Volume 73, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


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.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. INDEPTH, 2001. Population and Health in Developing Countries. Volume 1. Population, Health, and Survival at INDEPTH Sites. Ottawa, Ontario, Canada: International Development Research Centre.
  2. Binka FN, Ngom P, Phillips JF, Adazu K, MacLeod BB, 1999. Assessing population dynamics in a rural African society: the Navrongo Demographic Surveillance System. J Biosoc Sci 31 : 375–391. [Google Scholar]
  3. Armstrong Schellenberg JRM, Abdulla S, Minja H, Nathan R, Mukasa O, Marchant T, Mponda H, Nikumbih N, Lyimo EO, Manchester T, Tanner M, Lengeler C, 1999. KINET: a social marketing programme of treated nets and net treatment for malaria control in Tanzania, with evaluation of child health and long-term survival. Trans R Soc Trop Med Hyg 93 : 225–231. [Google Scholar]
  4. Phillips-Howard PA, Nahlen BL, Alaii JA, ter Kuile FO, Gimnig JE, Terlouw DJ, Kachur SP, Hightower AW, Lal AA, Schoute E, Oloo AJ, Hawley WA, 2003. The efficacy of permethrin-treated bednets on child mortality and morbidity in western Kenya. I: development of infrastructure and description of study site. Am J Trop Med Hyg 68 (Suppl 4): 3–9. [Google Scholar]
  5. Lindblade KA, Eisele TP, Gimnig JE, Alaii JA, Odhiambo F, ter Kuile FO, Hawley WA, Wannemuehler KA, Phillips-Howard PA, Rosen DH, Nahlen BL, Terlouw DJ, Adazu K, Vulule JM, Slutsker L, 2004. Sustainability of reductions in malaria transmission and infant mortality in western Kenya with use of insecticide-treated bednets: 4 to 6 years of follow-up. JAMA 291 : 2571–2580. [Google Scholar]
  6. Phillips-Howard PA, Nahlen BL, Kolczak MS, Hightower AW, ter Kuile FO, Alaii JA, Gimnig JE, Arudo J, Vulule JM, Odhacha A, Kachur SP, Schoute E, Rosen DH, Sexton JD, Oloo AJ, Hawley WA, 2003. Efficacy of permethrin-treated bed nets in the prevention of mortality in young children in an area of high perennial malaria transmission in western Kenya. Am J Trop Med Hyg 68 (Suppl 4): 23–29. [Google Scholar]
  7. Gimnig JE, Vulule JM, Lo TQ, Kamau L, Kolczak MS, Phillips-Howard PA, Mathenge EM, ter Kuile FO, Nahlen BL, High-tower AW, Hawley WA, 2003. Impact of permethrin-treated bed nets on entomologic indices in an area of intense year-round malaria transmission. Am J Trop Med Hyg 68 (Suppl 4): 16–22. [Google Scholar]
  8. Phillips-Howard PA, Nahlen BL, Wannemuehler KA, Kolczak MS, ter Kuile FO, Gimnig JE, Olson K, Alaii JA, Odhacha A, Vulule JM, Hawley WA, 2003. Impact of permethrin-treated bed nets on the incidence of sick child visits to peripheral health facilities. Am J Trop Med Hyg 68 (Suppl 4): 38–43. [Google Scholar]
  9. Kenya Ministry of Health, 2003. National Leprosy and Tuberculosis Program Annual Report - 2003. Nairobi, Kenya: Kenya Ministry of Health.
  10. Hightower AW, Ombok M, Otieno R, Odhiambo R, Oloo AJ, Lal AA, Nahlen BL, Hawley WA, 1998. A geographic information system applied to a malaria field study in western Kenya. Am J Trop Med Hyg 58 : 266–272. [Google Scholar]
  11. Wirtz RA, Zavala F, Charoenvit Y, Campbell GH, Burkot TR, Schneider I, Esser KM, Beaudoin RL, Andre RG, 1987. Comparative testing of monoclonal antibodies against Plasmodium falciparum sporozoites for ELISA development. Bull World Health Organ 65 : 39–45. [Google Scholar]
  12. Lines JD, Curtis CF, Wilkes TJ, Njumwa KJ, 1991. Monitoring human-biting mosquitoes (Diptera: Culicidae) in Tanzania with light-traps hung beside mosquito nets. Bull Entomol Res 81 : 77–84. [Google Scholar]
  13. Population Reference Bureau, 2004. 2004 World Population Data Sheet. Washington, DC: Population Reference Bureau.
  14. UNICEF, 2004. The State of the World’s Children 2005. New York: United Nations.
  15. Central Bureau of Statistics, (Kenya), Ministry of Health (Kenya), ORC Macro, 2004. Kenya Demographic and Health Survey 2003. Calverton, MD: CBS, MOH and ORC Macro.
  16. McElroy PD, ter Kuile FO, Hightower AW, Hawley WA, Phillips-Howard PA, Oloo AJ, Lal AA, Nahlen BL, 2001. All-cause mortality among young children in western Kenya. VI: The Asembo Bay cohort project. Am J Trop Med Hyg 64 (Suppl): 18–27. [Google Scholar]
  17. Preston SH, Heuveline P, Guillot M, 2001. Demography: Measuring and Modeling Population Processes. Oxford, United Kingdom: Blackwell Publishers.
  18. Kenya Ministry of Health, 2003. HIV/AIDS Surveillance in Kenya. Nairobi, Kenya: National AIDS and STD Control.
  19. Vetter KM, Djomand G, Zadi F, Diaby L, Brattegaard K, Timite M, Andoh J, Adou JA, De Cock KM, 1996. Clinical spectrum of human immunodeficiency virus disease in children in a west African city. Project RETRO-CI. Pediatr Infect Dis 15 : 438–442. [Google Scholar]
  20. Nunn AJ, Mulder DW, Kamali A, Ruberantwari A, Kengeya-Kayondo JF, Whitworth J, 1997. Mortality associated with HIV-1 infection over five years in a rural Ugandan population: cohort study. BMJ 315 : 767–771. [Google Scholar]
  21. Quigley MA, Armstrong Schellenberg JR, Snow RW, 1996. Algorithms for verbal autopsies: a validation study in Kenyan children. Bull World Health Organ 74 : 147–154. [Google Scholar]
  22. Beier JC, Killeen GF, Githure JI, 1999. Short report: etomologic inoculation rates and Plasmodium falciparum malaria prevalence in Africa. Am J Trop Med Hyg 61 : 109–113. [Google Scholar]
  23. MacLeod B, Phillips JF, 1998. The Household Registration System. The Population Council, New York, NY.
  24. de Savigny D, Binka F, 2004. Monitoring future impact on malaria burden in sub-Saharan Africa. Am J Trop Med Hyg 71 (2 Suppl): 224–231. [Google Scholar]

Data & Media loading...

  • Received : 30 Nov 2004
  • Accepted : 03 Aug 2005

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error