Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Jan 18;6(1):e16085.
doi: 10.1371/journal.pone.0016085.

The burden of common infectious disease syndromes at the clinic and household level from population-based surveillance in rural and urban Kenya

Daniel R Feikin  1 , Beatrice Olack, Godfrey M Bigogo, Allan Audi, Leonard Cosmas, Barrack Aura, Heather Burke, M Kariuki Njenga, John Williamson, Robert F Breiman
Affiliations

The burden of common infectious disease syndromes at the clinic and household level from population-based surveillance in rural and urban Kenya

Daniel R Feikin et al. PLoS One. .

Abstract

Background: Characterizing infectious disease burden in Africa is important for prioritizing and targeting limited resources for curative and preventive services and monitoring the impact of interventions.

Methods: From June 1, 2006 to May 31, 2008, we estimated rates of acute lower respiratory tract illness (ALRI), diarrhea and acute febrile illness (AFI) among >50,000 persons participating in population-based surveillance in impoverished, rural western Kenya (Asembo) and an informal settlement in Nairobi, Kenya (Kibera). Field workers visited households every two weeks, collecting recent illness information and performing limited exams. Participants could access free high-quality care in a designated referral clinic in each site. Incidence and longitudinal prevalence were calculated and compared using Poisson regression.

Results: INCIDENCE RATES RESULTING IN CLINIC VISITATION WERE THE FOLLOWING: ALRI--0.36 and 0.51 episodes per year for children <5 years and 0.067 and 0.026 for persons ≥ 5 years in Asembo and Kibera, respectively; diarrhea--0.40 and 0.71 episodes per year for children <5 years and 0.09 and 0.062 for persons ≥ 5 years in Asembo and Kibera, respectively; AFI--0.17 and 0.09 episodes per year for children <5 years and 0.03 and 0.015 for persons ≥ 5 years in Asembo and Kibera, respectively. Annually, based on household visits, children <5 years in Asembo and Kibera had 60 and 27 cough days, 10 and 8 diarrhea days, and 37 and 11 fever days, respectively. Household-based rates were higher than clinic rates for diarrhea and AFI, this difference being several-fold greater in the rural than urban site.

Conclusions: Individuals in poor Kenyan communities still suffer from a high burden of infectious diseases, which likely hampers their development. Urban slum and rural disease incidence and clinic utilization are sufficiently disparate in Africa to warrant data from both settings for estimating burden and focusing interventions.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Overall mortality rates by age for Asembo and Kibera in areas of population-based surveillance.
See this image and copyright information in PMC

References

    1. Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010;375:1969–1987. - PubMed
    1. World Health Organization. Geneva: World Health Organization; 2010. World Health Statistics. Available: http://apps.who.int/whosis/data/Search.jsp?indicators=[Indicator].[SDEC].Members. Accessed: May 1, 2009.
    1. Amin AA, Marsh V, Noor AM, Ochola SA, Snow RW. The use of formal and informal curative services in the management of paediatric fevers in four districts in Kenya. Trop Med Int Health. 2003;8:1143–1152. - PubMed
    1. Central Bureau of Statistics (CBS) [Kenya] Ministry of Health Kenya, and ORC Macro. Calverton, Maryland, USA: Central Bureau of Statistics (CBS) [Kenya], Ministry of Health (MOH) [Kenya], and ORC Macro; 2004. Kenya Demographic and Health Survey 2003: Key Findings.
    1. Adazu K, Lindblade KA, Rosen DH, Odhiambo F, Ofware P, et al. Health and demographic surveillance in rural western Kenya: a platform for evaluating interventions to reduce morbidity and mortality from infectious diseases. Am J Trop Med Hyg. 2005;73:1151–1158. - PubMed

Publication types