Experience on postmortem minimally invasive tissue sampling to ascertain the cause of death determination in South African children: A case for implementing as standard of care
Determining the death burden for prioritising public health interventions necessitates detailed data on the causal pathways to death. Postmortem minimally invasive tissue sampling (MITS), incorporating histology, molecular and microbial culture diagnostics, enhances cause-of-death attributi...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
South African Medical Association
2024-02-01
|
| Series: | South African Medical Journal |
| Subjects: | |
| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1538 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823860574936629248 |
|---|---|
| author | J du Toit K Storath I Dunn P Makekeng M Moosa K Mothibi N Umuneza C A Rees D Blau S Lala Y Adam S Velaphi M Hale P Swart J Wadula L Mothibi A Wise V Baba P Jaglal S Mahtab S Madhi Z Dangor |
| author_facet | J du Toit K Storath I Dunn P Makekeng M Moosa K Mothibi N Umuneza C A Rees D Blau S Lala Y Adam S Velaphi M Hale P Swart J Wadula L Mothibi A Wise V Baba P Jaglal S Mahtab S Madhi Z Dangor |
| author_sort | J du Toit |
| collection | DOAJ |
| description |
Determining the death burden for prioritising public health interventions necessitates detailed data on the causal pathways to death. Postmortem minimally invasive tissue sampling (MITS), incorporating histology, molecular and microbial culture diagnostics, enhances cause-of-death attribution, particularly for infectious deaths. MITS proves a valid alternative to full diagnostic autopsies, especially in low- and middle-income countries. In Soweto, South Africa (SA), the Child Health and Mortality Prevention Surveillance (CHAMPS) programme has delineated over 1 000 child and stillbirth deaths since 2017. This SA CHAMPS site supports advocating for the use of postmortem MITS as routine practice, for more granular insights into under-5 mortality causes. This knowledge is crucial for SA’s pursuit of Sustainable Development Goal 3.2, targeting reduced neonatal and under-5 mortality rates. This commentary explores the public health advantages and ethicolegal considerations surrounding implementing MITS as standard of care for stillbirths, neonatal and paediatric deaths in SA. Furthermore, based on the data from CHAMPS, we present three pragmatic algorithmic approaches to the wide array of testing options for cost-effectiveness and scalability of postmortem MITS in South African state facilities.
|
| format | Article |
| id | doaj-art-6eaebbf694dd44b5ab323d105953b2d7 |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-6eaebbf694dd44b5ab323d105953b2d72025-02-10T12:26:26ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-02-01114210.7196/SAMJ.2024.v114i2.1538Experience on postmortem minimally invasive tissue sampling to ascertain the cause of death determination in South African children: A case for implementing as standard of careJ du Toit0K Storath1I Dunn2P Makekeng3M Moosa4K Mothibi5N Umuneza6C A Rees7D Blau8S Lala9Y Adam10S Velaphi11M Hale12P Swart13J Wadula14L Mothibi15A Wise16V Baba17P Jaglal18S Mahtab19S Madhi20Z Dangor21South African Medical Research Council Vaccines and Infectious Diseases Analytics Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaSouth African Medical Research Council Vaccines and Infectious Diseases Analytics Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaSouth African Medical Research Council Vaccines and Infectious Diseases Analytics Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaSouth African Medical Research Council Vaccines and Infectious Diseases Analytics Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaSouth African Medical Research Council Vaccines and Infectious Diseases Analytics Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaSouth African Medical Research Council Vaccines and Infectious Diseases Analytics Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaSouth African Medical Research Council Vaccines and Infectious Diseases Analytics Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaDivision of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, USA; Department of Emergency Medicine, Children’s Healthcare of Atlanta, USAGlobal Health Center, US Centers for Disease Control and Prevention, Atlanta, USAOffice for Teaching and Learning; and Paediatric Education and Research Ladder, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaDepartment of Obstetrics and Gynaecology, University of the Witwatersrand, and Chris Hani Baragwanath Academic HospitalJohannesburg, South AfricaDepartment of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg, South AfricaDepartment of Anatomical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaDepartment of Anatomical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africaepartment of Clinical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of Witwatersrand, National Health Laboratory Services, Chris Hani Baragwanath Academic Hospital, Johannesburg, South AfricaDepartment of Clinical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of Witwatersrand, National Health Laboratory Services, Chris Hani Baragwanath Academic Hospital, Johannesburg, South AfricaRahima Moosa Mother and Child Hospital, Obstetrics and Gynaecology, University of the Witwatersrand, Johannesburg, South AfricaDepartment of Obstetrics and Gynaecology, University of the Witwatersrand, and Chris Hani Baragwanath