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Maternal, Child and Reproductive Health


Continued validation of the minimally invasive autopsy for the investigation of the causes of death in infants, and establishment of a research and training center to study causes of death

Photo: Quique Bassat
01/01/2016 – 31/12/2018
Jaume Ordi
Funded by
Bill & Melinda Gates Foundation (OPP1128001)

Project Description

 The CaDMIA study, funded by the Bill & Melinda Gates Foundation and coordinated by ISGlobal from January 2013 to December 2015, has demonstrated that the minimally invasive autopsy (MIA) tool can be used as a substitute for complete diagnostic autopsies (CDA) for cause of death determination (CoD) in all age groups. Preliminary results have shown that concordance between MIA and CDA is high, particularly for infectious causes of death.

The CaDMIA study has also highlighted, in different cultural, religious and geographical environments, an overall theoretical high acceptance of MIA by next of kin of deceased individuals, who also seem to be willing to know the causes of death of their loved ones. Altogether, these encouraging preliminary results have fueled the interest of funders and research groups for the potential use of MIAs as a tool to be used in real life conditions for CoD investigations in places where CDAs are unfeasible or unacceptable.

The CaDMIA-plus project, to be developed from January 2016 to December 2018 by ISGlobal together with CISM and the Maputo’s Central Hospital aims to:

  • Continue the validation of the minimally invasive tissue sampling (MIA) tool for its wider use for cause of death surveillance in children from developing countries
  • Create a training and research center for the evaluation of cause of death that can support current and future initiatives and research in this topic

CaDMIA-plus is coordinated by ISGlobal and is developed in the Central Hospital of Maputo, the Health Research Center in Manhiça and the Hospital Clinic at the University of Barcelona. The team also collaborats with the CHAMPS project, an international surveillance network of child mortality epidemiology, funded by the Bill & Melinda Gates Foundation and coordinated by the Emory University and the Centre of Disease Control (CDC), USA.   


  • Continue the validation of the MITS technique as compared to the complete autopsy to determine the causes of death in pediatric cases (including still births, neonates and children under five)
  • Adjust the MITS methodology for the study of specific conditions such as diarrheal diseases, malnutrition and anemia  
  • Determine the diagnosis threshold of MITS according to the time since death  
  • Evaluate the percentage of agreement in the diagnosis of causes of death with MITS and complete autopsy as compared to the verbal autopsy   
  • Establish a research and training center for post-mortem studies  


ISGlobal staff involved:

  • Jaume Ordi (PI)
  • Quique Bassat (co-PI)
  • Clara Menéndez (co-PI)
  • Paola Castillo (Senior pathologist)
  • Mikel Martínez (Senior microbiologist)
  • Juan Carlos Hurtado (Microbiologist)
  • Llorenç Quintó (Statistics)
  • Lorena Marimon (Lab technician)
  • Mireia Navarro (Lab technician)
  • Ariadna Sanz (Project manager)


Related publications:


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