

Abstract Mortality surveillance and cause of death data are instrumental in improving health, identifying diseases and conditions that cause a high burden of preventable deaths, and allocating resources to prevent these deaths. The Child Health and Mortality Prevention Surveillance (CHAMPS) network uses a standardized process to define, assign, and code causes of stillbirth and child death (<5 years of age) across the CHAMPS network. A Determination of Cause of Death (DeCoDe) panel composed of experts from a local CHAMPS site analyzes all available individual information, including laboratory, histopathology, abstracted clinical records, and verbal autopsy findings for each case and, if applicable, also for the mother. Using this information, the site panel ascertains the underlying cause (event that precipitated the fatal sequence of events) and other antecedent, immediate, and maternal causes of death in accordance with the International Classification of Diseases, Tenth Revision and the World Health Organization death certificate. Development and use of the CHAMPS diagnosis standards—a framework of required evidence to support cause of death determination—assures a homogenized procedure leading to a more consistent interpretation of complex data across the CHAMPS network. This and other standardizations ensures future comparability with other sources of mortality data produced externally to this project. Early lessons learned from implementation of DeCoDe in 5 CHAMPS sites in sub-Saharan Africa and Bangladesh have been incorporated into the DeCoDe process, and the implementation of DeCoDe has the potential to spur health systems improvements and local public health action.

scholarly journals Setting up child health and mortality prevention surveillance in Ethiopia

2021 ◽  
Vol 5 ◽  
pp. 173
Author(s):  
Anna C. Seale ◽  
Nega Assefa ◽  
Lola Madrid ◽  
Stefanie Wittmann ◽  
Hanan Abdurahman ◽  
...  
Keyword(s):  
Child Health ◽  
Cause Of Death ◽  
High Mortality ◽  
Demographic Data ◽  
Child Death ◽  
Sub Saharan Africa ◽  
London School ◽  
Eastern Ethiopia ◽  
Live Births ◽  
Health And Mortality

Background: Mortality rates for children under five years of age, and stillbirth risks, remain high in parts of sub-Saharan Africa and South Asia. The Child Health and Mortality Prevention Surveillance (CHAMPS) network aims to ascertain causes of child death in high child mortality settings (>50 deaths/1000 live-births). We aimed to develop a “greenfield” site for CHAMPS, based in Harar and Kersa, in Eastern Ethiopia. This very high mortality setting (>100 deaths/1000 live-births in Kersa) had limited previous surveillance capacity, weak infrastructure and political instability. Here we describe site development, from conception in 2015 to the end of the first year of recruitment. Methods: We formed a collaboration between Haramaya University and the London School of Hygiene & Tropical Medicine and engaged community, national and international partners to support a new CHAMPS programme. We developed laboratory infrastructure and recruited and trained staff. We established project specific procedures to implement CHAMPS network protocols including; death notifications, clinical and demographic data collection, post-mortem minimally invasive tissue sampling, microbiology and pathology testing, and verbal autopsy. We convened an expert local panel to determine cause-of-death. In partnership with the Ethiopian Public Health Institute we developed strategies to improve child and maternal health. Results: Despite considerable challenge, with financial support, personal commitment and effective partnership, we successfully initiated CHAMPS. One year into recruitment (February 2020), we had received 1173 unique death notifications, investigated 59/99 MITS-eligible cases within the demographic surveillance site, and assigned an underlying and immediate cause of death to 53 children. Conclusions: The most valuable data for global health policy are from high mortality settings, but initiating CHAMPS has required considerable resource. To further leverage this investment, we need strong local research capacity and to broaden the scientific remit. To support this, we have set up a new collaboration, the “Hararghe Health Research Partnership”.

scholarly journals Mortality Surveillance Methods to Identify and Characterize Deaths in Child Health and Mortality Prevention Surveillance Network Sites

2019 ◽  
Vol 69 (Supplement_4) ◽  
pp. S262-S273 ◽  
Author(s):  
Navit T Salzberg ◽  
Kasthuri Sivalogan ◽  
Quique Bassat ◽  
Allan W Taylor ◽  
Sunday Adedini ◽  
...  
Keyword(s):  
Child Health ◽  
South Asia ◽  
Cause Of Death ◽  
Demographic Data ◽  
Childhood Mortality ◽  
Sub Saharan Africa ◽  
Quality Data ◽  
Sub Saharan ◽  
Mortality Surveillance ◽  
Health And Mortality

