Deaths Ascribed to Non-Communicable Diseases among Rural Kenyan Adults Are Proportionately Increasing: Evidence from a Health and Demographic Surveillance System, 2003–2010

Abstract

BackgroundNon-communicable diseases (NCDs) result in more deaths globally than other causes. Monitoring systems require strengthening to attribute the NCD burden and deaths in low and middle-income countries (LMICs). Data from health and demographic surveillance systems (HDSS) can contribute towards this goal.Methods and FindingsBetween 2003 and 2010, 15,228 deaths in adults aged 15 years (y) and older were identified retrospectively using the HDSS census and verbal autopsy in rural western Kenya, attributed into broad categories using InterVA-4 computer algorithms; 37% were ascribed to NCDs, 60% to communicable diseases (CDs), 3% to injuries, and <1% maternal causes. Median age at death for NCDs was 66y and 71y for females and males, respectively, with 43% (39% male, 48% female) of NCD deaths occurring prematurely among adults aged below 65y. NCD deaths were mainly attributed to cancers (35%) and cardio-vascular diseases (CVDs; 29%). The proportionate mortality from NCDs rose from 35% in 2003 to 45% in 2010 (χ2 linear trend 93.4; p<0.001). While overall annual mortality rates (MRs) for NCDs fell, cancer-specific MRs rose from 200 to 262 per 100,000 population, mainly due to increasing deaths in adults aged 65y and older, and to respiratory neoplasms in all age groups. The substantial fall in CD MRs resulted in similar MRs for CDs and NCDs among all adult females by 2010. NCD MRs for adults aged 15y to <65y fell from 409 to 183 per 100,000 among females and from 517 to 283 per 100,000 population among males. NCD MRs were higher among males than females aged both below, and at or above, 65y.ConclusionsNCDs constitute a significant proportion of deaths in rural western Kenya. Evidence of the increasing contribution of NCDs to overall mortality supports international recommendations to introduce or enhance prevention, screening, diagnosis and treatment programmes in LMICs.

Community-based screening for cardiovascular risk using a novel mHealth tool in rural Kenya

“…Non-communicable diseases (NCDs) account for two out of every three deaths worldwide 1. Of 36 million deaths linked with NCDs globally, 80% occur in low-and middle-income countries (LMICs).…”

“…Of 36 million deaths linked with NCDs globally, 80% occur in low-and middle-income countries (LMICs). The proportion of NCD deaths is expected to increase to 69% of all deaths by 2030 1. The relative increase in NCDs burden has been classified as a global crisis and interventions are needed to address the growing burden in African countries 1 , 2.…”

“…The proportion of NCD deaths is expected to increase to 69% of all deaths by 2030 1. The relative increase in NCDs burden has been classified as a global crisis and interventions are needed to address the growing burden in African countries 1 , 2. NCD deaths are mainly caused by cardiovascular disease (CVD), cancer, chronic respiratory disease and diabetes 3…”

“…Although the growing burden of NCDs in LMICs is well recognised, primary data from these countries are scarce and the disease burden may be underreported 1. It is estimated that up to 85% of individuals with diabetes and 66.3% of individuals with hypertension remain undiagnosed 4.…”

Validity of an FFQ to measure nutrient and food intakes in Tanzania

“…In this region, the number of cardiovascular deaths has nearly doubled from 1990 to 2015 (1) , the prevalence of diabetes has more than doubled from 1980 to 2014 (2) and the prevalence of hypertension and obesity are both increasing (3,4) . In rural SSA, the proportion of adult deaths due to non-communicable diseases has increased: from 16 % in 2003 to 24 % in 2007 in Tanzania (5) and from 35 % in 2003 to 45 % in 2010 in Kenya (6) . One of the potentially modifiable risk factors for noncommunicable diseases is diet, which is well documented to affect the risk for many cardiometabolic diseases and cancers (7)(8)(9)(10) .…”