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Completeness and Quality of the Maputo Mortuary Dataset

Authors: Kavi Bhalla, Jerry P Abraham and Kidist Bartolomeos

Date: September 14, 2010

 

Objective: To do a crude test of the completeness and quality of the Maputo Central Hospital Mortuary dataset

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

Findings:

-          The quality of cause of death attribution of the dataset is high with a relatively small number of deaths assigned to unspecified causes.

-          Results suggest that the number of deaths recorded in the mortuary exceeds the expected number of injury deaths in the city. Further investigations are necessary.

 

 

 

Background

-          Data Source: Maputo Central Hospital Mortuary Records. The dataset contained records for ten years, 1994-2003.  Only data from the year 2003 was used in this completeness test. 

-          Note that the database was retrospectively constructed from existing mortuary records.

-          This mortuary database only contains predominantly injury cases.  Out of the total 12,354 deaths in the database from 1994-2003, only 5% are from non-injury causes (listed as “natural” deaths).  

 

Assessment of Quality of Injury Coding  (see Table 1)

·         See Table 1 for distribution of injury deaths

·         The quality of cause of death attribution in the dataset is high with relatively few cases assigned to partially-specified cause categories.

o   Overall intent is unknown for 13% of deaths. However, even within this category, the mechanism is known for 62% of the cases. 

o   The unknown mechanism category within the unintentional, self-inflicted and inter-personal categories is negligibly small.

·         However, note that sub-categories (i.e. road users) of road injury are not available.

 

 

 


 

Table 1: External cause distribution of deaths in the Maputo Mortuary Dataset

INTENT

MECHANISM

Total

%

Unintentional

Road Injury-Unknown

5509

77%

Falls

183

3%

Drowning

263

4%

Other Threats To Breathing

4

0%

Fire

656

9%

Sharp Object

2

0%

Poisoning

86

1%

Other

417

6%

Unknown

29

0%

 TOTAL

7149

100%

Self-inflicted

Falls

32

5%

Drowning

1

0%

Other Threats To Breathing

490

69%

Fire

53

7%

Firearm

15

2%

Sharp Object

6

1%

Poisoning

110

15%

Other

2

0%

Unknown

2

0%

                                    TOTAL

711

100%

Inter-personal

Road Injury-Unknown

2

0%

Falls

3

0%

Drowning

19

1%

Other Threats To Breathing

103

5%

Fire

52

2%

Firearm

982

44%

Sharp Object

319

14%

Poisoning

4

0%

Other

721

32%

Unknown

41

2%

 TOTAL

2246

100%

Unknown

Road Injury-Unknown

19

1%

Falls

69

3%

Drowning

200

9%

Other Threats To Breathing

50

2%

Fire

260

12%

Firearm

31

1%

Sharp Object

17

1%

Poisoning

110

5%

 

 

 

Other

245

11%

Unknown

610

27%

 TOTAL

2248

100%

Grand Total

 

11717

 

 

Assessment of Completeness

·         Age aggregation: The assessment focuses on deaths among young adults aged between 15-49 years in Maputo City.  Note that the choice of age-group (15-49 years) analyzed is based on the age aggregation used in the INCAM-2007 report. 


 

TABLE 2: Assessment of completeness of the Maputo mortuary dataset (Year 2000)

POPULATION CALCULATION

 

 1,096,000

both sexes

Population of Maputo Urban Area in 2005

 548,000

Male

 

 548,000

Female

 

 

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

% that are between 15-49 years

50.59%

Male

% of urban males, 15-49 years in Mozambique

48.32%

Female

% of urban females, 15-49 years in Mozambique

 

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

Population of Maputo between 15-49 years

 277,210

Male

 

 264,766

Female

 

 

Calculated from above

DEATHS CALCULATION

 

Death rate for 15-49 years in Mozambique

0.01350

Male

(per person)

0.01007

Female

 

 

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

Estimated all-cause deaths among 15-49 years in Maputo

3742

Male

 

2666

Female

 

 

Source:  Death rate applied to Maputo Population

Fraction of all-cause deaths that are due to injuries among people aged 15-49 years

7.02%

TOTAL (Male and Female)

 

Male

 

 

Female

 

 

Source: INCAM 2007

Estimates of injury deaths in age group 15-49 years in Maputo

450

TOTAL (Male and Female)

 -  

Male

 

 -  

Female

 

 

Calculated from above

COMPLETENESS TEST

 

Mortuary Injury Deaths between the ages of 15-49 years

831

TOTAL (Male and Female)

669

Male

 

161

Female

 

 

Source: Mortuary data

Completeness of injury deaths between ages 15-49 years

185%

TOTAL (Male and Female)

fraction of estimated injury deaths that were seen at the mortuary

 

Calculated from above

 

This comparison suggests that the number of deaths in the mortuary far exceeds the number of injury deaths in the city of Mortuary.  This is unexpected. We should take a closer look to check if the Mortuary receives many cases from outside of Maputo city.

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