Mortality in rural coastal Kenya measured using the Kilifi Health and Demographic Surveillance System: a 16-year descriptive analysis

Wellcome Open Research

article

Mark Otiende¹  Evasius Bauni¹  Amek Nyaguara¹  David Amadi¹  Christopher Nyundo¹  Emmanuel Tsory¹  David Walumbe¹  Michael Kinuthia¹  Norbert Kihuha¹  Michael Kahindi¹  Gideon Nyutu¹  Jennifer Moisi¹  Amare Deribew¹  Ambrose Agweyu¹  Kevin Marsh²  Benjamin Tsofa¹  Philip Bejon¹  Christian Bottomley³  Thomas N. Williams¹  J. Anthony G. Scott¹ 

[1] Epidemiology and Demography, KEMRI-Wellcome Trust Research Programme;Nuffield Department of Clinical Medicine, University of Oxford;Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine

关键词: Child mortality;    adult mortality;    all-cause mortality;    demography;    demographic surveillance system;    mortality trends;    Kenya;   

DOI  :  10.12688/wellcomeopenres.17307.2

学科分类：内科医学

来源: Wellcome

【 摘 要 】

Background: The Kilifi Health and Demographic Surveillance System (KHDSS) was established in 2000 to define the incidence and prevalence of local diseases and evaluate the impact of community-based interventions. KHDSS morbidity data have been reported comprehensively but mortality has not been described. This analysis describes mortality in the KHDSS over 16 years.Methods: We calculated mortality rates from 2003–2018 in four intervals of equal duration and assessed differences in mortality across these intervals by age and sex. We calculated the period survival function and median survival using the Kaplan–Meier method and mean life expectancies using abridged life tables. We estimated trend and seasonality by decomposing a time series of monthly mortality rates. We used choropleth maps and random-effects Poisson regression to investigate geographical heterogeneity.Results: Mortality declined by 36% overall between 2003–2018 and by 59% in children aged <5 years. Most of the decline occurred between 2003 and 2006. Among adults, the greatest decline (49%) was observed in those aged 15–54 years. Life expectancy at birth increased by 12 years. Females outlived males by 6 years. Seasonality was only evident in the 1–4 year age group in the first four years. Geographical variation in mortality was ±10% of the median value and did not change over time.Conclusions: Between 2003 and 2018, mortality among children and young adults has improved substantially. The steep decline in 2003–2006 followed by a much slower reduction thereafter suggests improvements in health and wellbeing have plateaued in the last 12 years. However, there is substantial inequality in mortality experience by geographical location.

【 授权许可】

CC BY