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EVALUATING THE COMPLETENESS OF DEMOGRAPHIC SURVEILLANCE OF CHILDREN LESS THAN FIVE YEARS OLD IN WESTERN KENYA: A CAPTURE-RECAPTURE APPROACH

We evaluated the completeness and differential ascertainment of vital events in children less than five years old registered in two rounds of a demographic surveillance system (DSS) in western Kenya using a two-sample capture-recapture. The primary lists consisted of births and child deaths identified by two rounds of the DSS conducted in October 2000 and August 2001. The secondary lists consisted of births and child deaths identified independently from two surveys of 5,000 randomly selected households conducted immediately after each DSS round, covering the same population over the same time period. Analysis of the overlap between lists yielded the following sensitivities for the two DSS rounds: 62% and 49%, respectively, for identifying neonatal deaths (<1 month); 72% and 78%, respectively, for post-neonatal child deaths (1–59 months); and 88% and 78%, respectively, for identifying newborns. Female deaths were less likely to be reported than male deaths. The primary limitation of using capture-recapture in this setting was difficulty in matching between lists due to inconsistent dates of birth and death and variability in spelling of names. Assuming limitations of current methods are sufficiently addressed, capture-recapture appears to be a useful tool in evaluating DSS completeness and differential ascertainment of vital events.

Received February 4, 2003. Accepted for publication April 26, 2003.

Acknowledgments: We express our gratitude to the villagers of Asembo and Gem for their participation in this research. George Olang, James Kwach, Michael Onyango, Richard Otieno, and Maurice Ombok are thanked for their field and data management skills. We are grateful to the Centers for Disease Control and Prevention/Kenya Medical Research Institute administrative team for their support. We thank Dr. William A. Hawley for reviewing the manuscript, and the Director of the Kenya Medical Research Institute for his permission to publish this manuscript.

Financial support: This research was funded by the United States Agency for International Development.

Disclaimer: The opinions or assertions contained in this manuscript are the private ones of the authors and are not to be construed as official or reflecting the views of the U.S. Public Health Service or Department of Health and Human Services.

Authors’ addresses: Thomas P. Eisele, 3243 Dellwood Road, Cleveland Heights, OH 44118. E-mail: teisele{at}tulane.edu. Kim A. Lindblade, Daniel H. Rosen, Frank Odhiambo, John M. Vulule, and Laurence Slutsker, Centers for Disease Control and Prevention/Kenya Medical Research Institute, PO Box 1578, Kisumu, Kenya.