The Burden of Common Infectious Disease Syndromes at the Clinic and Household Level from Population-Based Surveillance in Rural and Urban Kenya
Open Access
- 18 January 2011
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 6 (1), e16085
- https://doi.org/10.1371/journal.pone.0016085
Abstract
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. 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. 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. 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.Keywords
This publication has 56 references indexed in Scilit:
- Global, regional, and national causes of child mortality in 2008: a systematic analysisThe Lancet, 2010
- Evaluation of the optimal recall period for disease symptoms in home-based morbidity surveillance in rural and urban KenyaInternational Journal of Epidemiology, 2010
- Strategy to Enhance Influenza Surveillance Worldwide1Emerging Infectious Diseases, 2009
- Long‐Term Safety and Efficacy of the RTS,S/AS02A Malaria Vaccine in Mozambican ChildrenThe Journal of Infectious Diseases, 2009
- Evaluation of RTS,S/AS02A and RTS,S/AS01B in Adults in a High Malaria Transmission AreaPLOS ONE, 2009
- Efficacy of RTS,S/AS01E Vaccine against Malaria in Children 5 to 17 Months of AgeNew England Journal of Medicine, 2008
- Child survival gains in Tanzania: analysis of data from demographic and health surveysThe Lancet, 2008
- Community Participation to Refine Measures of Socio-Economic Status in Urban Slum Settings in KenyaInternational Quarterly of Community Health Education, 2008
- Impact of Artemisinin-Based Combination Therapy and Insecticide-Treated Nets on Malaria Burden in ZanzibarPLoS Medicine, 2007
- Impact of home-based management of malaria on health outcomes in Africa: a systematic review of the evidenceMalaria Journal, 2007