InterVA-4 as a public health tool for measuring HIV/AIDS mortality: a validation study from five African countries.
Identifieur interne : 000276 ( PubMed/Corpus ); précédent : 000275; suivant : 000277InterVA-4 as a public health tool for measuring HIV/AIDS mortality: a validation study from five African countries.
Auteurs : Peter Byass ; Clara Calvert ; Jessica Miiro-Nakiyingi ; Tom Lutalo ; Denna Michael ; Amelia Crampin ; Simon Gregson ; Albert Takaruza ; Laura Robertson ; Kobus Herbst ; Jim Todd ; Basia ZabaSource :
- Global health action [ 1654-9880 ] ; 2013.
Abstract
Background Reliable population-based data on HIV infection and AIDS mortality in sub-Saharan Africa are scanty, even though that is the region where most of the world's AIDS deaths occur. There is therefore a great need for reliable and valid public health tools for assessing AIDS mortality. Objective The aim of this article is to validate the InterVA-4 verbal autopsy (VA) interpretative model within African populations where HIV sero-status is recorded on a prospective basis, and examine the distribution of cause-specific mortality among HIV-positive and HIV-negative people. Design Data from six sites of the Alpha Network, including HIV sero-status and VA interviews, were pooled. VA data according to the 2012 WHO format were extracted, and processed using the InterVA-4 model into likely causes of death. The model was blinded to the sero-status data. Cases with known pre-mortem HIV infection status were used to determine the specificity with which InterVA-4 could attribute HIV/AIDS as a cause of death. Cause-specific mortality fractions by HIV infection status were calculated, and a person-time model was built to analyse adjusted cause-specific mortality rate ratios. Results The InterVA-4 model identified HIV/AIDS-related deaths with a specificity of 90.1% (95% CI 88.7-91.4%). Overall sensitivity could not be calculated, because HIV-positive people die from a range of causes. In a person-time model including 1,739 deaths in 1,161,688 HIV-negative person-years observed and 2,890 deaths in 75,110 HIV-positive person-years observed, the mortality ratio HIV-positive:negative was 29.0 (95% CI 27.1-31.0), after adjustment for age, sex, and study site. Cause-specific HIV-positive:negative mortality ratios for acute respiratory infections, HIV/AIDS-related deaths, meningitis, tuberculosis, and malnutrition were higher than the all-cause ratio; all causes had HIV-positive:negative mortality ratios significantly higher than unity. Conclusions These results were generally consistent with relatively small post-mortem and hospital-based diagnosis studies in the literature. The high specificity in cause of death attribution achieved in relation to HIV status, and large differences between specific causes by HIV status, show that InterVA-4 is an effective and valid tool for assessing HIV-related mortality.
DOI: 10.3402/gha.v6i0.22448
PubMed: 28140986
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">InterVA-4 as a public health tool for measuring HIV/AIDS mortality: a validation study from five African countries.</title><author><name sortKey="Byass, Peter" sort="Byass, Peter" uniqKey="Byass P" first="Peter" last="Byass">Peter Byass</name><affiliation><nlm:affiliation>a WHO Collaborating Centre for Verbal Autopsy, Umeå Centre for Global Health Research, Umeå University , Umeå , Sweden.</nlm:affiliation></affiliation></author><author><name sortKey="Calvert, Clara" sort="Calvert, Clara" uniqKey="Calvert C" first="Clara" last="Calvert">Clara Calvert</name><affiliation><nlm:affiliation>d London School of Hygiene and Tropical Medicine , London , UK.</nlm:affiliation></affiliation></author><author><name sortKey="Miiro Nakiyingi, Jessica" sort="Miiro Nakiyingi, Jessica" uniqKey="Miiro Nakiyingi J" first="Jessica" last="Miiro-Nakiyingi">Jessica Miiro-Nakiyingi</name><affiliation><nlm:affiliation>e MRC/UVRI Uganda Research Unit on AIDS , Entebbe , Uganda.</nlm:affiliation></affiliation></author><author><name sortKey="Lutalo, Tom" sort="Lutalo, Tom" uniqKey="Lutalo T" first="Tom" last="Lutalo">Tom Lutalo</name><affiliation><nlm:affiliation>f Rakai Health Sciences Program , Rakai , Uganda.</nlm:affiliation></affiliation></author><author><name sortKey="Michael, Denna" sort="Michael, Denna" uniqKey="Michael D" first="Denna" last="Michael">Denna Michael</name><affiliation><nlm:affiliation>g National Institute for Medical Research , Dar es Salaam , Tanzania.</nlm:affiliation></affiliation></author><author><name sortKey="Crampin, Amelia" sort="Crampin, Amelia" uniqKey="Crampin A" first="Amelia" last="Crampin">Amelia Crampin</name><affiliation><nlm:affiliation>d London School of Hygiene and Tropical Medicine , London , UK.