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HEALTH AND DEMOGRAPHIC SURVEILLANCE IN RURAL WESTERN KENYA: A PLATFORM FOR EVALUATING INTERVENTIONS TO REDUCE MORBIDITY AND MORTALITY FROM INFECTIOUS DISEASES

We established a health and demographic surveillance system in a rural area of western Kenya to measure the burden of infectious diseases and evaluate public health interventions. After a baseline census, all 33,990 households were visited every four months. We collected data on educational attainment, socioeconomic status, pediatric outpatient visits, causes of death in children, and malaria transmission. The life expectancy at birth was 38 years, the infant mortality rate was 125 per 1000 live births, and the under-five mortality rate was 227 per 1,000 live births. The increased mortality rate in younger men and women suggests high human immunodeficiency virus/acquired immunodeficiency syndrome–related mortality in the population. Of 5,879 sick child visits, the most frequent diagnosis was malaria (71.5%). Verbal autopsy results for 661 child deaths (1 month to <12 years) implicated malaria (28.9%) and anemia (19.8%) as the most common causes of death in children. These data will provide a basis for generating further research questions, developing targeted interventions, and evaluating their impact.

Received November 30, 2004. Accepted for publication August 3, 2005.

Acknowledgments: We are grateful for the dedicated performance of the field and data management staff of the HDSS and for the collaboration of our partners in Asembo and Gem. We thank KEMRI and CDC/KEMRI administrative staff for the support they provided and continue to provide to the project. We are particularly grateful to Sabina Dunton for directing overall operations for CDC/KEMRI. We also thank the residents of Asembo and Gem for their continued participation. This paper was published with the approval of the director of the Kenya Medical Research Institute.

Financial support: This project was supported by the U.S. Centers for Disease Control and Prevention.

Disclaimers: 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. Use of trade names is for identification only and does not imply endorsement by U.S. Public Health Service or Department of Health and Human Services.

^* Address correspondence to Kim A. Lindblade, AE Guatemala Unit 3321, APO, AA 34024. E-mail: kil2{at}@cdc.gov

Authors’ addresses: Kubaje Adazu, Frank Odhiambo, Peter Ofware, James Kwach, Anna M. van Eijk, Pauli Amornkul, Diana Karanja, John M. Vulule, and Laurence Slutsker, Kenya Medical Research Institute, Centre for Vector Biology and Control Research, P.O. Box 1578, Kisumu, Kenya, Telephone: 254-572-022902, Fax: 254-572-022981. Kim A. Lindblade, AE Guatemala Unit 3321, APO, AA 34024, Telephone: 502-5995-5780, Fax: 502-2369-7539. Daniel H. Rosen, Global AIDs Program, Centers for Disease Control and Prevention, 38 Samora Machel Avenue, Harare, Zimbabwe, Telephone: 263-4-796040. Kevin M. Decock, CDC/Kenya, Kenya Medical Research Institute, Mbagathi Road, Nairobi, Kenya, Telephone: 254-2-713008, Fax: 254-2-714745.

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