Accuracy of cause-of-death statements on death certificates; before and after a training program in Kuwait

Population-based mortality statistics are derived from the information recorded on death 1ertificates. Many physicians did not receive adequate training in completing death certulcates resulting in undermining the quality of the data derived from death certificates. A training program for all certifier physicians in Kuwait has been conducted. The objective of this study was to examine improving the accuracy of death certificates for coding and the results of an audit of death certificate accuracy before and after this training program. An educational intervention was designed and implemented to improve accuracy in death certificate completion. A total of 2020 death certificates [986 completed before and 1034 completed after the intervention] were audited for major and minor errors, and the proportion of errors before and after the intervention was compared. Major errors were identified in 69.1% of the death certificates completed before the intervention. Following the intervention the major error proportion decreased to 34.6% [P=0.001]. The reduction in the major error proportion was accounted for by significant reductions in the proportion of listing of mechanism of death whiteout a legitimate underlying cause of death [27.0% v. 18.4%, P=0.001] and the proportion of improper sequencing of death certificate information [41.8% v. 15.9% P=0.001]. No improvement in minor errors or demographic errors. Errors are common in the completion of death certificates in Kuwait. The accuracy of death certification can be improved with the implementation of a simple educational intervention

Youth and middle aged mortality in Kuwait [1987 - 1998]

This study assesses the proportionate mortality [PM] from the major causes of death among youth [20-34 year] and middle-aged population [35-64 year] in the years 1987-1998 in Kuwait. Deaths in the records were classified according to the Ninth Revision of the international Classification of Death [ICD-9], proportionate mortality computed for all causes of death combined and for the upper ranked 10 cause groups. The results revealed that PM among youth increased significantly from 7.6% in the pre-invasion period [1987-1989] to 10.8% in the early post-invasion period [1991-1994] and then started to decline reaching to 9.8% in the late post-invasion period [1995-1998]. On the other hand, the PM among middle aged population increased steadily from 32.1% in the pre-invasion to 33.3% and 34.9% in the post-invasion periods. The study also revealed that fatalities due to external causes constituted a major health problem among youth in Kuwait and the main cause of death is road transport accidents which accounted for 28.5% of all deaths among youth each year during the study periods. The second and third causes were ischaemic heart disease [7.6%] and consequences of violence [6.8%]. On the other hand, fatalities due to cardiovascular diseases constituted a major health problem among the middle aged individuals and the three leading causes of death were ischaemic heart disease. hypertensive disease and road transport accidents respectively Digestive system malignancy ranked fifth and malignancy of respiratory and intrathoracic organs ranked tenth. The results revealed that the main causes of death are the same among Kuwaiti and non-Kuwaiti segments with some differences in ranking order and frequency

Cataract, diabetes, and risk of cataract extraction among Arabs in Kuwait

The prevalence of diabetes among 352 Arab patients of two ethnic constitution [Kuwaiti and non-Kuwaiti] who had cataract extraction in the year 1983 was found to be 21%. The highest prevalence was among Kuwaiti females [28%], which matched that of the general population for the some age, sex, and ethnic constitution. Kuwaiti diabetics required cataract extraction at an earlier age in both sexes, but the difference for non-Kuwaiti was not significant. The annual rate of cataract extraction was higher for Kuwaiti in all age groups and in both sexes compared to non-Kuwaiti Arabs, and females in both groups had a higher rate than males. A high prevalence of prehensile cataract extraction in this population, reaching up to 58%, was documented. The presence of diabetes appeared to be a significant risk factor for the Arab female to have character extraction but not for the male