Evaluation of record linkage of mortality data between a health and demographic surveillance system and national civil registration system in South Africa

Kabudula, Chodziwadziwa Whiteson; Joubert, Jané; Tuoane-Nkhasi, Maletela; Kahn, Kathleen; Rao, Chalapati; Gómez‐Olivé, Francesc Xavier; Mee, Paul; Tollman, Stephen; López, Alan D.; Vos, Theo; Bradshaw, Debbie

doi:10.1186/s12963-014-0023-z

Cited by 12 publications

(12 citation statements)

References 41 publications

(51 reference statements)

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“…This analysis suggests that approximately 95% of adult deaths with IDs in South Africa are recorded through the vital registration system, which is similar to recent estimates obtained using DDMs [ 13 – 15 ] and a 94% completeness among individuals with IDs in a demographic surveillance site [ 35 ]. Although this consistency with DDM estimates is reassuring, this analysis raises concern about one of the central assumptions of DDMs, namely that the completeness of death reporting is constant with respect to age in adults [ 11 ].…”

Section: Discussionsupporting

confidence: 86%

A comparison of death recording by health centres and civil registration in South Africans receiving antiretroviral treatment

Johnson

Dorrington

Laubscher

et al. 2015

Journal of the International AIDS Society

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IntroductionThere 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).MethodsCompleteness 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.ResultsAfter 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).ConclusionsSouth 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.

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Section: Discussionsupporting

confidence: 86%

A comparison of death recording by health centres and civil registration in South Africans receiving antiretroviral treatment

Johnson

Dorrington

Laubscher

et al. 2015

Journal of the International AIDS Society

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“…Out of the 1,001 deaths recorded in the population, only 187 could be matched by name in hospital registers (38). Another recent attempt conducted in 2006–2009 showed that there was no major bias in death registration between HDSS and CRVS in the Agincourt area, demonstrated that 60.8% of death records could be matched using complex procedures, and confirmed that those that could not be matched were mostly the deaths of young children, those in poorer households, and Mozambicans, most likely because these deaths did not occur in hospitals and were never registered (41). …”

Section: Discussionmentioning

confidence: 99%

Completeness of birth and death registration in a rural area of South Africa: the Agincourt health and demographic surveillance, 1992–2014

Garenne

Collinson

Kabudula

et al. 2016

Global Health Action

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BackgroundCompleteness of vital registration remains very low in sub-Saharan Africa, especially in rural areas.ObjectivesTo investigate trends and factors in completeness of birth and death registration in Agincourt, a rural area of South Africa covering a population of about 110,000 persons, under demographic surveillance since 1992. The population belongs to the Shangaan ethnic group and hosts a sizeable community of Mozambican refugees.DesignStatistical analysis of birth and death registration over time in a 22-year perspective (1992–2014). Over this period, major efforts were made by the government of South Africa to improve vital registration. Factors associated with completeness of registration were investigated using univariate and multivariate analysis.ResultsBirth registration was very incomplete at onset (7.8% in 1992) and reached high values at end point (90.5% in 2014). Likewise, death registration was low at onset (51.4% in 1992), also reaching high values at end point (97.1% in 2014). For births, the main factors were mother's age (much lower completeness among births to adolescent mothers), refugee status, and household wealth. For deaths, the major factors were age at death (lower completeness among under-five children), refugee status, and household wealth. Completeness increased for all demographic and socioeconomic categories studied and is likely to approach 100% in the future if trends continue at this speed.ConclusionReaching high values in the completeness of birth and death registration was achieved by excellent organization of the civil registration and vital statistics, a variety of financial incentives, strong involvement of health personnel, and wide-scale information and advocacy campaigns by the South African government.

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“…As a pilot, prior to the first round of HBT (HBT‐R1) a standard deterministic and probabilistic record‐linkage was conducted in order to match the HDSS individuals simple randomized for HBT and the Manhiça hospital ePTS records for those already enrolled in care.…”

Section: Methodsmentioning

confidence: 99%

Monitoring progress towards the first UNAIDS target: understanding the impact of people living with HIV who re‐test during HIV‐testing campaigns in rural Mozambique

et al. 2018

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IntroductionAwareness of HIV‐infection goes beyond diagnosis, and encompasses understanding, acceptance, disclosure and initiation of the HIV‐care. We aimed to characterize the HIV‐positive population that underwent repeat HIV‐testing without disclosing their serostatus and the impact on estimates of the first UNAIDS 90 target.MethodsThis analysis was nested in a prospective cohort established in southern Mozambique which conducted three HIV‐testing modalities: voluntary counselling and testing (VCT), provider‐initiated counselling and testing (PICT) and home‐based testing (HBT). Participants were given the opportunity to self‐report their status to lay counsellors and HIV‐positive diagnoses were verified for previous enrolment in care. This study included 1955 individuals diagnosed with HIV through VCT/PICT and 11,746 participants of a HBT campaign. Those who did not report their serostatus prior to testing, and were found to have a previous HIV‐diagnosis, were defined as non‐disclosures. Venue‐stratified descriptive analyses were performed and factors associated with non‐disclosure were estimated through log‐binomial regression.ResultsIn the first round of 2500 adults randomized for HBT, 1725 were eligible for testing and 18.7% self‐reported their HIV‐positivity. Of those tested with a positive result, 38.9% were found to be non‐disclosures. Similar prevalence of non‐disclosures was found in clinical‐testing modalities, 29.4% (95% CI 26.7 to 32.3) for PICT strategy and 13.0% (95% CI 10.9 to 15.3) for VCT. Prior history of missed visits (adjusted prevalence ratio (APR) 4.2, 95% CI 2.6 to 6.8), younger age (APR 2.5, 95% CI 1.4 to 4.4) and no prior history of treatment ((APR) 1.4, 95% CI 1.0 to 2.1) were significantly associated with non‐disclosure as compared to patients who self‐reported. When considering non‐disclosures as people living with HIV (PLWHIV) aware of their HIV‐status, the proportion of PLWHIV aware increased from 78.3% (95% CI 74.2 to 81.6) to 86.8% (95% CI 83.4 to 89.6).ConclusionMore than one‐third of individuals testing HIV‐positive did not disclose their previous positive HIV‐diagnosis to counsellors. This proportion varied according to testing modality and age. In the absence of an efficient and non‐anonymous tracking system for HIV‐testers, repeat testing of non‐disclosures leads to wasted resources and may distort programmatic indicators. Developing interventions that ensure appropriate psychosocial support are needed to encourage this population to disclose their status and optimize scarce resources.

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Evaluation of record linkage of mortality data between a health and demographic surveillance system and national civil registration system in South Africa

Cited by 12 publications

References 41 publications

A comparison of death recording by health centres and civil registration in South Africans receiving antiretroviral treatment

A comparison of death recording by health centres and civil registration in South Africans receiving antiretroviral treatment

Completeness of birth and death registration in a rural area of South Africa: the Agincourt health and demographic surveillance, 1992–2014

Monitoring progress towards the first UNAIDS target: understanding the impact of people living with HIV who re‐test during HIV‐testing campaigns in rural Mozambique

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