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Completeness and Quality of Addis Ababa Mortuary Data

Authors: Kavi Bhalla, Jerry P Abraham and Kunuz Abdella

Date: July 6, 2010

 

Objective: To do a crude test of the completeness and quality of the Addis Ababa Mortuary dataset

Method: The number of deaths in the mortuary records was compared with an estimate of the number of deaths expected in the Addis Ababa metropolitan area

Findings:

-          The mortuary dataset captures a substantial fraction of injury deaths in Addis Ababa (43% by this assessment)

-          The quality of the data is high with relatively few deaths assigned to partially specified causes.

 

 

Background

-          Data Source Analyzed: Menelik II Hospital Mortuary records, 1 year (June 2006-July 2007)

-          Analysis in this report should be repeated with Census 2007 data:

o   The analysis in this report uses crude estimates of population and mortality in Addis Ababa. Typically these have been extrapolated from estimates available for the country in international databases. Accurate data for population and mortality in Addis Ababa will be available from the 2007 Census. This analysis should be updated when these estimates are available. (Note that the 2007 Census includes a question on household deaths but unlike some other censuses does not ask if the death was due to injury/violence)

-          Injury cases comprise 100% of the deaths in the mortuary dataset. 

 

Assessment of Quality of Injury Coding

-          Dump codes within unintentional injuries

o   Unspecified unintentional injuries account for 5% of all injuries (9% of unintentional injuries). This is relatively small.

o   Undetermined Intent account for 3% of the cases.  This too is relatively small.


 

TABLE 1: Distribution of external causes in the mortuary dataset

 

 

 

Inside/Outside Addis

 

Intent

Broad

Specific

Outside

Inside

Unknown

Total

Un-intentional

Road Injury

Pedestrian

128

15%

170

20%

85

19%

383

18%

Occupant

181

22%

136

16%

61

14%

378

18%

Falls

 

9

1%

26

3%

2

0%

37

2%

Fire

 

 

0%

1

0%

1

0%

2

0%

Mechanical forces

Firearm

1

0%

 

0%

 

0%

1

0%

Sharp obj

1

0%

 

0%

 

0%

1

0%

Threats to Breathing

Drowning

32

4%

39

5%

29

6%

100

5%

Other

6

1%

10

1%

7

2%

23

1%

Poisoning

 

3

0%

20

2%

 

0%

23

1%

Other

 

30

4%

44

5%

12

3%

86

4%

Unspecified

 

41

5%

45

5%

19

4%

105

5%

Self-inflicted

Falls

 

1

0%

1

0%

 

0%

2

0%

Mechanical forces

 

9

1%

4

0%

2

0%

15

1%

Threats to Breathing

Other

45

5%

112

13%

29

6%

186

9%

Poisoning

 

14

2%

6

1%

10

2%

30

1%

Other

 

 

0%

 

0%

1

0%

1

0%

Inter-personal

Falls

 

 

0%

1

0%

 

0%

1

0%

Mechanical forces

Firearm

62

7%

49

6%

25

6%

136

6%

Sharp object

45

5%

35

4%

23

5%

103

5%

Threats to Breathing

Drowning

1

0%

 

0%

1

0%

2

0%

Other

25

3%

18

2%

15

3%

58

3%

Poisoning

 

 

0%

1

0%

 

0%

1

0%

Other

 

165

20%

85

10%

92

20%

342

16%

Un-determined Intent

Falls

 

2

0%

2

0%

1

0%

5

0%

Fire

 

 

0%

1

0%

2

0%

3

0%

Mechanical forces

Firearm

 

0%

1

0%

2

0%

3

0%

Sharp obj

 

0%

 

0%

2

0%

2

0%

Threats to Breathing

Drowning

1

0%

1

0%

1

0%

3

0%

Other

 

0%

1

0%

 

0%

1

0%

Poisoning

 

1

0%

3

0%

 

0%

4

0%

Other

 

25

3%

18

2%

27

6%

70

3%

Unspecified

Unspecified

 

6

1%

 

0%

1

0%

7

0%

 

 

 

834

100%

830

100%

450

100%

2114

100%

 

Assessment of Completeness

Coverage assumptions: As shown in Table 1, the Mortuary receives cases from both inside and outside Addis Ababa. Half of the cases for which location was specified are from within Addis Ababa. Thus, for the comparison in Table 2, we assume that half of the mortuary cases are from Addis Ababa.

Age aggregation:  The assessment focuses on deaths among young adults aged between 15-59 years in Addis. This was done to reduce uncertainty in this analysis. (Injuries occur primarily among young adults and the high mortality among children and older adults can add substantial uncertainty to analysis)


 

TABLE 2: Assessment of completeness of the Addis Ababa Mortuary dataset

POPULATION CALCULATION

2,633,000

both sexes

Population of Addis Ababa Agglomeration

1,316,500

Male

 

1,316,500

Female

 

 

Source: World Urbanization Prospects for total population + assuming 50-50 gender distribution

% that are between 15-59 years

59.20%

Male

% OF URBAN MALES THAT ARE 15-59 YEARS IN Ethiopia (YEAR 2005)

59.17%

Female

% OF URBAN FEMALES THAT ARE 15-59 YEARS IN Ethiopia

 

Source: UNPD World Population Prospects 2008 (all urban population)

Population of Addis Ababa between 15-59 years

 779,347

Male

 

 778,932

Female

 

 

Calculated from above

DEATHS CALCULATION

Death rate for 15-59 years in Addis Ababa

0.01047

Male

(per person)

0.00927

Female

 

 

Source: Estimated from UNPD all-cause deaths and UNPD population for year 2000

Estimated all-cause deaths among 15-59 years in Addis Ababa in 2005

8161

Male

 

7222

Female

 

 

Source:  Death rate applied to Addis Ababa Population

Fraction of all-cause deaths that are due to injuries among people aged 15-59 years

19.7%

Male

 

5.2%

Female

 

 

Source: GBD-2004, Africa region

Estimates of injury deaths in age group 15-59 years in Addis Ababa in 2005

 1,611

Male

 

 373

Female

 

 

Calculated from above

COMPLETENESS TEST

Mortuary Injury Deaths in 2008 between the ages of 15-59 years

694

Male

 

160

Female

 

 

Source: Menelik Hospital Mortuary (assuming 50% cases are from Addis)

Completeness of injury deaths between ages 15-59 years

43%

Male

fraction of estimated injury deaths that were seen at the mortuary

43%

Female

 

43%

Total

 

 

Calculated from above

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