Evaluating the use of verbal autopsy methods for producing cause of death estimates in Uganda

在过去60年中，与其他区域相比，非洲从一种人口和流行病学制度向另一种制度发生了微小的循证转变。部分原因是撒哈拉以南非洲（包括乌干达）由于缺乏有效的民事登记系统，死因确定工作仍然很差。世界卫生组织建议在缺乏全面的生命登记系统的情况下使用死因推断（VA），它可以嵌入健康和人口监测系统（HDSS）。有一个正在进行的辩论的最佳方法分配死亡原因从VA采访。我的博士项目将评估用于从VA访谈中分配死亡原因的不同方法，然后估计乌干达的特定原因死亡率。它规定，国家的特定原因死亡率概况随着时间的推移而发生变化，并因年龄、性别和地区而异。为了实现这一点，我的项目将分为四个主要研究。在研究1中，我将根据医生对死因推断访谈数据的审查，估计乌干达Rakai的成人死因特异性死亡率。研究2将评估用于从死因推断访谈中确定潜在死因的不同方法的性能。在研究3中，我将估计和检查乌干达三个地点的死因特异性死亡率的年龄，性别和日历年，而研究4将估计原因特异性死亡率的马萨卡，根据VA访谈数据的叙述部分。我将使用在VA访谈中收集的数据在三个HDSS在该国。我将使用先进的定量分析方法来实现上述目标。预计这项研究的结果将有助于现有的文献和辩论的原因特异性死亡率清楚地显示如何流行病学的转变已经演变了多年。

Over the past 60 years, Africa has demonstrated a small evidence-based shift from one demographic and epidemiological regime to another as compared to other regions. This is partly because cause-of-death determination in Sub-Saharan Africa (including Uganda) remain very poor due to the lack of effective civil registration vital systems. World Health Organization recommends use of verbal autopsy (VA) in the absence of a comprehensive, vital registration systems and it can be embedded within Health and Demographic Surveillance Systems (HDSS). There is an ongoing debate on the best method for assigning cause of death from VA interviews. My PhD project will evaluate the different methods used to assign cause of death from VA interviews and then estimate cause-specific mortality in Uganda. It stipulates that the cause specific mortality profile of the country has changed over time, and it differs by age, gender, and region. To achieve this, my project will be divided into four major studies. In study 1, I will estimate the adult cause specific mortality rates in Rakai, Uganda based on Physician reviews of the verbal autopsy interview data. Study 2 will evaluate the performance of the different methods used in assigning underlying cause of death from verbal autopsy interviews. In study 3, I will estimate and examine the cause specific mortality rates of the three Ugandan sites by age, sex and calendar year, while study 4 will estimate cause specific mortality rates of Masaka, based on VA interview data in the narratives section.I will use data collected in VA interviews conducted in three HDSS within the country. I will use advanced quantitative analysis methods to achieve the above objectives. It is expected that the findings of this study will contribute to the existing literature and debate on cause specific mortality clearly showing how the epidemiological transition has evolved over the years.