</nlm:affiliation></affiliation></author><author><name sortKey="Gregson, Simon" sort="Gregson, Simon" uniqKey="Gregson S" first="Simon" last="Gregson">Simon Gregson</name><affiliation><nlm:affiliation>i Manicaland HIV-STD Prevention Project , Zimbabwe.</nlm:affiliation></affiliation></author><author><name sortKey="Takaruza, Albert" sort="Takaruza, Albert" uniqKey="Takaruza A" first="Albert" last="Takaruza">Albert Takaruza</name><affiliation><nlm:affiliation>i Manicaland HIV-STD Prevention Project , Zimbabwe.</nlm:affiliation></affiliation></author><author><name sortKey="Robertson, Laura" sort="Robertson, Laura" uniqKey="Robertson L" first="Laura" last="Robertson">Laura Robertson</name><affiliation><nlm:affiliation>i Manicaland HIV-STD Prevention Project , Zimbabwe.</nlm:affiliation></affiliation></author><author><name sortKey="Herbst, Kobus" sort="Herbst, Kobus" uniqKey="Herbst K" first="Kobus" last="Herbst">Kobus Herbst</name><affiliation><nlm:affiliation>k Africa Centre for Health and Population Studies, University of KwaZulu-Natal , KwaZulu-Natal , South Africa.</nlm:affiliation></affiliation></author><author><name sortKey="Todd, Jim" sort="Todd, Jim" uniqKey="Todd J" first="Jim" last="Todd">Jim Todd</name><affiliation><nlm:affiliation>d London School of Hygiene and Tropical Medicine , London , UK.</nlm:affiliation></affiliation></author><author><name sortKey="Zaba, Basia" sort="Zaba, Basia" uniqKey="Zaba B" first="Basia" last="Zaba">Basia Zaba</name><affiliation><nlm:affiliation>d London School of Hygiene and Tropical Medicine , London , UK.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2013">2013</date><idno type="RBID">pubmed:28140986</idno><idno type="pmid">28140986</idno><idno type="doi">10.3402/gha.v6i0.22448</idno><idno type="wicri:Area/PubMed/Corpus">000276</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000276</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">InterVA-4 as a public health tool for measuring HIV/AIDS mortality: a validation study from five African countries.</title><author><name sortKey="Byass, Peter" sort="Byass, Peter" uniqKey="Byass P" first="Peter" last="Byass">Peter Byass</name><affiliation><nlm:affiliation>a WHO Collaborating Centre for Verbal Autopsy, Umeå Centre for Global Health Research, Umeå University , Umeå , Sweden.</nlm:affiliation></affiliation></author><author><name sortKey="Calvert, Clara" sort="Calvert, Clara" uniqKey="Calvert C" first="Clara" last="Calvert">Clara Calvert</name><affiliation><nlm:affiliation>d London School of Hygiene and Tropical Medicine , London , UK.</nlm:affiliation></affiliation></author><author><name sortKey="Miiro Nakiyingi, Jessica" sort="Miiro Nakiyingi, Jessica" uniqKey="Miiro Nakiyingi J" first="Jessica" last="Miiro-Nakiyingi">Jessica Miiro-Nakiyingi</name><affiliation><nlm:affiliation>e MRC/UVRI Uganda Research Unit on AIDS , Entebbe , Uganda.</nlm:affiliation></affiliation></author><author><name sortKey="Lutalo, Tom" sort="Lutalo, Tom" uniqKey="Lutalo T" first="Tom" last="Lutalo">Tom Lutalo</name><affiliation><nlm:affiliation>f Rakai Health Sciences Program , Rakai , Uganda.</nlm:affiliation></affiliation></author><author><name sortKey="Michael, Denna" sort="Michael, Denna" uniqKey="Michael D" first="Denna" last="Michael">Denna Michael</name><affiliation><nlm:affiliation>g National Institute for Medical Research , Dar es Salaam , Tanzania.</nlm:affiliation></affiliation></author><author><name sortKey="Crampin, Amelia" sort="Crampin, Amelia" uniqKey="Crampin A" first="Amelia" last="Crampin">Amelia Crampin</name><affiliation><nlm:affiliation>d London School of Hygiene and Tropical Medicine , London , UK.</nlm:affiliation></affiliation></author><author><name sortKey="Gregson, Simon" sort="Gregson, Simon" uniqKey="Gregson S" first="Simon" last="Gregson">Simon Gregson</name><affiliation><nlm:affiliation>i Manicaland HIV-STD Prevention Project , Zimbabwe.</nlm:affiliation></affiliation></author><author><name sortKey="Takaruza, Albert" sort="Takaruza, Albert" uniqKey="Takaruza A" first="Albert" last="Takaruza">Albert Takaruza</name><affiliation><nlm:affiliation>i Manicaland HIV-STD Prevention Project , Zimbabwe.</nlm:affiliation></affiliation></author><author><name sortKey="Robertson, Laura" sort="Robertson, Laura" uniqKey="Robertson L" first="Laura" last="Robertson">Laura Robertson</name><affiliation><nlm:affiliation>i Manicaland HIV-STD Prevention Project , Zimbabwe.</nlm:affiliation></affiliation></author><author><name sortKey="Herbst, Kobus" sort="Herbst, Kobus" uniqKey="Herbst K" first="Kobus" last="Herbst">Kobus Herbst</name><affiliation><nlm:affiliation>k Africa Centre for Health and Population Studies, University of KwaZulu-Natal , KwaZulu-Natal , South Africa.</nlm:affiliation></affiliation></author><author><name sortKey="Todd, Jim" sort="Todd, Jim" uniqKey="Todd J" first="Jim" last="Todd">Jim Todd</name><affiliation><nlm:affiliation>d London School of Hygiene and Tropical Medicine , London , UK.