Verifying causes of death in Thailand: Rationale and methods for empirical investigation

Rao, Chalapati, Porapakkham, Yawarat, Pattaraarchachai, Junya, Polprasert, Warangkana, Swampunyalert, Narumol and Lopez, Alan D. (2010) Verifying causes of death in Thailand: Rationale and methods for empirical investigation. Population Health Metrics, 8 11: . doi:10.1186/1478-7954-8-11

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Author Rao, Chalapati
Porapakkham, Yawarat
Pattaraarchachai, Junya
Polprasert, Warangkana
Swampunyalert, Narumol
Lopez, Alan D.
Title Verifying causes of death in Thailand: Rationale and methods for empirical investigation
Journal name Population Health Metrics   Check publisher's open access policy
ISSN 1478-7954
Publication date 2010-05-18
Sub-type Article (original research)
DOI 10.1186/1478-7954-8-11
Open Access Status DOI
Volume 8
Issue 11
Total pages 11
Editor Emmanuela Gakidou
Christopher J. L. Murray
Alan D. Lopez
Place of publication London, U.K
Publisher BioMed Central
Collection year 2011
Language eng
Formatted abstract
Background: Cause-specific mortality statistics by age and sex are primary evidence for epidemiological research and health policy. Annual mortality statistics from vital registration systems in Thailand are of limited utility because about 40% of deaths are registered with unknown or nonspecific causes. This paper reports the rationale, methods, and broad results from a comprehensive study to verify registered causes in Thailand.

Methods: A nationally representative sample of 11,984 deaths was selected using a multistage stratified cluster sampling approach, distributed across 28 districts located in nine provinces of Thailand. Registered causes were verified through medical record review for deaths in hospitals and standard verbal autopsy procedures for deaths outside hospitals, the results of which were used to measure validity and reliability of registration data. Study findings were used to develop descriptive estimates of cause-specific mortality by age and sex in Thailand.

Results: Causes of death were verified for a total of 9,644 deaths in the study sample, comprised of 3,316 deaths in hospitals and 6,328 deaths outside hospitals. Field studies yielded specific diagnoses in almost all deaths in the sample originally assigned an ill-defined cause of death at registration. Study findings suggest that the leading causes of death in Thailand among males are stroke (9.4%); transport accidents (8.1%); HIV/AIDS (7.9%); ischemic heart diseases (6.4%); and chronic obstructive lung diseases (5.7%). Among females, the leading causes are stroke (11.3%); diabetes (8%); ischemic heart disease (7.5%); HIV/AIDS (5.7%); and renal diseases (4%).

Conclusions: Empirical investigation of registered causes of death in the study sample yielded adequate information to enable estimation of cause-specific mortality patterns in Thailand. These findings will inform burden of disease estimation and economic evaluation of health policy choices in the country. The development and implementation of research methods in this study will contribute to improvements in the quality of annual mortality statistics in Thailand. Similar research is recommended for other countries where the quality of mortality statistics is poor.
© 2010 Rao et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keyword AIDS
Death rate
Human immunodeficiency virus infections
Ischaemic heart disease
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes This article is part of the series "Measuring mortality in Thailand".

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 23 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 31 times in Scopus Article | Citations
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Created: Thu, 10 Mar 2011, 14:23:20 EST by Geraldine Fitzgerald on behalf of School of Public Health