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. 2014 Nov 26;9(11):e114010.
doi: 10.1371/journal.pone.0114010. eCollection 2014.

Deaths ascribed to non-communicable diseases among rural Kenyan adults are proportionately increasing: evidence from a health and demographic surveillance system, 2003-2010

Penelope A Phillips-Howard  1 , Kayla F Laserson  2 , Nyaguara Amek  3 , Caryl M Beynon  4 , Sonia Y Angell  5 , Sammy Khagayi  3 , Peter Byass  6 , Mary J Hamel  7 , Anne M van Eijk  8 , Emily Zielinski-Gutierrez  9 , Laurence Slutsker  7 , Kevin M De Cock  10 , John Vulule  3 , Frank O Odhiambo  3
Affiliations

Deaths ascribed to non-communicable diseases among rural Kenyan adults are proportionately increasing: evidence from a health and demographic surveillance system, 2003-2010

Penelope A Phillips-Howard et al. PLoS One. .

Abstract

Background: Non-communicable diseases (NCDs) result in more deaths globally than other causes. Monitoring systems require strengthening to attribute the NCD burden and deaths in low and middle-income countries (LMICs). Data from health and demographic surveillance systems (HDSS) can contribute towards this goal.

Methods and findings: Between 2003 and 2010, 15,228 deaths in adults aged 15 years (y) and older were identified retrospectively using the HDSS census and verbal autopsy in rural western Kenya, attributed into broad categories using InterVA-4 computer algorithms; 37% were ascribed to NCDs, 60% to communicable diseases (CDs), 3% to injuries, and <1% maternal causes. Median age at death for NCDs was 66y and 71y for females and males, respectively, with 43% (39% male, 48% female) of NCD deaths occurring prematurely among adults aged below 65y. NCD deaths were mainly attributed to cancers (35%) and cardio-vascular diseases (CVDs; 29%). The proportionate mortality from NCDs rose from 35% in 2003 to 45% in 2010 (χ2 linear trend 93.4; p<0.001). While overall annual mortality rates (MRs) for NCDs fell, cancer-specific MRs rose from 200 to 262 per 100,000 population, mainly due to increasing deaths in adults aged 65y and older, and to respiratory neoplasms in all age groups. The substantial fall in CD MRs resulted in similar MRs for CDs and NCDs among all adult females by 2010. NCD MRs for adults aged 15y to <65y fell from 409 to 183 per 100,000 among females and from 517 to 283 per 100,000 population among males. NCD MRs were higher among males than females aged both below, and at or above, 65y.

Conclusions: NCDs constitute a significant proportion of deaths in rural western Kenya. Evidence of the increasing contribution of NCDs to overall mortality supports international recommendations to introduce or enhance prevention, screening, diagnosis and treatment programmes in LMICs.

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Conflict of interest statement

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

Figures

Figure 1
Figure 1. Causes of deaths among all adults aged 15 years and above, rural western Kenya, 2003–2010.
A. Female Deaths. B. Male Deaths.
Figure 2
Figure 2. Comparison of median ages at death between CDs and NCDs by sex.
A. All Deaths. B. Deaths <65y.
Figure 3
Figure 3. Trends in absolute number of adult deaths attributed to CD and NCD causes in western Kenya, 2003–2010.
A. All Deaths. B. Deaths <65y. C. Deaths ≥65y.
Figure 4
Figure 4. Causes of NCDs deaths among adults in rural western Kenya, 2003
–2010. A. Female NCD Deaths. B. Male NCD Deaths.
Figure 5
Figure 5. Comparison of median ages of adult deaths by sex, for different NCD causes in rural western Kenya.
A. All Deaths. B. Deaths <65y.
See this image and copyright information in PMC

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