</nlm:affiliation></affiliation></author><author><name sortKey="Zaba, Basia" sort="Zaba, Basia" uniqKey="Zaba B" first="Basia" last="Zaba">Basia Zaba</name><affiliation><nlm:affiliation>d London School of Hygiene and Tropical Medicine , London , UK.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Global health action</title><idno type="eISSN">1654-9880</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background Reliable population-based data on HIV infection and AIDS mortality in sub-Saharan Africa are scanty, even though that is the region where most of the world's AIDS deaths occur. There is therefore a great need for reliable and valid public health tools for assessing AIDS mortality. Objective The aim of this article is to validate the InterVA-4 verbal autopsy (VA) interpretative model within African populations where HIV sero-status is recorded on a prospective basis, and examine the distribution of cause-specific mortality among HIV-positive and HIV-negative people. Design Data from six sites of the Alpha Network, including HIV sero-status and VA interviews, were pooled. VA data according to the 2012 WHO format were extracted, and processed using the InterVA-4 model into likely causes of death. The model was blinded to the sero-status data. Cases with known pre-mortem HIV infection status were used to determine the specificity with which InterVA-4 could attribute HIV/AIDS as a cause of death. Cause-specific mortality fractions by HIV infection status were calculated, and a person-time model was built to analyse adjusted cause-specific mortality rate ratios. Results The InterVA-4 model identified HIV/AIDS-related deaths with a specificity of 90.1% (95% CI 88.7-91.4%). Overall sensitivity could not be calculated, because HIV-positive people die from a range of causes. In a person-time model including 1,739 deaths in 1,161,688 HIV-negative person-years observed and 2,890 deaths in 75,110 HIV-positive person-years observed, the mortality ratio HIV-positive:negative was 29.0 (95% CI 27.1-31.0), after adjustment for age, sex, and study site. Cause-specific HIV-positive:negative mortality ratios for acute respiratory infections, HIV/AIDS-related deaths, meningitis, tuberculosis, and malnutrition were higher than the all-cause ratio; all causes had HIV-positive:negative mortality ratios significantly higher than unity. Conclusions These results were generally consistent with relatively small post-mortem and hospital-based diagnosis studies in the literature. The high specificity in cause of death attribution achieved in relation to HIV status, and large differences between specific causes by HIV status, show that InterVA-4 is an effective and valid tool for assessing HIV-related mortality.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">28140986</PMID><DateCreated><Year>2017</Year><Month>01</Month><Day>31</Day></DateCreated><DateRevised><Year>2017</Year><Month>08</Month><Day>17</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1654-9880</ISSN><JournalIssue CitedMedium="Internet"><Volume>6</Volume><Issue>1</Issue><PubDate><Year>2013</Year><Month>Jan</Month></PubDate></JournalIssue><Title>Global health action</Title><ISOAbbreviation>Glob Health Action</ISOAbbreviation></Journal><ArticleTitle>InterVA-4 as a public health tool for measuring HIV/AIDS mortality: a validation study from five African countries.</ArticleTitle><Pagination><MedlinePgn>22448</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3402/gha.v6i0.22448</ELocationID><Abstract><AbstractText>Background Reliable population-based data on HIV infection and AIDS mortality in sub-Saharan Africa are scanty, even though that is the region where most of the world's AIDS deaths occur. There is therefore a great need for reliable and valid public health tools for assessing AIDS mortality. Objective The aim of this article is to validate the InterVA-4 verbal autopsy (VA) interpretative model within African populations where HIV sero-status is recorded on a prospective basis, and examine the distribution of cause-specific mortality among HIV-positive and HIV-negative people. Design Data from six sites of the Alpha Network, including HIV sero-status and VA interviews, were pooled. VA data according to the 2012 WHO format were extracted, and processed using the InterVA-4 model into likely causes of death. The model was blinded to the sero-status data. Cases with known pre-mortem HIV infection status were used to determine the specificity with which InterVA-4 could attribute HIV/AIDS as a cause of death. Cause-specific mortality fractions by HIV infection status were calculated, and a person-time model was built to analyse adjusted cause-specific mortality rate ratios. Results The InterVA-4 model identified HIV/AIDS-related deaths with a specificity of 90.1% (95% CI 