Abstract Despite reductions over the past 2 decades, childhood mortality remains high in low- and middle-income countries in sub-Saharan Africa and South Asia. In these settings, children often die at home, without contact with the health system, and are neither accounted for, nor attributed with a cause of death. In addition, when cause of death determinations occur, they often use nonspecific methods. Consequently, findings from models currently utilized to build national and global estimates of causes of death are associated with substantial uncertainty. Higher-quality data would enable stakeholders to effectively target interventions for the leading causes of childhood mortality, a critical component to achieving the Sustainable Development Goals by eliminating preventable perinatal and childhood deaths. The Child Health and Mortality Prevention Surveillance (CHAMPS) Network tracks the causes of under-5 mortality and stillbirths at sites in sub-Saharan Africa and South Asia through comprehensive mortality surveillance, utilizing minimally invasive tissue sampling (MITS), postmortem laboratory and pathology testing, verbal autopsy, and clinical and demographic data. CHAMPS sites have established facility- and community-based mortality notification systems, which aim to report potentially eligible deaths, defined as under-5 deaths and stillbirths within a defined catchment area, within 24–36 hours so that MITS can be conducted quickly after death. Where MITS has been conducted, a final cause of death is determined by an expert review panel. Data on cause of death will be provided to local, national, and global stakeholders to inform strategies to reduce perinatal and childhood mortality in sub-Saharan Africa and South Asia.

scholarly journals Ketepatan Penentuan Kode Diagnosis Utama Penyebab Kematian Pada Kasus Stroke Di RSUD Brigjend H. Hasan Basry Kandangan

2019 ◽  
Vol 9 (2) ◽  
pp. 104
Author(s):  
Nina Rahmadiliyani Rahmadiliyani ◽  
Aida Fitria
Keyword(s):  
Medical Record ◽  
Cause Of Death ◽  
Causes Of Death ◽  
World Health ◽  
Main Diagnosis ◽  
Quantitative Studies ◽  
Sequence Of Events ◽  
Diagnosis Codes ◽  
Accuracy Determination

World Health Information (WHO) establishes a set of rules or procedures that must be followed for granting kodefikasi UCoD determination of the code on certificate of death must pay attention to the sequence of events leading to the death of the disease and the cause of the beginning of the sequence such. Some hospitals are not doing the coding causes of death and inaccuracies in coding causes of death data produces the wrong health. This research aims to know the description of accuracy determination of main diagnosis codes cause of death in the case of a stroke in a hospital Brigjend H.Hasan Basry Kandangan. This research use descriptive qualitative research methods with quantitative studies. This research was conducted with observation 68 medical record documents and interviewing doctors, koder and head installation medical record as supporting in this research. In this research note the hospital does not have an SOP and the absence of writing the cause of death on a death certificate so as not to kodefikasi the implementation and reporting of the implementation of the hospital not be RL4 about mortality reporting.

scholarly journals Institutional mortality rate and cause of death at health facilities in Ghana between 2014 and 2018

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256515
Author(s):  
Adobea Yaa Owusu ◽  
Sandra Boatemaa Kushitor ◽  
Anthony Adofo Ofosu ◽  
Mawuli Komla Kushitor ◽  
Atsu Ayi ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Infectious Diseases ◽  
Cause Of Death ◽  
Information Management System ◽  
Health Facilities ◽  
World Health ◽  
Urban Region ◽  
Mortality Data ◽  
National Trends ◽  
Ghana Health

Background The epidemiological transition, touted as occurring in Ghana, requires research that tracks the changing patterns of diseases in order to capture the trend and improve healthcare delivery. This study examines national trends in mortality rate and cause of death at health facilities in Ghana between 2014 and 2018. Methods Institutional mortality data and cause of death from 2014–2018 were sourced from the Ghana Health Service’s District Health Information Management System. The latter collates healthcare service data routinely from government and non-governmental health institutions in Ghana yearly. The institutional mortality rate was estimated using guidelines from the Ghana Health Service. Percent change in mortality was examined for 2014 and 2018. In addition, cause of death data were available for 2017 and 2018. The World Health Organisation’s 11th International Classification for Diseases (ICD-11) was used to group the cause of death. Results Institutional mortality decreased by 7% nationally over the study period. However, four out of ten regions (Greater Accra, Volta, Upper East, and Upper West) recorded increases in institutional mortality. The Upper East (17%) and Volta regions (13%) recorded the highest increase. Chronic non-communicable diseases (NCDs) were the leading cause of death in 2017 (25%) and 2018 (20%). This was followed by certain infectious and parasitic diseases (15% for both years) and respiratory infections (10% in 2017 and 13% in 2018). Among the NCDs, hypertension was the leading cause of death with 2,243 and 2,472 cases in 2017 and 2018. Other (non-ischemic) heart diseases and diabetes were the second and third leading NCDs. Septicaemia, tuberculosis and pneumonia were the predominant infectious diseases. Regional variations existed in the cause of death. NCDs showed more urban-region bias while infectious diseases presented more rural-region bias. Conclusions This study examined national trends in mortality rate and cause of death at health facilities in Ghana. Ghana recorded a decrease in institutional mortality throughout the study. NCDs and infections were the leading causes of death, giving a double-burden of diseases. There is a need to enhance efforts towards healthcare and health promotion programmes for NCDs and infectious diseases at facility and community levels as outlined in the 2020 National Health Policy of Ghana.

