Age-Specific Malaria Mortality Rates in the KEMRI/CDC Health and Demographic Surveillance System in Western Kenya, 2003–2010

Abstract

Recent global malaria burden modeling efforts have produced significantly different estimates, particularly in adult malaria mortality. To measure malaria control progress, accurate malaria burden estimates across age groups are necessary. We determined age-specific malaria mortality rates in western Kenya to compare with recent global estimates. We collected data from 148,000 persons in a health and demographic surveillance system from 2003–2010. Standardized verbal autopsies were conducted for all deaths; probable cause of death was assigned using the InterVA-4 model. Annual malaria mortality rates per 1,000 person-years were generated by age group. Trends were analyzed using Poisson regression. From 2003–2010, in children <5 years the malaria mortality rate decreased from 13.2 to 3.7 per 1,000 person-years; the declines were greatest in the first three years of life. In children 5–14 years, the malaria mortality rate remained stable at 0.5 per 1,000 person-years. In persons ≥15 years, the malaria mortality rate decreased from 1.5 to 0.4 per 1,000 person-years. The malaria mortality rates in young children and persons aged ≥15 years decreased dramatically from 2003–2010 in western Kenya, but rates in older children have not declined. Sharp declines in some age groups likely reflect the national scale up of malaria control interventions and rapid expansion of HIV prevention services. These data highlight the importance of age-specific malaria mortality ascertainment and support current strategies to include all age groups in malaria control interventions.

Assessment of submicroscopic infections and gametocyte carriage of Plasmodium falciparum during peak malaria transmission season in a community-based cross-sectional survey in western Kenya, 2012

“…This new distribution pattern might be a result of the decreased EIR over 9–16 years of interventions in this area. However, the finding that children 5–15 years old were a significant reservoir for potential transmission was consistent with the recent malaria epidemiology in western Kenya [1, 2, 31]. Many factors might account for the unique age patterns for parasitaemia and gametocytaemia observed in the present study.…”

Monocyte dysregulation and systemic inflammation during pediatric falciparum malaria

“…The clinic is located approximately 10 kilometers from the research laboratory at the Kenya Medical Research Institute research station in Kisian. Malaria transmission in this area is perennially high, with peaks coinciding with seasonal rains in May-July and October-November (31,71). The study population was almost exclusively of the Luo ethnicity.…”

Paediatric respiratory infections

“…A comparison of data relating to infant and child mortality from rural Kenya [1] with data from North America looking at hospitalisation with "radiologically proven pneumonia" [2] highlights the difference in challenges facing the different healthcare systems. In rural Kenya, infant and childhood mortality (60 and 20 per 1000 live births, respectively) remains very high when compared with that observed in developed countries, even though infant mortality almost halved over the 8 years (2003-2010) of the study.…”