MIAs are useful in determining the cause of death in settings where performing a full diagnostic autopsy is not possible, says Emily Gurley, director of the Centre for Communicable Diseases at the icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh).
While complete diagnostic autopsies are considered to be more accurate, MIA offers an alternative method in remote and resource-poor areas, according to a press note released by icddr,b in April.
“MIA is logistically much easier to perform,” Gurley tells SciDev.Net. “It takes less than one hour and does not require the same kind of specialised training as a full autopsy, although some additional training is required.”
According to Gurley, MIAs are also “more acceptable to families because no organs are removed, there are no large wounds or stitching on the body, and it does not delay burial in a significant way.”
Results from the icddr,b study in Faridpur Medical College Hospital in southern Bangladesh where surveillance for acute meningo-encephalitis and acute respiratory illness was ongoing show that MIAs can be easily implemented in hospitals.
Conventional autopsies are difficult to perform when there is a lack of facilities and trained personnel or when there are a large number of deaths occurring outside the public health system or there are cultural or religious reservations about performing procedures on a dead body.
In Bangladesh where Islamic principles against violating the sanctity of the dead body are a major barrier to destructive autopsy methods, MIAs are an acceptable option.
Gurley and her colleagues first found MIAs or post-mortem needle biopsies acceptable during an outbreak of the Nipah virus in 2009. Family members of victims and religious community leaders were convinced that MIAs benefited the community and society at large.
Fazlul Karim, former professor of forensics at the Comilla Medical College and Hospital and currently practitioner at the Dhaka Community Hospital, tells SciDev.Net that MIA has many advantages such as speed and reliability, but calls for better facilities and training.
"Our hospitals do not use modern technology to perform MIA as a better and more reliable option for lack of support and logistics. In most cases autopsies are done hastily, without following proper procedures,” Karim said.
This article has been produced by SciDev.Net's South Asia desk.