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close this bookRapid Assessment Procedures: Qualitative Methodologies for Planning and Evaluation of Health Related Programmes (International Nutrition Foundation for Developing Countries - INFDC, 1992, 528 pages)
close this folderSection II: Development and applications of rapid assessment procedures in Africa, Asia and the Americas
close this folder21. Interview-based diagnosis of illness and causes of death in children
View the document(introductory text...)
View the documentThe basis for interview diagnosis
View the documentStructure of interviews
View the documentValidation of verbal autopsy
View the documentNeonatal tetanus
View the documentPerinatal deaths, prematurity, and low birth weight
View the documentMeasles
View the documentDiarrhoea and dysentery
View the documentAcute lower respiratory infection (ALRI)
View the documentPertussis (whooping cough)
View the documentMalaria
View the documentMeningitis
View the documentChronic illnesses: malnutrition, tuberculosis, and AIDS
View the documentInjury and violence
View the documentSummary and conclusions
View the documentReferences

The basis for interview diagnosis

Certain diseases have characteristic symptoms and signs that, in association often form a relatively distinct clinical syndrome. The objective of an interview based diagnosis is to identify such medical syndromes using information about the illness elicited from relatives, and the approach is most useful when the characteristic symptoms and signs of the disease are sufficiently distinctive to differentiate the disease of interest from other conditions with which it might be confused. In essence the interview attempts to replicate elements of a conventional medical history used to establish a differential diagnosis (i.e., a list of conditions consistent with a patient's symptoms and signs). However, unlike a physician's diagnosis, the interview may not establish a definitive diagnosis because there is no confirmatory information derived from physical examination by a trained health professional, nor information from medical investigations, laboratory tests or autopsy. There is, therefore, inevitable uncertainty in the accuracy of verbal autopsy diagnosis.

There are only a limited number of diseases that present sufficiently distinct syndromes to be potentially suitable for verbal autopsy diagnosis. In children, these include acute conditions such as neonatal tetanus, prematurity/low birth weight and birth injury, measles, diarrhoea/dysentery, acute lower respiratory infection (ALRI), pertussis, meningitis, and injury [1]. However, malaria and chronic conditions such as tuberculosis (TB), nutritional deficiency and AIDS present serious difficulty in diagnosis [1]. The main focus of research has been on diseases that constitute common causes of morbidity and mortality amenable to prevention or treatment.