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Title: Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study
Author: Castillo, Paola
Martínez Yoldi, Miguel Julián
Ussene, Esperança
Jordão, Dercio
Lovane, Lucilia
Ismail, Mamudo R.
Lorenzoni, Cesaltina
Fernandes, Fabiola
Bene, Rosa
Palhares, Antonio
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, Eusébio
Alonso, Pedro
Bassat Orellana, Quique
Menéndez, Clara
Ordi i Majà, Jaume
Keywords: Autòpsia
Malalties infeccioses
Communicable diseases
Issue Date: 22-Nov-2016
Publisher: Public Library of Science (PLoS)
Abstract: 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.
Note: Reproducció del document publicat a:
It is part of: PLoS Medicine, 2016, vol. 13, num. 11, p. e1002171
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ISSN: 1549-1277
Appears in Collections:Articles publicats en revistes (ISGlobal)
Articles publicats en revistes (Fonaments Clínics)

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