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首页> 外文期刊>BMC Pediatrics >Diagnostic accuracy of WHO verbal autopsy tool for ascertaining causes of neonatal deaths in the urban setting of Pakistan: a hospital-based prospective study
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Diagnostic accuracy of WHO verbal autopsy tool for ascertaining causes of neonatal deaths in the urban setting of Pakistan: a hospital-based prospective study

机译：世卫组织口头尸检工具对巴基斯坦城市环境新生儿死亡原因的诊断准确性：一项基于医院的前瞻性研究

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Background Globally, clinical certification of the cause of neonatal death is not commonly available in developing countries. Under such circumstances it is imperative to use available WHO verbal autopsy tool to ascertain causes of death for strategic health planning in countries where resources are limited and the burden of neonatal death is high. The study explores the diagnostic accuracy of WHO revised verbal autopsy tool for ascertaining the causes of neonatal deaths against reference standard diagnosis obtained from standardized clinical and supportive hospital data. Methods All neonatal deaths were recruited between August 2006 –February 2008 from two tertiary teaching hospitals in Province Sindh, Pakistan. The reference standard cause of death was established by two senior pediatricians within 2?days of occurrence of death using the International Cause of Death coding system. For verbal autopsy, trained female community health worker interviewed mother or care taker of the deceased within 2–6 weeks of death using a modified WHO verbal autopsy tool. Cause of death was assigned by 2 trained pediatricians. The performance was assessed in terms of sensitivity and specificity. Results Out of 626 neonatal deaths, cause-specific mortality fractions for neonatal deaths were almost similar in both verbal autopsy and reference standard diagnosis. Sensitivity of verbal autopsy was more than 93?% for diagnosing prematurity and 83.5?% for birth asphyxia. However the verbal autopsy didn’t have acceptable accuracy for diagnosing the congenital malformation 57?%. The specificity for all five major causes of neonatal deaths was greater than 90?%. Conclusion The WHO revised verbal autopsy tool had reasonable validity in determining causes of neonatal deaths. The tool can be used in resource limited community-based settings where neonatal mortality rate is high and death certificates from hospitals are not available.
机译：背景技术在全球范围内，发展中国家通常不提供新生儿死亡原因的临床证明。在这种情况下，必须在资源有限且新生儿死亡负担高的国家中，使用可用的世卫组织口头尸检工具来确定死亡原因，以便进行战略卫生规划。这项研究探索了WHO修订的口头尸检工具的诊断准确性，该工具可根据从标准化临床和支持性医院数据获得的参考标准诊断来确定新生儿死亡的原因。方法2006年8月至2008年2月之间，从巴基斯坦信德省的两家三级教学医院招募所有新生儿死亡。参考标准死亡原因是由两名资深儿科医生在使用国际死亡原因编码系统在死亡发生后的2天之内建立的。对于言语尸检，经过培训的女性社区卫生工作者使用改良的WHO言语尸检工具在死亡2至6周内采访了死者的母亲或照顾者。死亡原因由2位训练有素的儿科医生确定。根据敏感性和特异性评估性能。结果在626例新生儿死亡中，无论是口头尸检还是参考标准诊断，因特定原因而导致的新生儿死亡分数几乎相同。对于早产的诊断，言语尸检的敏感性大于93％，对于出生窒息的敏感性大于83.5％。但是，口头尸检对先天性畸形的诊断准确性不高，为57％。所有五个新生儿死亡原因的特异性均大于90％。结论WHO修订的语言尸检工具在确定新生儿死亡原因方面具有合理的有效性。该工具可用于资源有限的社区环境中，新生儿死亡率很高，并且没有医院的死亡证明。

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