scholarly journals Cause of death in fatal cases associated with positive COVID-19 PCR tests

2021 ◽  
Vol 9 (40) ◽  
pp. 3-8
Author(s):  
Christopher Peterson ◽  
John Fanous ◽  
Haneen Mallah ◽  
Shengping Yang ◽  
Gilbert Berdine
Keyword(s):  
Cause Of Death ◽  
Scoring System ◽  
Intraclass Correlation ◽  
World Health ◽  
Who Guidelines ◽  
Comorbid Conditions ◽  
Death Certification ◽  
Patient Death ◽  
Health Organization

The response to the COVID-19 pandemic is heavily influenced by reported fatalities from the virus and, by implication, the criteria used to determine those fatalities. Given complications, such as the presence of comorbidities and limitations in testing, the World Health Organization (WHO) guidelines recommend counting both confirmed and suspected COVID-19 deaths as fatalities. While easily implementable, this method does little to indicate the degrees of certainty for a COVID-19 death, and thus concerns have arisen that this may overcount the number of COIVD-19 fatalities. In response, we developed and implemented a scoring system to determine the likelihood that COVID-19 contributed to patient death. Three reviewers independently assessed records of 47 patients who reportedly died from COVID-19. Greatest consensus was observed at the ends of the scoring spectrum, with twelve patients having complete consensus among reviewers. Intraclass correlation among the three reviewers was 0.52 (95% CI, 0.25-0.72). Middle scores had the greatest variability, possibly due to plausible alternative diagnoses, suggesting the potential for variability in death certification and the need for a scoring system that reports degrees of certainty. Although scoring rules can guide reviewers toward greater consensus about cause of death, in the absence of an objective criteria for COVID-19 disease, the determination of cause of death in paitents with positive PCR tests for SARS-CoV-2 who also have significant comorbid conditions will remain subjective. Keywords: COVID-19; fatality; cause of death

scholarly journals Global child health: What we have achieved and what needs to be done

2020 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Venkatraman Radhakrishnan
Keyword(s):  
Child Health ◽  
Sub Saharan Africa ◽  
World Health ◽  
Special Focus ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Important Health ◽  
Sub Saharan ◽  
Health Organization

Global child health has cemented itself as an important branch of global health. It is said that the development of a nation is gauged by its infant and under-5 mortality rates. Coordinated efforts by organizations such as the United Nations, the World Health Organization, and Governments are essential to maintain the momentum of improving the health of children across the world. Special focus needs to be put on areas such as Sub-Saharan Africa and conflict-prone regions where the initial positive gains are being erased. As we achieve success in controlling malaria, pneumonia, and diarrhea in many countries, we need to start focusing on areas such as cancer, accidents, climate change, and child abuse which will soon become important health problems in children in low- and middle-income countries.

scholarly journals 923Quantifying multiple causes of death: Observed patterns in Australia, 2006–2017

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Karen Bishop ◽  
Saliu Balogun ◽  
James Eynston-Hinkins ◽  
Lauren Moran ◽  
Margarita Moreno-Betancur ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Causes Of Death ◽  
International Classification Of Diseases ◽  
World Health ◽  
Mortality Data ◽  
Multiple Causes Of Death ◽  
Underlying Causes ◽  
Health Organization ◽  
The Impact ◽  
Multiple Causes

Abstract Background Four fifths of deaths in Australia involve multiple causes, but statistics typically use a single underlying cause of death (UC). The UC approach alone is insufficient for understanding the impact of non-underlying causes and identifying comorbid disease associations at death. Analysis of multiple causes of death (MC) is needed to measure the impact of all causes. We described MC patterns, considering cause-of-death coding and certification practices in Australia. Methods Using deaths registered in Australia from 2006 to 2017 (n = 1773525) coded to the International Classification of Diseases (ICD) and an extended classification (n = 136 causes) based on a World Health Organization short list, we described MCoD data by cause. Age-standardised rates based on UC and MC were compared using the standardised ratio of multiple to underlying causes (SRMU) to estimate the contribution of the cause to mortality compared to using the UC approach. Comorbidity was explored using the cause of death association indicator (CDAI) to compare the observed joint frequency of a contributory-underlying cause combined with expected frequency of the contributory cause (with any UC). Results On average 3.4 conditions caused each death and 24.4% of deaths had 5 plus causes. Largest SRMUs were for genitourinary diseases (8.0), blood diseases (7.8) and musculoskeletal conditions (6.7). CDAIs showed high associations between, for example, accidental alcohol and opioid poisoning, septicaemia and skin infections, and traumatic brain injury and falls. Conclusions MC indicators enhance measures of mortality and reassess the role of causes of death for descriptive and analytical epidemiology. Key messages This research demonstrates the value of MC analysis for Australian mortality data.

