A comparison of death recording by health centres and civil registration in South Africans receiving antiretroviral treatment
Identifieur interne : 001898 ( Main/Exploration ); précédent : 001897; suivant : 001899A comparison of death recording by health centres and civil registration in South Africans receiving antiretroviral treatment
Auteurs : Leigh F. Johnson [Afrique du Sud] ; Rob E. Dorrington [Afrique du Sud] ; Ria Laubscher [Afrique du Sud] ; Christopher J. Hoffmann [Afrique du Sud, États-Unis] ; Robin Wood [Afrique du Sud] ; Matthew P. Fox [États-Unis, Afrique du Sud] ; Morna Cornell [Afrique du Sud] ; Michael Schomaker [Afrique du Sud] ; Hans Prozesky [Afrique du Sud] ; Frank Tanser [Afrique du Sud] ; Mary-Ann Davies [Afrique du Sud] ; Andrew Boulle [Afrique du Sud]Source :
- Journal of the International AIDS Society [ 1758-2652 ] ; 2015.
Abstract
There is uncertainty regarding the completeness of death recording by civil registration and by health centres in South Africa. This paper aims to compare death recording by the two systems, in cohorts of South African patients receiving antiretroviral treatment (ART).
Completeness of death recording was estimated using a capture–recapture approach. Six ART programmes linked their patient record systems to the vital registration system using civil identity document (ID) numbers and provided data comparing the outcomes recorded in patient files and in the vital registration. Patients were excluded if they had missing/invalid IDs or had transferred to other ART programmes.
After exclusions, 91,548 patient records were included. Of deaths recorded in patients files after 2003, 94.0% (95% CI: 93.3–94.6%) were recorded by civil registration, with completeness being significantly higher in urban areas, older adults and females. Of deaths recorded by civil registration after 2003, only 35.0% (95% CI: 34.2–35.8%) were recorded in patient files, with this proportion dropping from 60% in 2004–2005 to 30% in 2010 and subsequent years. Recording of deaths in patient files was significantly higher in children and in locations within 50 km of the health centre. When the information from the two systems was combined, an estimated 96.2% of all deaths were recorded (93.5% in children and 96.2% in adults).
South Africa's civil registration system has achieved a high level of completeness in the recording of mortality. However, the fraction of deaths recorded by health centres is low and information from patient records is insufficient by itself to evaluate levels and predictors of ART patient mortality. Previously documented improvements in ART mortality over time may be biased if based only on data from patient records.
Url:
DOI: 10.7448/IAS.18.1.20628
PubMed: 26685125
PubMed Central: 4684576
Affiliations:
- Afrique du Sud, États-Unis
- Gauteng, Maryland, Massachusetts
- Johannesbourg
- Université du Witwatersrand
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Le document en format XML
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<author><name sortKey="Tanser, Frank" sort="Tanser, Frank" uniqKey="Tanser F" first="Frank" last="Tanser">Frank Tanser</name>
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<author><name sortKey="Davies, Mary Ann" sort="Davies, Mary Ann" uniqKey="Davies M" first="Mary-Ann" last="Davies">Mary-Ann Davies</name>
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<author><name sortKey="Boulle, Andrew" sort="Boulle, Andrew" uniqKey="Boulle A" first="Andrew" last="Boulle">Andrew Boulle</name>
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<front><div type="abstract" xml:lang="en"><sec id="st1"><title>Introduction</title>
<p>There is uncertainty regarding the completeness of death recording by civil registration and by health centres in South Africa. This paper aims to compare death recording by the two systems, in cohorts of South African patients receiving antiretroviral treatment (ART).</p>
</sec>
<sec id="st2"><title>Methods</title>
<p>Completeness of death recording was estimated using a capture–recapture approach. Six ART programmes linked their patient record systems to the vital registration system using civil identity document (ID) numbers and provided data comparing the outcomes recorded in patient files and in the vital registration. Patients were excluded if they had missing/invalid IDs or had transferred to other ART programmes.</p>
</sec>
<sec id="st3"><title>Results</title>
<p>After exclusions, 91,548 patient records were included. Of deaths recorded in patients files after 2003, 94.0% (95% CI: 93.3–94.6%) were recorded by civil registration, with completeness being significantly higher in urban areas, older adults and females. Of deaths recorded by civil registration after 2003, only 35.0% (95% CI: 34.2–35.8%) were recorded in patient files, with this proportion dropping from 60% in 2004–2005 to 30% in 2010 and subsequent years. Recording of deaths in patient files was significantly higher in children and in locations within 50 km of the health centre. When the information from the two systems was combined, an estimated 96.2% of all deaths were recorded (93.5% in children and 96.2% in adults).</p>
</sec>
<sec id="st4"><title>Conclusions</title>
<p>South Africa's civil registration system has achieved a high level of completeness in the recording of mortality. However, the fraction of deaths recorded by health centres is low and information from patient records is insufficient by itself to evaluate levels and predictors of ART patient mortality. Previously documented improvements in ART mortality over time may be biased if based only on data from patient records.</p>
</sec>
</div>
</front>
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