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Verbal autopsies (VA) are frequently used to determine causes of death for individuals for whom there is no reliable clinical information regarding the terminal illness. VA interviews are used to note key symptoms and signs recalled by relatives of the deceased and diagnoses ascribed according to the symptom complexes. The VA technique assumes that individual disease entities have discrete symptom complexes and that these can be accurately recognized and recalled by the interviewees. We have examined the accuracy with which specific symptoms are recalled over time by mothers or normal guardians of 491 children who died on the paediatric wards of two district hospitals in East Africa. Kwashiorkor, measles, trauma, generalized convulsions and neonatal tetanus were all reported with a high degree of accuracy for children who died of these conditions and had low false positive rates for children without these conditions. Recall was similar within 1 month of death compared to recall after 6 months for most symptoms and signs except neonatal tetanus where false positive reports by mothers increased with time since death. Symptoms and signs commonly used to describe malaria, respiratory tract and diarrhoea-related deaths were reported by mothers to have been present during the terminal illness in 43% of cases where these features were absent. Recall abilities differed between the two communities studied for some symptoms and signs highlighting the importance of such studies in every setting where VA are applied.

Original publication




Journal article


Int J Epidemiol

Publication Date





677 - 683


Africa, Africa South Of The Sahara, Age Factors, Causes Of Death, Child, Child Mortality, Data Collection, Data Reporting, Demographic Factors, Developing Countries, Diseases, Eastern Africa, English Speaking Africa, Error Sources, Examinations And Diagnoses, Family And Household, Family Characteristics, Family Relationships, Interviews, Kenya, Measurement, Methodological Studies, Mortality, Mothers, Parents, Physical Examinations And Diagnoses, Population, Population Characteristics, Population Dynamics, Research Methodology, Research Report, Rural Population, Signs And Symptoms, Tanzania, Time Factors, Youth, Bereavement, Bias, Cause of Death, Child, Child Welfare, Child, Preschool, Evaluation Studies as Topic, Humans, Infant, Infant, Newborn, Kenya, Kwashiorkor, Measles, Medical History Taking, Medical Records, Memory, Mothers, Population Surveillance, Prospective Studies, Reproducibility of Results, Rural Health, Seizures, Tanzania, Tetanus, Time Factors, Wounds and Injuries