InterVA-4 as a public health tool for measuring HIV/AIDS mortality: a validation study from five African countries

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dc.contributor.authorByass, Peter
dc.contributor.authorCalvert, Clara
dc.contributor.authorNakiyingi-Miiro, Jessica
dc.contributor.authorLutalo, Tom
dc.contributor.authorMichael, Denna
dc.contributor.authorCrampin, Amelia
dc.contributor.authorGregson, Simon
dc.contributor.authorTakaruza, Albert
dc.contributor.authorRobertson, Laura
dc.contributor.authorHerbst, Kobus
dc.contributor.authorTodd, Jim
dc.contributor.authorZaba, Basia
dc.date.accessioned2022-03-11T06:07:43Z
dc.date.available2022-03-11T06:07:43Z
dc.date.issued2013
dc.description.abstractReliable population-based data on HIV infection and AIDS mortality in sub-Saharan Africa are scanty, even though that is the region where most of the world’s AIDS deaths occur. There is therefore a great need for reliable and valid public health tools for assessing AIDS mortality. Objective: The aim of this article is to validate the InterVA-4 verbal autopsy (VA) interpretative model within African populations where HIV sero-status is recorded on a prospective basis, and examine the distribution of cause-specific mortality among HIV-positive and HIV-negative people. Design: Data from six sites of the Alpha Network, including HIV sero-status and VA interviews, were pooled. VA data according to the 2012 WHO format were extracted, and processed using the InterVA-4 model into likely causes of death. The model was blinded to the sero-status data. Cases with known pre-mortem HIV infection status were used to determine the specificity with which InterVA-4 could attribute HIV/AIDS as a cause of death. Cause-specific mortality fractions by HIV infection status were calculated, and a person-time model was built to analyse adjusted cause-specific mortality rate ratios. Results: The InterVA-4 model identified HIV/AIDS-related deaths with a specificity of 90.1% (95% CI 88.7 91.4%). Overall sensitivity could not be calculated, because HIV-positive people die from a range of causes. In a person-time model including 1,739 deaths in 1,161,688 HIV-negative person-years observed and 2,890 deaths in 75,110 HIV-positive person-years observed, the mortality ratio HIV-positive:negative was 29.0 (95% CI 27.1 31.0), after adjustment for age, sex, and study site. Cause-specific HIV-positive:negative mortality ratios for acute respiratory infections, HIV/AIDS-related deaths, meningitis, tuberculosis, and malnutrition were higher than the all-cause ratio; all causes had HIV-positive:negative mortality ratios significantly higher than unity.en_US
dc.identifier.citationPeter Byass, Clara Calvert, Jessica Miiro-Nakiyingi, Tom Lutalo, Denna Michael, Amelia Crampin, Simon Gregson, Albert Takaruza, Laura Robertson, Kobus Herbst, Jim Todd & Basia Zaba (2013) InterVA-4 as a public health tool for measuring HIV/AIDS mortality: a validation study from five African countries, Global Health Action, 6:1, 22448, DOI: 10.3402/ gha.v6i0.22448en_US
dc.identifier.issn1654-9716 (Print)
dc.identifier.issn1654-9880 (Online)
dc.identifier.urihttps://doi.org/10.3402/gha.v6i0.22448
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/2672
dc.language.isoenen_US
dc.publisherGlobal Health Actionen_US
dc.subjectHIV/AIDSen_US
dc.subjectmortalityen_US
dc.subjectAfricaen_US
dc.subjectverbal autopsyen_US
dc.subjectInterVAen_US
dc.subjectAlpha Networken_US
dc.titleInterVA-4 as a public health tool for measuring HIV/AIDS mortality: a validation study from five African countriesen_US
dc.typeArticleen_US
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