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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
4139.0: Tuesday, December 13, 2005 - 1:15 PM

Abstract #112756

Validity and use of verbal autopsy-derived information for assessing and responding to malaria mortality in children and adults: Experiences from Tanzania

Philip W. Setel, PhD, MEASURE Evaluation--Carolina Population Center, University of North Carolina at Chapel Hill, 123 W. Franklin Street, Suite 310, Chapel Hill, NC 27516, 919-966-7541, psetel@unc.edu, David Whiting, BSc, School of Clinical Medical Sciences (Diabetes), University of Newcastle upon Tyne, Framlington Place, Newcastle upon Tyne, NE24HH, England, Yusuf Hemed, Tanzanian Ministry of Health, P.O. Box 65243, Dar es Salaam, Tanzania, Daniel Chandramohan, MD, PhD, Department of Infectious and Tropical Disease, London School of Hygeine and Tropical Medicine, LSHTM Keppel St, London, England, Lara J. Wolfson, PhD, Vaccine Assessment and Monitoring, World Health Organization, CH-1211 Geneva 27, Geneva 27, Switzerland, KGMM Alberti, MD, PhD, Department of Endocrinology and Metabolism, Imperial College, St. Mary's Campus, Praed St., London, W2 1NY, England, and Alan Lopez, PhD, Head of School of Population, University of Queensland, Herston Rd., Herston, QLD 4006, Australia.

Verbal autopsy (VA) procedures are an increasingly important method for obtaining mortality information for populations with the greatest disease burdens, and are often the only source of community-based information on mortality attributed to malaria. In this paper we review the rationale for VA and sample vital registration; describes proposed core procedures for VA; presents results of a validation study for malaria-specific mortality in children and adults; and provide examples from Tanzania on the use of malaria data in policy and practice. Data presented come from the largest demographic surveillance system in Africa and the one of largest validation studies conducted to date. Measures of validity to be presented include: cause-specific mortality fractions (CSMF) and coefficients of variation; sensitivity; specificity; and positive predictive value. Criteria for evaluating the accuracy of VA in generating true proportional mortality were also discussed. Examples of data use to be discussed include production of evidence-based district health priorities and budgets; setting national first-line antimalarial drug policy; estimates of Roll Back Malaria indicators; and evaluation of the impact of the Integrated Management of Childhood Illnesses (IMCI), which includes management of malaria as a major component.

Learning Objectives:

Related Web page: www.ncl.ac.un/ammp/

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

[ Recorded presentation ] Recorded presentation

Monitoring and Evaluation of Malaria Programs: Perspectives from the Global, Regional and Local Levels

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA