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2. Sustained impact of 10-valent pneumococcal conjugate vaccine on invasive pneumococcal disease in Kenya, 2011-2022

Author

Kagucia, E Wangeci, primary, Nyamwaya, Brian, additional, Ongayo, Gerald, additional, Kaniu, Mary, additional, Sang, Samuel, additional, Lucinde, Ruth K, additional, Karani, Angela, additional, Akech, Donald, additional, Odiwuor, Fredrick, additional, Mataza, Christine, additional, Tabu, Collins, additional, Mturi, Neema, additional, Ndaa, Siti, additional, Mulunda, