The MRC/Wits-Agincourt Research Unit leads multinational Excess Mortality initiative

Kathy Kahn presenting on the use of verbal autopsy in mortality surveillance.

It’s been just over 2 years since Covid-19 was declared a pandemic on 30 January 2020 by the World Health Organization. As of 12 April 2022, the global number of confirmed Covid-19 deaths was over 6,2 million. Despite high levels of reported deaths, at least in countries with functioning civil registration and vital statistics (CRVS), these largely under-represent the true mortality due to COVID-19. A fundamental question, then, is what is the impact of COVID-19 on mortality and the scale of excess deaths, and the population sub-groups most affected, particularly in low- and middle-income settings? Excess mortality is a concept used in epidemiology for measuring the total number of deaths during pandemic conditions, including unrecorded Covid-19 deaths as well as other causes of deaths. Constructing a true representation of Covid-19 deaths can be useful for social policies and future pandemic preparedness planning.

Sammy Khagayi (Senior Data Analyst: Kenya Medical Research Institute (KEMRI)) engaged with the group in the discussion on verbal autopsy methods.

A multinational Excess Mortality initiative is being led by the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), at the University of the Witwatersrand, funded by the Bill and Melinda Gates Foundation, USA. The initiative aims to characterise all-cause and cause-specific (using verbal autopsy data) mortality rates and trends, by age and sex, across a range of rural and urban sub-Saharan African and South Asian settings under continuous health and demographic surveillance.

Solveig Argeseanu (Head: Demographic Surveillance System and Pregnancy Surveillance, Child Health and Mortality Prevention Surveillance (CHAMPS) Program Office) described the method of verbal and social autopsy (VASA) mortality surveillance to the group.

Strides were made on the Excess Mortality initiative when Dr Chodziwadziwa Kabudula of the MRC/Wits-Agincourt Research Unit and Prof Kobus Herbst of the South African Population Research Infrastructure Network (SAPRIN) co-hosted a 30 person face-to-face week-long data preparation workshop with data managers from all the participating research centres from 28 March-1 April 2022 at Wits University. The purpose of the workshop was to strengthen each site’s capacity to extract data from their respective databases into a common standard format.  This meant familiarising the research teams with the data collection system and quality assurance standards, harmonising the data to enable comparisons across the sites, and reviewing the historical mortality data. The workshop’s activities included presentations on data collection and analysis methods; and breakaway sessions for participants to work on, compare, and assist each other with constructing the data. This format, with dedicated time to focus on data, created a space for learning, support, and collaboration among the data managers.  

Data managers participating in an MRC/Wits-Agincourt Research Unit-led multinational initiative on Excess Mortality, met at the School of Public Health, University of Witwatersrand for a data preparation workshop.