Accuracy of Physicians in Diagnosing HIV and AIDS-Related Death in the Adult Population of Addis Ababa, Ethiopia — Oak Academic Publishing
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Accuracy of Physicians in Diagnosing HIV and AIDS-Related Death in the Adult Population of Addis Ababa, Ethiopia
School of Public Health, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; Addis Ababa Mortality Surveillance Program (AAMSP), Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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Addis Ababa Mortality Surveillance Program (AAMSP), Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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School of Public Health, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; Brighton & Sussex Medical School, Falmer Campus, University of Sussex, Brighton, UK
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School of Public Health, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
1 School of Public Health, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; Addis Ababa Mortality Surveillance Program (AAMSP), Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
2 Addis Ababa Mortality Surveillance Program (AAMSP), Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
3 School of Public Health, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; Brighton & Sussex Medical School, Falmer Campus, University of Sussex, Brighton, UK
4 School of Public Health, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
Background: The lack of cause of death information is the main challenge in monitoring the effectiveness of interventions aimed at reducing HIV and AIDS-related deaths in countries where the majority of deaths occur at home. Objective: To evaluate the accuracy of physician reviewers of verbal autopsies in diagnosing HIV and AIDS-related deaths in the adult population of Addis Ababa, the capital of Ethiopia. Methods: This study was done within the context of a burial surveillance system in Addis Ababa. Trained interviewers completed a standard verbal autopsy questionnaire and an independent panel of physicians reviewed the completed form to assign cause of death. Physicians' review was compared to a reference standard constructed based on prospectively collected HIV-serostatus and patients' hospital record. Sensitivity and specificity were calculated to validate the physicians' verbal autopsy diagnoses against reference standards. Results: Physicians accurately identified AIDS-related deaths with sensitivity and specificity of 0.88 (95% CI: 0.80 - 0.93) and 0.77 (95% CI: 0.64 - 0.87), respectively. Generally, there was high level of agreement (Cohen's Kappa Statistic (K > 0.6) between the first two physicians with some yearly variations. In 2008 and 2009 there was an almost perfect agreement (K > 0.80). Conclusion: This study demonstrated the agreement level between two independent physicians in diagnosing AIDS-related death is very high and thus using a single verbal autopsy coder is practical for programmatic purposes in countries where there is critical shortage of doctors.
KeywordsPhysician AccuracyHIV-SerostatusVerbal AutopsyDiagnosisHIV and AIDS-Related DeathBurial SurveillanceCemeteryAddis AbabaEthiopia
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