The Performance of Verbal Autopsy Tools for Capturing HIV/AIDS-Related Mortality in Sub-Saharan Africa

Shammi Luhar
Anushe Hassan, London School of Hygiene and Tropical Medicine (LSHTM)
Clara Calvert, London School of Hygiene and Tropical Medicine (LSHTM)
Mia Crampin, London School of Hygiene and Tropical Medicine (LSHTM)
Abraham Herbst, Africa Centre for Health and Population Studies
Mark Urassa, National Institute for Medical Research, Mwanza
Emma Slaymaker, London School of Hygiene and Tropical Medicine (LSHTM)
Samuel J. Clark, The Ohio State University
Georges Reniers, London School of Hygiene and Tropical Medicine (LSHTM)

Verbal Autopsies (VA) are a cost-effective method for attributing Causes of Death in settings where medical certification is not routinely done. Using data from three African Demographic Surveillance Sites where HIV status of most residents is known, we quantify the sensitivity and specificity of VAs for identifying HIV/AIDS-related mortality. Preliminary analyses highlight considerable variability in the sensitivity, and to a lesser extent, specificity of VAs, suggesting that their diagnostic accuracy depends on age, sex and HIV-prevalence. Deaths attributed to HIV/AIDS and TB are the most predictive of HIV/AIDS-related mortality, but a severe TB epidemic affecting HIV-negatives, as in South Africa, can compromise its specificity. VAs also perform worse in older adults, having implications for their future use as the burden of AIDS-related mortality starts to shift into older ages. By the time of the conference, we will extend our analysis with results other study sites, and other VA interpretation.

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 Presented in Session 11. Health & Mortality 2