Lessons Learned from Data Mining of WHO Mortality Database

2011 ◽  
Vol 50 (04) ◽  
pp. 380-385 ◽  
Author(s):  
W. Paoin
Keyword(s):  
Data Mining ◽  
Cause Of Death ◽  
Association Analysis ◽  
Causes Of Death ◽  
World Health ◽  
Mortality Data ◽  
Common Causes ◽  
The World ◽  
C4.5 Decision Tree ◽  
Health Organization

SummaryObjectives: The objectives of this research were to test the ability of classification algorithms to predict the cause of death in the mortality data with unknown causes, to find association between common causes of death, to identify groups of countries based on their common causes of death, and to extract knowledge gained from data mining of the World Health Organization mortality database.Methods: The WEKA software version 3.5.3 was used for classification, clustering and association analysis of the World Health Organization mortality database which contained 1,109,537 records. Three major steps were performed: Step 1 – preprocessing of data to convert all records into suitable formats for each type of analysis algorithm; Step 2 – analyzing data using the C4.5 decision tree and Naïve Bayes classification algorithm, K-means clustering algorithm and Apriori association analysis algorithm; Step 3 – interpretation of results and hypothesis testing after clustering analysis.Results: Using a C4.5 decision tree classifier to predict cause of death, we obtained 440 leaf nodes that correctly classify death instances with an accuracy of 40.06%. Naïve Bayes classification algorithm calculated probability of death from each disease that correctly classify death instances with an accuracy of 28.13%. K means clustering divided the data into four clusters with 189, 59, 65, 144 country-years in each cluster. A Chi-square was used to test discriminate disease differences found in each cluster which had different diseases as predominant causes of death. Apriori association analysis produced association rules of linkage among cancer of the lung, hypertension and cerebrovascular diseases. These were found in the top five leading causes of death with 99–100% confidence level.Conclusion: Classification tools produced the poorest results in predicting cause of death. Given the inadequacy of variables in the WHO database, creation of a classification model to predict specific cause of death was impossible. Clustering and association tools yielded interesting results that could be used to identify new areas of interest in mortality data analysis. This can be used in data mining analysis to help solve some quality problems in mortality data.

scholarly journals Development and Implementation of Multiplex TaqMan Array Cards for Specimen Testing at Child Health and Mortality Prevention Surveillance Site Laboratories

2019 ◽  
Vol 69 (Supplement_4) ◽  
pp. S311-S321 ◽  
Author(s):  
Maureen H Diaz ◽  
Jessica L Waller ◽  
M Jordan Theodore ◽  
Nishi Patel ◽  
Bernard J Wolff ◽  
...  
Keyword(s):  
Child Health ◽  
Data Management ◽  
Real Time ◽  
Sub Saharan Africa ◽  
Quality Data ◽  
Molecular Testing ◽  
Acid Extraction ◽  
Infectious Disease Diagnostics ◽  
Taqman Array ◽  
Health And Mortality

Abstract Child Health and Mortality Prevention Surveillance (CHAMPS) laboratories are employing a variety of laboratory methods to identify infectious agents contributing to deaths of children <5 years old and stillbirths in sub-Saharan Africa and South Asia. In support of this long-term objective, our team developed TaqMan Array Cards (TACs) for testing postmortem specimens (blood, cerebrospinal fluid, lung tissue, respiratory tract swabs, and rectal swabs) for >100 real-time polymerase chain reaction (PCR) targets in total (30–45 per card depending on configuration). Multipathogen panels were configured by syndrome and customized to include pathogens of significance in young children within the regions where CHAMPS is conducted, including bacteria (57 targets covering 30 genera), viruses (48 targets covering 40 viruses), parasites (8 targets covering 8 organisms), and fungi (3 targets covering 3 organisms). The development and application of multiplex real-time PCR reactions to the TAC microfluidic platform increased the number of targets in each panel while maintaining assay efficiency and replicates for heightened sensitivity. These advances represent a substantial improvement in the utility of this technology for infectious disease diagnostics and surveillance. We optimized all aspects of the CHAMPS molecular laboratory testing workflow including nucleic acid extraction, quality assurance, and data management to ensure comprehensive molecular testing of specimens and high-quality data. Here we describe the development and implementation of multiplex TACs and associated laboratory protocols for specimen processing, testing, and data management at CHAMPS site laboratories.

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