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Childhood cause-specific mortality in rural Western Kenya: application of the InterVA-4 model.

Abstract：

BACKGROUND:Assessing the progress in achieving the United Nation's Millennium Development Goals in terms of population health requires consistent and reliable information on cause-specific mortality, which is often rare in resource-constrained countries. Health and demographic surveillance systems (HDSS) have largely used medical personnel to review and assign likely causes of death based on the information gathered from standardized verbal autopsy (VA) forms. However, this approach is expensive and time consuming, and it may lead to biased results based on the knowledge and experience of individual clinicians. We assessed the cause-specific mortality for children under 5 years old (under-5 deaths) in Siaya County, obtained from a computer-based probabilistic model (InterVA-4). DESIGN:Successfully completed VA interviews for under-5 deaths conducted between January 2003 and December 2010 in the Kenya Medical Research Institute/US Centers for Disease Control and Prevention HDSS were extracted from the VA database and processed using the InterVA-4 (version 4.02) model for interpretation. Cause-specific mortality fractions were then generated from the causes of death produced by the model. RESULTS:A total of 84.33% (6,621) childhood deaths had completed VA data during the study period. Children aged 1-4 years constituted 48.53% of all cases, and 42.50% were from infants. A single cause of death was assigned to 89.18% (5,940) of cases, 8.35% (556) of cases were assigned two causes, and 2.10% (140) were assigned 'indeterminate' as cause of death by the InterVA-4 model. Overall, malaria (28.20%) was the leading cause of death, followed by acute respiratory infection including pneumonia (25.10%), in under-5 children over the study period. But in the first 5 years of the study period, acute respiratory infection including pneumonia was the main cause of death, followed by malaria. Similar trends were also reported in infants (29 days-11 months) and children aged 1-4 years. CONCLUSIONS:Under-5 cause-specific mortality obtained using the InterVA-4 model is consistent with existing knowledge on the burden of childhood diseases in rural western Kenya.

journal_name

Glob Health Action

journal_title

Global health action

authors

Amek NO,Odhiambo FO,Khagayi S,Moige H,Orwa G,Hamel MJ,Van Eijk A,Vulule J,Slutsker L,Laserson KF

doi

10.3402/gha.v7.25581

subject

Has Abstract

pub_date

2014-10-29 00:00:00

pages

25581

eissn

1654-9716

issn

1654-9880

pii

25581

journal_volume

pub_type

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Childhood cause-specific mortality in rural Western Kenya: application of the InterVA-4 model.