Minimally Invasive Tissue Sampling in Preterm Deaths: A Validation Study

Author:

Hailu Rahell1ORCID,Desta Tigist1,Bekuretsion Yonas1,Bezabih Messele2,Alemu Addisu3,Bekele Tiruzer4,Abebe Bewketu4,Asefa Mesfin2,Tigabu Zemene2,Girma Yonas1,Eshetu Beza2ORCID,Abayneh Mahlet3,Mekasha Amha1,Nigussie Assaye Kassie5,McClure Elizabeth M6,Goldenberg Robert L7,Muhe Lulu M1ORCID

Affiliation:

1. Addis Ababa University, Addis Ababa, Ethiopia

2. St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

3. Jimma University, Jimma, Ethiopia

4. University of Gondar, Gondar, Ethiopia

5. Bill and Melinda Gates Foundation, Seattle, WA, USA

6. RTI International, Durham, NC, USA

7. Columbia University, New York, NY, USA

Abstract

Uncertainty about the causes of neonatal deaths impedes achieving global health targets to reduce mortality. Complete diagnostic autopsy (CDA) is the gold standard to determine cause of death. However, it is often difficult to perform in high-burden, low-income settings. Validations of more feasible methods to determine cause of death are needed. This prospective, multi-center study in Ethiopia assessed the validity of the minimally invasive tissue sampling (MITS) approach to contribute to causes of death in preterm neonates compared to CDA. The MITS and CDA of 105 cases were reviewed. The MITS sampling success for lungs and liver was 100% and 84%, respectively. The kidney and brain had sampling successes of 58% each. MITS showed good agreement with CDA for the diagnosis of hyaline membrane disease (kappa = 0.78), and moderate to substantial agreement for pneumonia and pulmonary hemorrhage (kappa = 0.59 and 0.68, respectively). Even though CDA is the gold standard in identifying the cause of death, we believe that the MITS method can be a useful alternative method in supporting determination of cause of death in low-resource settings.

Funder

Bill & Melinda Gates Foundation

Publisher

SAGE Publications

Subject

Pediatrics,Pediatrics, Perinatology and Child Health

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