Academic Hospital, Johannesburg, South AfricaDepartment of Clinical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of Witwatersrand, National Health Laboratory Services, Chris Hani Baragwanath Academic Hospital, Johannesburg, South AfricaSouth African Medical Research Council Vaccines and Infectious Diseases Analytics Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaSouth African Medical Research Council Vaccines and Infectious Diseases Analytics Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Wits Infectious Diseases and Oncology Research Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaSouth African Medical Research Council Vaccines and Infectious Diseases Analytics Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Determining the death burden for prioritising public health interventions necessitates detailed data on the causal pathways to death. Postmortem minimally invasive tissue sampling (MITS), incorporating histology, molecular and microbial culture diagnostics, enhances cause-of-death attribution, particularly for infectious deaths. MITS proves a valid alternative to full diagnostic autopsies, especially in low- and middle-income countries. In Soweto, South Africa (SA), the Child Health and Mortality Prevention Surveillance (CHAMPS) programme has delineated over 1 000 child and stillbirth deaths since 2017. This SA CHAMPS site supports advocating for the use of postmortem MITS as routine practice, for more granular insights into under-5 mortality causes. This knowledge is crucial for SA’s pursuit of Sustainable Development Goal 3.2, targeting reduced neonatal and under-5 mortality rates. This commentary explores the public health advantages and ethicolegal considerations surrounding implementing MITS as standard of care for stillbirths, neonatal and paediatric deaths in SA. Furthermore, based on the data from CHAMPS, we present three pragmatic algorithmic approaches to the wide array of testing options for cost-effectiveness and scalability of postmortem MITS in South African state facilities. https://samajournals.co.za/index.php/samj/article/view/1538PaediatricInfectious diseasesPostmoterm |
| spellingShingle | J du Toit K Storath I Dunn P Makekeng M Moosa K Mothibi N Umuneza C A Rees D Blau S Lala Y Adam S Velaphi M Hale P Swart J Wadula L Mothibi A Wise V Baba P Jaglal S Mahtab S Madhi Z Dangor Experience on postmortem minimally invasive tissue sampling to ascertain the cause of death determination in South African children: A case for implementing as standard of care South African Medical Journal Paediatric Infectious diseases Postmoterm |
| title | Experience on postmortem minimally invasive tissue sampling to ascertain the cause of death determination in South African children: A case for implementing as standard of care |
| title_full | Experience on postmortem minimally invasive tissue sampling to ascertain the cause of death determination in South African children: A case for implementing as standard of care |
| title_fullStr | Experience on postmortem minimally invasive tissue sampling to ascertain the cause of death determination in South African children: A case for implementing as standard of care |
| title_full_unstemmed | Experience on postmortem minimally invasive tissue sampling to ascertain the cause of death determination in South African children: A case for implementing as standard of care |
| title_short | Experience on postmortem minimally invasive tissue sampling to ascertain the cause of death determination in South African children: A case for implementing as standard of care |
| title_sort | experience on postmortem minimally invasive tissue sampling to ascertain the cause of death determination in south african children a case for implementing as standard of care |
| topic | Paediatric Infectious diseases Postmoterm |
| url | https://samajournals.co.za/index.php/samj/article/view/1538 |
| work_keys_str_mv | AT jdutoit experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT kstorath experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT idunn experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT pmakekeng experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT mmoosa experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT kmothibi experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT numuneza experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT carees experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT dblau experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT slala experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT yadam experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT svelaphi experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT mhale experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT pswart experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT jwadula experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT lmothibi experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT awise experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT vbaba experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT pjaglal experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT smahtab experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT smadhi experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare AT zdangor experienceonpostmortemminimallyinvasivetissuesamplingtoascertainthecauseofdeathdeterminationinsouthafricanchildrenacaseforimplementingasstandardofcare |