A Reversal in Reductions of Child Mortality in Western Kenya, 2003–2009

Abstract

We report and explore changes in child mortality in a rural area of Kenya during 2003–2009, when major public health interventions were scaled-up. Mortality ratios and rates were calculated by using the Kenya Medical Research Institute/Centers for Disease Control and Prevention Demographic Surveillance System. Inpatient and outpatient morbidity and mortality, and verbal autopsy data were analyzed. Mortality ratios for children less than five years of age decreased from 241 to 137 deaths/1,000 live-births in 2003 and 2007 respectively. In 2008, they increased to 212 deaths/1,000 live-births. Mortality remained elevated during the first 8 months of 2009 compared with 2006 and 2007. Malaria and/or anemia accounted for the greatest increases in child mortality. Stock-outs of essential antimalarial drugs during a time of increased malaria transmission and disruption of services during civil unrest may have contributed to increased mortality in 2008–2009. To maintain gains in child survival, implementation of good policies and effective interventions must be complemented by reliable supply and access to clinical services and essential drugs.

The silent threat: asymptomatic parasitemia and malaria transmission

“…For example, in western Kenya, despite more than 10 years with high coverage of ITNs, parasite prevalence in children <5 years of age had declined from 83% in 1992 to only 41% by slide microscopy in 2009 [5,6]. Similar observations have been noted in areas formerly considered as high-transmission areas, such as Zambia [7] and Uganda [8].…”

Comparison of severe acute respiratory illness (sari) and clinical pneumonia case definitions for the detection of influenza virus infections among hospitalized patients, western Kenya, 2009‐2013

“…It is culturally homogenous and almost entirely rural. The area is endemic for malaria with a high child mortality rate (212 deaths per 1000 live births in 2008) 14 and a high HIV prevalence (14% in 2008) 15. In 2006–2008, the burden of acute lower respiratory illness—calculated using a modified version of the IMCI pneumonia case definition—was 0·36 episodes per year for children aged <5 years and 0·067 episodes per year for persons aged ≥5 years 9…”

Schistosoma mansoni Morbidity among School-Aged Children: A SCORE Project in Kenya

“…5,32 The positive association between S. mansoni and P. falciparum infections has been found in many studies 5,33,34 and may be driven by immunologic factors. [35][36][37] Anemia.…”