88.7-91.4%). Overall sensitivity could not be calculated, because HIV-positive people die from a range of causes. In a person-time model including 1,739 deaths in 1,161,688 HIV-negative person-years observed and 2,890 deaths in 75,110 HIV-positive person-years observed, the mortality ratio HIV-positive:negative was 29.0 (95% CI 27.1-31.0), after adjustment for age, sex, and study site. Cause-specific HIV-positive:negative mortality ratios for acute respiratory infections, HIV/AIDS-related deaths, meningitis, tuberculosis, and malnutrition were higher than the all-cause ratio; all causes had HIV-positive:negative mortality ratios significantly higher than unity. Conclusions These results were generally consistent with relatively small post-mortem and hospital-based diagnosis studies in the literature. The high specificity in cause of death attribution achieved in relation to HIV status, and large differences between specific causes by HIV status, show that InterVA-4 is an effective and valid tool for assessing HIV-related mortality.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Byass</LastName><ForeName>Peter</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>a WHO Collaborating Centre for Verbal Autopsy, Umeå Centre for Global Health Research, Umeå University , Umeå , Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>b School of Public Health , University of the Witwatersrand , Johannesburg , South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>c INDEPTH Network , Accra , Ghana.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Calvert</LastName><ForeName>Clara</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>d London School of Hygiene and Tropical Medicine , London , UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Miiro-Nakiyingi</LastName><ForeName>Jessica</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>e MRC/UVRI Uganda Research Unit on AIDS , Entebbe , Uganda.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lutalo</LastName><ForeName>Tom</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>f Rakai Health Sciences Program , Rakai , Uganda.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Michael</LastName><ForeName>Denna</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>g National Institute for Medical Research , Dar es Salaam , Tanzania.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Crampin</LastName><ForeName>Amelia</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>d London School of Hygiene and Tropical Medicine , London , UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>h Karonga Prevention Study , Karonga , Malawi.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gregson</LastName><ForeName>Simon</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>i Manicaland HIV-STD Prevention Project , Zimbabwe.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>j Imperial College School of Public Health , London , UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Takaruza</LastName><ForeName>Albert</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>i Manicaland HIV-STD Prevention Project , Zimbabwe.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Robertson</LastName><ForeName>Laura</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>i Manicaland HIV-STD Prevention Project , Zimbabwe.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>j Imperial College School of Public Health , London , UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Herbst</LastName><ForeName>Kobus</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>k Africa Centre for Health and Population Studies, University of KwaZulu-Natal , KwaZulu-Natal , South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Todd</LastName><ForeName>Jim</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>d London School of Hygiene and Tropical Medicine , London , UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zaba</LastName><ForeName>Basia</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>d London School of Hygiene and Tropical Medicine , London , UK.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Glob Health Action</MedlineTA><NlmUniqueID>101496665</NlmUniqueID><ISSNLinking>1654-9880</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Africa</Keyword><Keyword MajorTopicYN="N">Alpha Network</Keyword><Keyword MajorTopicYN="N">HIV/AIDS</Keyword><Keyword MajorTopicYN="N">InterVA</Keyword><Keyword MajorTopicYN="N">mortality</Keyword><Keyword MajorTopicYN="N">verbal autopsy</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>2</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2013</Year><Month>1</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2013</Year><Month>1</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28140986</ArticleId><ArticleId 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