As with other surveys, information collected via verbal autopsies was based on a questionnaire.

© IRD - Marianne Donnat

Verbal autopsies: a public health tool


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Updated 05.07.2019

Months after the burial a questionnaire to people close to the deceased allow to establish cause of death when it hadn’t been certified by a professional.

Cause of death is a vital piece of information for public health that is established when a doctor issues a death certificate. Analysed at the population or territory level, this information helps us understand the conditions that need to be addressed to reduce mortality. “However, in many regions of the world without civil registers or health authorities who note the habitual findings in the event of death, collection of this information is inadequate.This is notably the case in most rural areas of Africa and Asia”, explains Aldiouma Diallo, a doctor and epidemiologist.

To mitigate this issue, scientists had the idea to periodically go out and collect epidemiological information in the field. This involves establishing the cause of death of the people who died that year days, weeks, or even months after they have been buried. What is the principle? Asking people close to the deceased about the circumstances of their death. This “verbal autopsy” is normally conducted by a doctor. In order to widen the scope of the investigation to an entire region, IRD researchers who are pioneers in the field of verbal autopsies, have created a well-codified clinical questionnaire. Interviews can therefore be entrusted to investigators without having to mobilise a doctor in the field. The information collected is then submitted to doctors who work in teams of two. Based on the symptoms described by the family, the epidemiological context of the region, and the logic of individual cases, they perform a differential diagnosis. In many cases, they establish a probable cause of death.

An investigator conducts a verbal autopsy with a family in Niakhar, Senegal.

© IRD - Abdoulaye Karim Sow

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This pragmatic approach has proven to be extremely useful: the research by IRD conducted in Morocco thirty years ago used the verbal autopsy technique and revealed that tetanus was the cause of death for an unexpected portion of newborn deaths. A vaccination campaign followed and helped save many lives. “More recently, this technique has shown the previously underestimated number of deaths related to primary liver cancer in Senegal”, the specialist stated. Preventative action based around vaccination for hepatitis B was established”. 

The use of digital tools (such as laptops, tablets, or smartphones) and questionnaires standardised by the WHO for entering and transmitting information directly to databases has helped improve the efficiency and efficacy of the technique. Recently, India was able to launch a study with an unprecedented scope, aiming to elucidate the cause of over 100,000 deaths.

Contact : Aldiouma Diallo