Launch of the CaDMIA Project to Design New Tools for Investigating Causes of Death in Developing Countries

Two meetings held in February and March in Mozambique marked the launch of the CaDMIA project. The goals of this initiative are to design and test new tools for determining infectious causes of death and to evaluate the theoretical acceptability and actual feasibility of using these tools in different cultural, religious and geographical settings. The project is led by Dr. Quique Bassat, Dr. Clara Menéndez and Dr. Jaume Ordi of ISGlobal and its research centre CRESIB.

Clinicians, pathologists and microbiologists from Brazil, Mozambique and Spain who will participate in the project met for the first time in Maputo, Mozambique, between February 25 and March 1 this year. The purpose of the meeting was to decide on a technical protocol for validating Minimally Invasive Autopsy (MIA) and comparing it with Complete Diagnostic Autopsy, the chief objectives of the study that will be carried out in Manaus (Brazil) and Maputo (Mozambique). During the discussions, MIA was defined as a post-mortem sampling of various target organs using closed needle biopsies performed with or without the guidance of a scanner. The content of a future training workshop on diagnostic imaging principally aimed at pathologists was also developed at the same meeting.

The participants at a second meeting held in Maputo between 23 and 25 March discussed the design of a protocol intended to explore social factors that could encourage future acceptance of MIA in areas where post-mortem studies traditionally cannot be performed. In attendance were social scientists from the centres involved in the project: Gabon, Kenya, Mozambique and Pakistan (the representative from Mali was unable to attend). These experts emphasized that the key factor in achieving acceptance will be involving local people in the project—including religious leaders, politicians, community spokespersons and health professionals, as well as individuals who have recently suffered the loss of a close relative. With the help of these participants, it would be possible to design a plan for implementing MIA in rural areas that would take into account the idiosyncrasies specific to each cultural and religious environment.

In the coming months, working groups will develop the definitive technical and social protocols, which will then be submitted to the pertinent ethics committees of the participating centres so that the field work can commence.