ArticleGlobal health action2013
InterVA-4 as a public health tool for measuring HIV/AIDS mortality: a validation study from five African countries.
Article in Global health action, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers.
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39 citing papers in PubMed, 52 citations in OpenAlex.
- Verbal autopsy-assigned causes of death among adults being investigated for TB in South Africa.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2016Trial
- All-cause and cause-specific mortality trends among people with and without HIV in the Siaya health and demographic surveillance system, Kenya, 2011-2018.Global health action · 2026Article
- A comparison of verbal autopsy assignment methods to obtain adult cause-specific mortality in two longitudinal studies in Rakai and Kalungu districts of South Central, Uganda.PLOS global public health · 2026Article
- Agreement between cause of death assignment by computer-coded verbal autopsy methods and physician coding of verbal autopsy interviews in South Africa.Global health action · 2023Article
- Outcomes After Being Lost to Follow-up Differ for Pregnant and Postpartum Women When Compared With the General HIV Treatment Population in Rural South Africa.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Migration and first-year maternal mortality among HIV-positive postpartum women: A population-based longitudinal study in rural South Africa.PLoS medicine · 2020Article
- Article
- Association between internal migration and epidemic dynamics: an analysis of cause-specific mortality in Kenya and South Africa using health and demographic surveillance data.BMC public health · 2018Article
- Performance of verbal autopsy methods in estimating HIV-associated mortality among adults in South Africa.BMJ global health · 2018Article
- Socioeconomic differences in mortality in the antiretroviral therapy era in Agincourt, rural South Africa, 2001-13: a population surveillance analysis.The Lancet. Global health · 2017Article
- Trends in the burden of HIV mortality after roll-out of antiretroviral therapy in KwaZulu-Natal, South Africa: an observational community cohort study.The lancet. HIV · 2017Observational
- Constructing maternal morbidity - towards a standard tool to measure and monitor maternal health beyond mortality.BMC pregnancy and childbirth · 2016Article
- Data Resource Profile: Network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA Network).International journal of epidemiology · 2016Article
- The development of a localised HIV epidemic and the associated excess mortality burden in a rural area of South Africa.Global health, epidemiology and genomics · 2016Article
- Article
- Health & Demographic Surveillance System Profile: The Magu Health and Demographic Surveillance System (Magu HDSS).International journal of epidemiology · 2015Article
- Innovations in health and demographic surveillance systems to establish the causal impacts of HIV policies.Current opinion in HIV and AIDS · 2015Review
- Mass HIV Treatment and Sex Disparities in Life Expectancy: Demographic Surveillance in Rural South Africa.PLoS medicine · 2015Article
- Trends in Causes of Adult Deaths among the Urban Poor: Evidence from Nairobi Urban Health and Demographic Surveillance System, 2003-2012.Journal of urban health : bulletin of the New York Academy of Medicine · 2015Article
- Comparing verbal autopsy cause of death findings as determined by physician coding and probabilistic modelling: a public health analysis of 54 000 deaths in Africa and Asia.Journal of global health · 2015Article
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Authors and funding
12 authors at 9 institutions in 8 countries.
Funding
Abstract
backgroundReliable 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.
objectiveThe 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.
designData 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.
resultsThe 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.
conclusionsThese results were generally consistent with relatively small post-mortem and hospital-based diagnosis studies in the literature. The high specificity in cause of death attribution achieved in relation to HIV status, and large differences between specific causes by HIV status, show that InterVA-4 is an effective and valid tool for assessing HIV-related mortality.
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