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

Phillips-Howard, Penelope ORCID: https://orcid.org/0000-0003-1018-116X, Laserson, Kayla F., Amek, Nyaguara, Beynon, Caryl M., Angell, Sonia Y., Khagayi, Sammy, Byass, Peter, Hamel, Mary J., van Eijk, Anna ORCID: https://orcid.org/0000-0003-1635-1289, Zielinski-Gutierrez, Emily, Slutsker, Laurence, De Cock, Kevin M., Vulule, John and Odhiambo, Frank O. (2014) 'Deaths Ascribed to Non-Communicable Diseases among Rural Kenyan Adults Are Proportionately Increasing: Evidence from a Health and Demographic Surveillance System, 2003–2010'. PLoS ONE, Vol 9, Issue 11, e114010.

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Abstract

Background

Non-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 Findings

Between 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.

Conclusions

NCDs 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.

Item Type:	Article
Subjects:	WA Public Health > WA 105 Epidemiology WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WA Public Health > Statistics. Surveys > WA 900 Public health statistics
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1371/journal.pone.0114010
Depositing User:	Lynn Roberts-Maloney
Date Deposited:	17 Mar 2015 11:35
Last Modified:	13 Sep 2019 14:16
URI:	https://archive.lstmed.ac.uk/id/eprint/5021

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