The extent of misclassification of causes of death: a case study of Emalahleni Municipality, Mpumalanga Province, South Africa

Christine CG Khoza, Statistics South Africa

Based on manual and computer linkage of death certificate and hospital record data, cause-of-death data are compared for 1292 in-hospital deaths for deceased aged 15-49 years that occurred in Emalahleni Municipality in 2003-2005. The purpose of record linkage is to establish the extent to which causes of death are misclassified on death certificates. Results show that there is a statistically significant relationship between hospital of death and agreement of underlying cause. The study concludes that causes of death for the age group 15-49 were misclassified to a large extent in Emalahleni Municipality during the study period given the overall agreement of underlying cause of 56%. Infectious diseases and diseases of the respiratory system are more likely to be misclassified upon death certification compared to diseases of the circulatory system. Deaths due to HIV/AIDS are misclassified to several other diseases.