Causes of death among persons of all ages within the Kilifi Health and Demographic Surveillance System, Kenya, determined from verbal autopsies interpreted using the InterVA-4 model

Carolyne Ndila,Evasius Bauni,George Mochamah,Vysaul Nyirongo,Alex Makazi,Patrick Kosgei,Benjamin Tsofa,Gideon Nyutu,Anthony Etyang,Peter Byass,Thomas N Williams

doi:10.3402/gha.v7.25593

Abstract

Background The vast majority of deaths in the Kilifi study area are not recorded through official systems of vital registration. As a result, few data are available regarding causes of death in this population. Objective To describe the causes of death (CODs) among residents of all ages within the Kilifi Health and Demographic Surveillance System (KHDSS) on the coast of Kenya. Design Verbal autopsies (VAs) were conducted using the 2007 World Health Organization (WHO) standard VA questionnaires, and VA data further transformed to align with the 2012 WHO VA instrument. CODs were then determined using the InterVA-4 computer-based probabilistic model. Results Five thousand one hundred and eighty seven deaths were recorded between January 2008 and December 2011. VA interviews were completed for 4,460 (86%) deaths. Neonatal pneumonia and birth asphyxia were the main CODs in neonates; pneumonia and malaria were the main CODs among infants and children aged 1–4, respectively, while HIV/AIDS was the main COD for adult women of reproductive age. Road traffic accidents were more commonly observed among men than women. Stroke and neoplasms were common CODs among the elderly over the age of 65. Conclusions We have established the main CODs among people of all ages within the area served by the KHDSS on the coast of Kenya using the 2007 WHO VA questionnaire coded using InterVA-4. We hope that our data will allow local health planners to estimate the burden of various diseases and to allocate their limited resources more appropriately.

Highlights

The vast majority of deaths in the Kilifi study area are not recorded through official systems of vital registration
We have established the main CODs among people of all ages within the area served by the Kilifi Health and Demographic Surveillance System (KHDSS) on the coast of Kenya using the 2007 World Health Organization (WHO) Verbal autopsies (VAs) questionnaire coded using InterVA-4
Failure to identify an appropriate respondent was the main reason for missing data. Among those deaths in which a VA was performed, 57% occurred at home and 36% occurred in a health facility

Summary

Introduction

The vast majority of deaths in the Kilifi study area are not recorded through official systems of vital registration. Few data are available regarding causes of death in this population. Objective: To describe the causes of death (CODs) among residents of all ages within the Kilifi Health and Demographic Surveillance System (KHDSS) on the coast of Kenya. Neonatal pneumonia and birth asphyxia were the main CODs in neonates; pneumonia and malaria were the main CODs among infants and children aged 1Á4, respectively, while HIV/AIDS was the main COD for adult women of reproductive age. Road traffic accidents were more commonly observed among men than women. Conclusions: We have established the main CODs among people of all ages within the area served by the KHDSS on the coast of Kenya using the 2007 WHO VA questionnaire coded using InterVA-4. We hope that our data will allow local health planners to estimate the burden of various diseases and to allocate their limited resources more appropriately

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Discussion

Conclusion