A comparison of death recording by health centres and civil registration in South Africans receiving antiretroviral treatment
Date
2015-12-16
Journal Title
Journal ISSN
Volume Title
Publisher
International AIDS Society
Abstract
Introduction: There is uncertainty regarding the completeness of death recording by civil registration and by health centres in South Africa. This paper aims to compare death recording by the two systems, in cohorts of South African patients receiving
antiretroviral treatment (ART).
Methods: Completeness of death recording was estimated using a capture recapture approach. Six ART programmes linked their patient record systems to the vital registration system using civil identity document (ID) numbers and provided data
comparing the outcomes recorded in patient files and in the vital registration. Patients were excluded if they had missing/invalid IDs or had transferred to other ART programmes.
Results: After exclusions, 91,548 patient records were included. Of deaths recorded in patients files after 2003, 94.0% (95% CI:
93.3 94.6%) were recorded by civil registration, with completeness being significantly higher in urban areas, older adults and
females. Of deaths recorded by civil registration after 2003, only 35.0% (95% CI: 34.2 35.8%) were recorded in patient files, with
this proportion dropping from 60% in 2004 2005 to 30% in 2010 and subsequent years. Recording of deaths in patient files was significantly higher in children and in locations within 50 km of the health centre. When the information from the two systems
was combined, an estimated 96.2% of all deaths were recorded (93.5% in children and 96.2% in adults).
Conclusions: South Africa’s civil registration system has achieved a high level of completeness in the recording of mortality.
However, the fraction of deaths recorded by health centres is low and information from patient records is insufficient by itself to evaluate levels and predictors of ART patient mortality. Previously documented improvements in ART mortality over time may be biased if based only on data from patient records.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar
Description
CITATION: Johnson, L. F. et al. 2015. A comparison of death recording by health centres and civil registration in South Africans receiving antiretroviral treatment. Journal of the International AIDS Society, 18:20628, doi:10.7448/IAS.18.1.20628.
The original publication is available at http://www.jiasociety.org
The original publication is available at http://www.jiasociety.org
Keywords
Antiretroviral drugs, HIV infections -- Patients, Vital statistics -- Recording and registration, Death registration
Citation
Johnson, L. F. et al. 2015. A comparison of death recording by health centres and civil registration in South Africans receiving antiretroviral treatment. Journal of the International AIDS Society, 18:20628, doi:10.7448/IAS.18.1.20628.