Deaths Ascribed to Non-Communicable Diseases among Rural Kenyan Adults Are Proportionately Increasing: Evidence from a Health and Demographic Surveillance System, 2003–2010
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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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As life expectancies increase, women across low and middle-income countries are more likely to experience uterine or cervical cancers, both of which cause vaginal bleeding.
“As life expectancies increase, women across LMIC are more likely to experience uterine or cervical cancers,19 both of which cause vaginal bleeding.”
From Beyond menstrual hygiene: addressing vaginal bleeding throughout the life course in low and middle-income countries (2017) · cites this paper as [19]
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- Authors
- Phillips-Howard, P. A., Laserson, K. F., Amek, N., Beynon, C. M., Angell, S. Y., Khagayi, S., Byass, P., Hamel, M. J., van Eijk, A. M., Zielinski-Gutierrez, E., Slutsker, L., De Cock, K. M., Vulule, J., & Odhiambo, F. O.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Liverpool John Moores University (GB)
- Kenya Medical Research Institute (KE)
- Umeå University (SE)
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-11-26
- Volume
- 9
- Issue
- 11
- Pages
- e114010
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4245262
- OpenAlex
- W2007972844
- Cited by
- 33
- References
- 61
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 3 · 2022: 9 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 6 · 2017: 2 · 2016: 1
- FWCI
- 1.82
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, public-domain)
- Europe PMC (PubMed Central) (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- LSTM Online Archive (Liverpool School of Tropical Medicine) (acceptedVersion)
- DiVA at Umeå University (Umeå University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Health Professions › Health Information Management › Global Health and Epidemiology
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Social Sciences › Demography › Insurance, Mortality, Demography, Risk Management
- Keywords
- non-communicable diseases, adult mortality, rural Kenya, verbal autopsy, InterVA-4, cancer mortality, cardiovascular mortality, respiratory neoplasms, premature mortality, sex differences in mortality, age at death, infectious diseases, health and demographic surveillance system, Western Kenya, low- and middle-income countries
- MeSH terms
- Adolescent, Adult, Aged, Cardiovascular Diseases, Cause of Death, Communicable Diseases, Data Collection, Female, Humans, Kenya, Kidney Diseases, Lung Diseases, Male, Metabolic Diseases, Middle Aged, Neoplasms, Population Surveillance, Retrospective Studies, Risk Factors, Rural Population, Young Adult
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