Coding causes of death to statistical categories
A common problem in many countries is that the death certificate does not provide enough information for the coder to select a valid UCOD, as only the immediate COD is reported on line 1(a). Although it is acceptable to have a single COD, the cause should be based on all possible clinical information that could be derived from the deceased. For example, a healthy individual who has a sudden onset of severe malaria and dies within 24 hours may have only a single cause (malaria) entered in line 1(a).
In practice, most deaths result from a sequence of conditions, all of which should be noted on the death certificate and all of which should be considered when selecting and coding the UCOD. The problem of insufficiently detailed death certificates can only be resolved by querying physicians for further information. As few countries have a query system in place, deaths are often coded either incorrectly or to an ill-defined category for convenience. Coding the immediate COD as if it were the underlying cause means that the results of the aggregation stage will be misleading. The COD distribution will be distorted and incorrect.