Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study

Background There is an urgent need to identify tools able to provide reliable information on the cause of death in low-income regions, since current methods (verbal autopsy, clinical records, and complete autopsies) are either inaccurate, not feasible, or poorly accepted. We aimed to compare the per...

Full description

Bibliographic Details
Authors: Castillo, Paola, Martínez Yoldi, Miguel Julián, Ussene, Esperança, Jordão, Dercio, Lovane, Lucilia, Ismail, Mamudo Rafik, Lorenzoni, Cesaltina, Fernandes, Fabiola, Bene, Rosa, Palhares, Antonio E. M., Ferreira, Luiz C. L., Lacerda, Marcus Vinícius Guimarães, Mandomando, Inácio, Vila Estapé, Jordi, Hurtado, Juan Carlos, Munguambe, Khátia, Maixenchs, Maria, Sanz, Ariadna, Quintó, Llorenç, Macete, Eusebio Víctor, Alonso, Pedro, Bassat Orellana, Quique, Menéndez, Clara, Ordi i Majà, Jaume
Format: article
Status:Published version
Publication Date:2016
Country:España
Institution:Universidad de Barcelona
Repository:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/104549
Online Access:https://hdl.handle.net/2445/104549
Access Level:Open access
Keyword:Autòpsia
Diagnòstic
Malalties infeccioses
Moçambic
Autopsy
Diagnosis
Communicable diseases
Mozambique
id ES_332c20e3be1cca6d3cd65e405f0a4cdf
oai_identifier_str oai:diposit.ub.edu:2445/104549
network_acronym_str ES
network_name_str España
repository_id_str
spelling Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational StudyCastillo, PaolaMartínez Yoldi, Miguel JuliánUssene, EsperançaJordão, DercioLovane, LuciliaIsmail, Mamudo RafikLorenzoni, CesaltinaFernandes, FabiolaBene, RosaPalhares, Antonio E. M.Ferreira, Luiz C. L.Lacerda, Marcus Vinícius GuimarãesMandomando, InácioVila Estapé, JordiHurtado, Juan CarlosMunguambe, KhátiaMaixenchs, MariaSanz, AriadnaQuintó, LlorençMacete, Eusebio VíctorAlonso, PedroBassat Orellana, QuiqueMenéndez, ClaraOrdi i Majà, JaumeAutòpsiaDiagnòsticMalalties infecciosesMoçambicAutopsyDiagnosisCommunicable diseasesMozambiqueBackground There is an urgent need to identify tools able to provide reliable information on the cause of death in low-income regions, since current methods (verbal autopsy, clinical records, and complete autopsies) are either inaccurate, not feasible, or poorly accepted. We aimed to compare the performance of a standardized minimally invasive autopsy (MIA) approach with that of the gold standard, the complete diagnostic autopsy (CDA), in a series of adults who died at Maputo Central Hospital in Mozambique. Methods and Findings In this observational study, coupled MIAs and CDAs were performed in 112 deceased patients. The MIA analyses were done blindly, without knowledge of the clinical data or the results of the CDA. We compared the MIA diagnosis with the CDA diagnosis of cause of death. CDA diagnoses comprised infectious diseases (80; 71.4%), malignant tumors (16; 14.3%), and other diseases, including non-infectious cardiovascular, gastrointestinal, kidney, and lung diseases (16; 14.3%). A MIA diagnosis was obtained in 100/112 (89.2%) cases. The overall concordance between the MIA diagnosis and CDA diagnosis was 75.9% (85/112). The concordance was higher for infectious diseases and malignant tumors (63/80 [78.8%] and 13/16 [81.3%], respectively) than for other diseases (9/16; 56.2%). The specific microorganisms causing death were identified in the MIA in 62/74 (83.8%) of the infectious disease deaths with a recognized cause. The main limitation of the analysis is that both the MIA and the CDA include some degree of expert subjective interpretation. Conclusions A simple MIA procedure can identify the cause of death in many adult deaths in Mozambique. This tool could have a major role in improving the understanding and surveillance of causes of death in areas where infectious diseases are a common cause of mortality.Public Library of Science (PLoS)2016info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/104549Articles publicats en revistes (ISGlobal)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: http://dx.doi.org/10.1371/journal.pmed.1002171PLoS Medicine, 2016, vol. 13, num. 11, p. e1002171http://dx.doi.org/10.1371/journal.pmed.1002171cc by (c) Castillo et al., 2016http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1045492026-05-27T06:46:51Z
dc.title.none.fl_str_mv Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study
title Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study
spellingShingle Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study
Castillo, Paola
Autòpsia
Diagnòstic
Malalties infeccioses
