A Reversal in Reductions of Child Mortality in Western Kenya, 2003–2009

Mary J. Hamel Malaria Branch, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, International Emerging Infections Program, Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya

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Kubaje Adazu Malaria Branch, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, International Emerging Infections Program, Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya

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David Obor Malaria Branch, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, International Emerging Infections Program, Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya

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Maquins Sewe Malaria Branch, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, International Emerging Infections Program, Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya

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John Vulule Malaria Branch, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, International Emerging Infections Program, Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya

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John M. Williamson Malaria Branch, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, International Emerging Infections Program, Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya

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Laurence Slutsker Malaria Branch, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, International Emerging Infections Program, Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya

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Daniel R. Feikin Malaria Branch, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, International Emerging Infections Program, Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya

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Kayla F. Laserson Malaria Branch, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, International Emerging Infections Program, Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya

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We report and explore changes in child mortality in a rural area of Kenya during 2003–2009, when major public health interventions were scaled-up. Mortality ratios and rates were calculated by using the Kenya Medical Research Institute/Centers for Disease Control and Prevention Demographic Surveillance System. Inpatient and outpatient morbidity and mortality, and verbal autopsy data were analyzed. Mortality ratios for children less than five years of age decreased from 241 to 137 deaths/1,000 live-births in 2003 and 2007 respectively. In 2008, they increased to 212 deaths/1,000 live-births. Mortality remained elevated during the first 8 months of 2009 compared with 2006 and 2007. Malaria and/or anemia accounted for the greatest increases in child mortality. Stock-outs of essential antimalarial drugs during a time of increased malaria transmission and disruption of services during civil unrest may have contributed to increased mortality in 2008–2009. To maintain gains in child survival, implementation of good policies and effective interventions must be complemented by reliable supply and access to clinical services and essential drugs.

Author Notes

*Address correspondence to Mary J. Hamel, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop F-22, Atlanta, GA 30333. E-mail: mhamel@cdc.gov
†Deceased.

Disclosure: None of the authors have any conflicts of interest.

Authors' addresses: Mary J. Hamel, Laurence Slutsker, and Daniel R. Feikin, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: mhamel@cdc.gov, lslutsker@cdc.gov, and dfeikin@jhsph.edu. David Obor and Maquins Sewe, KEMRI/CDC Research Station, Kisumu, Kenya, E-mails: dobor@ke.cdc.gov and msewe@ke.cdc.gov. John Vulule, Kenya Medial Research Institute, Kisumu, Kenya, E-mail: jvulule@ke.cdc.gov. John Williamson and Kayla Laserson, KEMRI/CDC Research Station, Unit 64112, E-mails: jwilliamson@ke.cdc.gov and klaserson@ke.cdc.gov.

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