Minimally invasive autopsy can identify causes of Mozambique newborn and childhood deaths
- Date:
- June 20, 2017
- Source:
- PLOS
- Summary:
- Minimally invasive autopsy can identify cause of death in pediatric, perinatal and neonatal deaths in Mozambique with significant precision and accuracy compared with complete diagnostic autopsy, according to two new studies.
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Minimally invasive autopsy (MIA) can identify cause of death in pediatric, perinatal and neonatal deaths in Mozambique with significant precision and accuracy compared with complete diagnostic autopsy (CDA), according to two studies published by Clara Menéndez, Quique Bassat and colleagues from ISGlobal, Barcelona, Spain, in PLOS Medicine.
In the first study, the researchers compared cause of death determination from MIA and CDA in 18 stillbirths and 41 neonatal deaths. A cause of death was identified in 16/18 (89%) and 15/18 (83%) of stillborn babies and in all (100%) and 35/41 (85%) neonatal deaths in the CDA and the MIA, respectively. Causes of death identified for stillborn babies included fetal growth restriction (39%), infectious diseases (22%), intrapartum hypoxia (17%), and intrauterine hypoxia (11%), with the MIA showing substantial agreement with the CDA for categorization of disease (Kappa = 0.78, 95% CI [0.56-0.99]). For neonates, the majority of deaths were due to infectious diseases (66%) and the overall agreement of the MIA with the CDA for categorization of disease was moderate (Kappa = 0.40, 95% CI [0.18-0.63]).
In the second study, the researchers compared findings from MIA and CDA for 54 deaths in children <15 years of age. A cause of death was identified in all cases in the CDA and in 52/54 (96%) of the cases in the MIA, with infections (78%) and malignant tumors (13%) accounting for the majority of diagnoses. The MIA categorization of disease showed a substantial agreement with the CDA categorization (Kappa = 0.70, 95% CI 0.49-0.92).
The authors say: "Reliable estimates of the causes of stillbirths and neonatal and child mortality can help policy makers design and implement better and more evidence-based preventive strategies to improve child survival in high-burden low-income settings."
These two studies are part of an ongoing series of articles examining the validity of MIA in different populations. More articles about MIA can be found on the PLOS Minimally Invasive Autopsy collection page.
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Journal References:
- Quique Bassat, Paola Castillo, Miguel J. Martínez, Dercio Jordao, Lucilia Lovane, Juan Carlos Hurtado, Tacilta Nhampossa, Paula Santos Ritchie, Sónia Bandeira, Calvino Sambo, Valeria Chicamba, Mamudo R. Ismail, Carla Carrilho, Cesaltina Lorenzoni, Fabiola Fernandes, Pau Cisteró, Alfredo Mayor, Anelsio Cossa, Inacio Mandomando, Mireia Navarro, Isaac Casas, Jordi Vila, Khátia Munguambe, Maria Maixenchs, Ariadna Sanz, Llorenç Quintó, Eusebio Macete, Pedro Alonso, Clara Menéndez, Jaume Ordi. Validity of a minimally invasive autopsy tool for cause of death determination in pediatric deaths in Mozambique: An observational study. PLOS Medicine, 2017; 14 (6): e1002317 DOI: 10.1371/journal.pmed.1002317
- Clara Menendez, Paola Castillo, Miguel J. Martínez, Dercio Jordao, Lucilia Lovane, Mamudo R. Ismail, Carla Carrilho, Cesaltina Lorenzoni, Fabiola Fernandes, Tacilta Nhampossa, Juan Carlos Hurtado, Mireia Navarro, Isaac Casas, Paula Santos Ritchie, Sonia Bandeira, Sibone Mocumbi, Zara Jaze, Flora Mabota, Khátia Munguambe, Maria Maixenchs, Ariadna Sanz, Inacio Mandomando, Alfons Nadal, Anna Goncé, Carmen Muñoz-Almagro, Llorenç Quintó, Jordi Vila, Eusebio Macete, Pedro Alonso, Jaume Ordi, Quique Bassat. Validity of a minimally invasive autopsy for cause of death determination in stillborn babies and neonates in Mozambique: An observational study. PLOS Medicine, 2017; 14 (6): e1002318 DOI: 10.1371/journal.pmed.1002318
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