Moçambic
Autopsy
Diagnosis
Communicable diseases
Mozambique
title_short Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study
title_full Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study
title_fullStr Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study
title_full_unstemmed Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study
title_sort Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study
dc.creator.none.fl_str_mv Castillo, Paola
Martínez Yoldi, Miguel Julián
Ussene, Esperança
Jordão, Dercio
Lovane, Lucilia
Ismail, Mamudo Rafik
Lorenzoni, Cesaltina
Fernandes, Fabiola
Bene, Rosa
Palhares, Antonio E. M.
Ferreira, Luiz C. L.
Lacerda, Marcus Vinícius Guimarães
Mandomando, Inácio
Vila Estapé, Jordi
Hurtado, Juan Carlos
Munguambe, Khátia
Maixenchs, Maria
Sanz, Ariadna
Quintó, Llorenç
Macete, Eusebio Víctor
Alonso, Pedro
Bassat Orellana, Quique
Menéndez, Clara
Ordi i Majà, Jaume
author Castillo, Paola
author_facet Castillo, Paola
Martínez Yoldi, Miguel Julián
Ussene, Esperança
Jordão, Dercio
Lovane, Lucilia
Ismail, Mamudo Rafik
Lorenzoni, Cesaltina
Fernandes, Fabiola
Bene, Rosa
Palhares, Antonio E. M.
Ferreira, Luiz C. L.
Lacerda, Marcus Vinícius Guimarães
Mandomando, Inácio
Vila Estapé, Jordi
Hurtado, Juan Carlos
Munguambe, Khátia
Maixenchs, Maria
Sanz, Ariadna
Quintó, Llorenç
Macete, Eusebio Víctor
Alonso, Pedro
Bassat Orellana, Quique
Menéndez, Clara
Ordi i Majà, Jaume
author_role author
author2 Martínez Yoldi, Miguel Julián
Ussene, Esperança
Jordão, Dercio
Lovane, Lucilia
Ismail, Mamudo Rafik
Lorenzoni, Cesaltina
Fernandes, Fabiola
Bene, Rosa
Palhares, Antonio E. M.
Ferreira, Luiz C. L.
Lacerda, Marcus Vinícius Guimarães
Mandomando, Inácio
Vila Estapé, Jordi
Hurtado, Juan Carlos
Munguambe, Khátia
Maixenchs, Maria
Sanz, Ariadna
Quintó, Llorenç
Macete, Eusebio Víctor
Alonso, Pedro
Bassat Orellana, Quique
Menéndez, Clara
Ordi i Majà, Jaume
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Autòpsia
Diagnòstic
Malalties infeccioses
Moçambic
Autopsy
Diagnosis
Communicable diseases
Mozambique
topic Autòpsia
Diagnòstic
Malalties infeccioses
Moçambic
Autopsy
Diagnosis
Communicable diseases
Mozambique
description Background There is an urgent need to identify tools able to provide reliable information on the cause of death in low-income regions, since current methods (verbal autopsy, clinical records, and complete autopsies) are either inaccurate, not feasible, or poorly accepted. We aimed to compare the performance of a standardized minimally invasive autopsy (MIA) approach with that of the gold standard, the complete diagnostic autopsy (CDA), in a series of adults who died at Maputo Central Hospital in Mozambique. Methods and Findings In this observational study, coupled MIAs and CDAs were performed in 112 deceased patients. The MIA analyses were done blindly, without knowledge of the clinical data or the results of the CDA. We compared the MIA diagnosis with the CDA diagnosis of cause of death. CDA diagnoses comprised infectious diseases (80; 71.4%), malignant tumors (16; 14.3%), and other diseases, including non-infectious cardiovascular, gastrointestinal, kidney, and lung diseases (16; 14.3%). A MIA diagnosis was obtained in 100/112 (89.2%) cases. The overall concordance between the MIA diagnosis and CDA diagnosis was 75.9% (85/112). The concordance was higher for infectious diseases and malignant tumors (63/80 [78.8%] and 13/16 [81.3%], respectively) than for other diseases (9/16; 56.2%). The specific microorganisms causing death were identified in the MIA in 62/74 (83.8%) of the infectious disease deaths with a recognized cause. The main limitation of the analysis is that both the MIA and the CDA include some degree of expert subjective interpretation. Conclusions A simple MIA procedure can identify the cause of death in many adult deaths in Mozambique. This tool could have a major role in improving the understanding and surveillance of causes of death in areas where infectious diseases are a common cause of mortality.
publishDate 2016
dc.date.none.fl_str_mv 2016
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/104549
url https://hdl.handle.net/2445/104549
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pmed.1002171
PLoS Medicine, 2016, vol. 13, num. 11, p. e1002171
http://dx.doi.org/10.1371/journal.pmed.1002171
dc.rights.none.fl_str_mv cc by (c) Castillo et al., 2016
http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Castillo et al., 2016
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (ISGlobal)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869405729737146368
score 15,198674

Similar Items