Authors: Kavi Bhalla, Jerry P Abraham and Safa Abdalla
Date: July 6, 2010
Objective: To do a crude test of the completeness and quality of the Khartoum Mortuary Data
Method: The number of deaths in the mortuary records was compared with an estimate of the number of deaths expected in Khartoum state
- The mortuary dataset is not representative of all-cause deaths (80% of deaths are injury related)
- The mortuary dataset captures a substantial fraction of injury deaths in Khartoum (84% by this calculation).
- Data Source Analyzed: Khartoum Teaching Hospital 2008 records
o There are two mortuaries in the Khartoum Metropolitan Area located at the Khartoum Teaching Hospital and the Omdurman Teaching Hospital. The Omdurman mortuary was established in 2009. Thus, until 2008, the Khartoum Teaching Hospital Mortuary was the only mortuary in the region. Thus, we test the completeness and quality of this dataset.
- Analysis in this report should be repeated with Census 2008 data:
o The analysis in this report uses crude estimates of population and mortality in Khartoum. Typically these have been extrapolated from estimates available for the country in international databases. Accurate data for population and mortality in Khartoum will be available from the 2008 Census. This analysis should be updated then.
TABLE 1: Distribution of causes in the 2008 Khartoum Mortuary Dataset
- Injury cases comprise 80% of the all-cause deaths in the mortuary dataset. The mortuary dataset is severely biased towards injury cases. The mortuary dataset is unlikely to be representative of all-cause mortality in Khartoum.
Assessment of Quality of Injury Coding
- Outside the injury chapters:
o The use of partially specified cause categories is relatively rare. Cause categories with more than 2% of mortuary cases are as follows:
§ Intra-cerebral hemorrhage: 6%
§ Other Diseases of the Respiratory System: 5%
o The Intra-cerebral hemorrhage deaths may include injuries.
- Within the injury chapter:
o Key external causes that are not included:
§ Sub-categories of road injuries, homicides, etc.
o Dump codes: The only dump code used is “Fracture” – with 40% of the injury cases.
§ Falls are likely classified here
§ It is unclear if road injuries get classified here
- It should be noted that prospective data gathering is ongoing at the recently established Omdurman mortuary. We expect that data from that mortuary will be available to us soon. The quality of cause-of-death attribution of that database is expected to be very high.
Assessment of Completeness
Coverage: It is assumed that the Mortuary receives cases only from Khartoum State.
- The assessment focuses on deaths among young adults aged between 15-44 years in Khartoum. 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)
- The cut-offs chosen were dictated by the age aggregation in the Khartoum Mortuary dataset. (Deaths among 45+ years are in one category)
TABLE 2: Assessment of completeness of the Khartoum Mortuary dataset