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Table 1 Overview of the method

From: Undereporting of acute pesticide poisoning in Tanzania: modelling results from two cross-sectional studies

Step 1

Health facility admissions in 3 regions of Tanzania over the period of 12 months were monitored prospectively from Jan 2006 to December 2006 using intensified surveillance to generate population-based estimates for the incidence of APP, stratified by circumstances of poisoning (occupational, accidental, suicide, homicide and unknown circumstances). These generated baseline APP rates for further adjustment.

Step 2

Data from a household survey of farmers was compared to records in health facilities to generate a ratio of occupational APP cases reported at health facilities, reflecting the extent of under-reporting of APP cases due to occupational circumstances. The 95% confidence interval for this ratio was used to generate a high and low boundary for the estimate.

Step 3

Cases of APP in the prospective study for which circumstances were unknown were allocated in a sensitivity analysis to each of the other four known circumstancesa, and the contribution of newly allocated occupational APP adjusted for under-reporting.

Step 4

The rate of occupational APP recorded at health facilities was adjusted to account for the under-reporting of occupational APP identified in Step 2, including high and low boundary estimates, and to account for reallocation of unknown to known circumstances as identified in in Step 3.

Step 5

Total APP incidence rates, summing across all circumstances, were generated under the different contingencies identified. The contribution of occupational poisoning as a proportion to overall APP incidence was described.

  1. a Known circumstances included suicide, occupational, accidental and homicide. However, because cases with homicide were so few (1.1% of all cases), the sensitivity analysis included homicide within the category accidental for allocation and only three circumstances were used for allocation: suicide, accidental and occupational