Misclassification of pregnancy-related deaths in adult mortality surveys: Case study in Senegal

Stephane Helleringer, Géraldine Duthé, Almamy Malick Kante, Armelle Andro, Cheikh Sokhna, Jean François Trape, Gilles Pison

Research output: Contribution to journalArticle

Abstract

Objective: In countries with limited vital registration data, maternal mortality levels are often estimated using siblings' survival histories (SSH) collected during retrospective adult mortality surveys. We explored how accurately adult deaths can be classified as pregnancy related using such data. Method: The study was conducted in a rural area of south-eastern Senegal with high maternal mortality, Bandafassi. We used data from a demographic surveillance system (DSS) in this area to identify deaths of women at reproductive ages between 2003 and 2009 and to locate the surviving adult sisters of the deceased and interview them. Siblings' survival histories were linked at the individual level to death records, and verbal autopsy data obtained by the demographic surveillance system. We compared the classification of adult female deaths as pregnancy related or not in interviews and DSS records. Results: There were 91 deaths at reproductive ages in the Bandafassi DSS between 2003 and 2009, but only 59 had known surviving sisters. Some deaths were omitted by respondents, or reported as alive or as having occurred during childhood (n = 8). Among deaths reported both in the SSH and DSS data, 94% of deaths classified as pregnancy related in the DSS data were also classified as such by siblings' survival histories. Only 70% of deaths classified as not pregnancy related in the DSS data were also classified as such by siblings' survival histories. Conclusion: Misclassifications of pregnancy-related deaths in retrospective adult mortality surveys may affect estimates of pregnancy-related mortality rates.

Original languageEnglish (US)
Pages (from-to)27-34
Number of pages8
JournalTropical Medicine and International Health
Volume18
Issue number1
DOIs
StatePublished - Jan 2013
Externally publishedYes

Fingerprint

Senegal
Siblings
Pregnancy
Mortality
Demography
Survival
Information Systems
Maternal Mortality
Interviews
Surveys and Questionnaires
Death Certificates
Autopsy

Keywords

  • Adult mortality
  • Demographic surveillance
  • Maternal mortality
  • Sibling method
  • Surveys

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases
  • Parasitology

Cite this

Misclassification of pregnancy-related deaths in adult mortality surveys : Case study in Senegal. / Helleringer, Stephane; Duthé, Géraldine; Kante, Almamy Malick; Andro, Armelle; Sokhna, Cheikh; Trape, Jean François; Pison, Gilles.

In: Tropical Medicine and International Health, Vol. 18, No. 1, 01.2013, p. 27-34.

Research output: Contribution to journalArticle

Helleringer, Stephane ; Duthé, Géraldine ; Kante, Almamy Malick ; Andro, Armelle ; Sokhna, Cheikh ; Trape, Jean François ; Pison, Gilles. / Misclassification of pregnancy-related deaths in adult mortality surveys : Case study in Senegal. In: Tropical Medicine and International Health. 2013 ; Vol. 18, No. 1. pp. 27-34.
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abstract = "Objective: In countries with limited vital registration data, maternal mortality levels are often estimated using siblings' survival histories (SSH) collected during retrospective adult mortality surveys. We explored how accurately adult deaths can be classified as pregnancy related using such data. Method: The study was conducted in a rural area of south-eastern Senegal with high maternal mortality, Bandafassi. We used data from a demographic surveillance system (DSS) in this area to identify deaths of women at reproductive ages between 2003 and 2009 and to locate the surviving adult sisters of the deceased and interview them. Siblings' survival histories were linked at the individual level to death records, and verbal autopsy data obtained by the demographic surveillance system. We compared the classification of adult female deaths as pregnancy related or not in interviews and DSS records. Results: There were 91 deaths at reproductive ages in the Bandafassi DSS between 2003 and 2009, but only 59 had known surviving sisters. Some deaths were omitted by respondents, or reported as alive or as having occurred during childhood (n = 8). Among deaths reported both in the SSH and DSS data, 94{\%} of deaths classified as pregnancy related in the DSS data were also classified as such by siblings' survival histories. Only 70{\%} of deaths classified as not pregnancy related in the DSS data were also classified as such by siblings' survival histories. Conclusion: Misclassifications of pregnancy-related deaths in retrospective adult mortality surveys may affect estimates of pregnancy-related mortality rates.",
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AB - Objective: In countries with limited vital registration data, maternal mortality levels are often estimated using siblings' survival histories (SSH) collected during retrospective adult mortality surveys. We explored how accurately adult deaths can be classified as pregnancy related using such data. Method: The study was conducted in a rural area of south-eastern Senegal with high maternal mortality, Bandafassi. We used data from a demographic surveillance system (DSS) in this area to identify deaths of women at reproductive ages between 2003 and 2009 and to locate the surviving adult sisters of the deceased and interview them. Siblings' survival histories were linked at the individual level to death records, and verbal autopsy data obtained by the demographic surveillance system. We compared the classification of adult female deaths as pregnancy related or not in interviews and DSS records. Results: There were 91 deaths at reproductive ages in the Bandafassi DSS between 2003 and 2009, but only 59 had known surviving sisters. Some deaths were omitted by respondents, or reported as alive or as having occurred during childhood (n = 8). Among deaths reported both in the SSH and DSS data, 94% of deaths classified as pregnancy related in the DSS data were also classified as such by siblings' survival histories. Only 70% of deaths classified as not pregnancy related in the DSS data were also classified as such by siblings' survival histories. Conclusion: Misclassifications of pregnancy-related deaths in retrospective adult mortality surveys may affect estimates of pregnancy-related mortality rates.

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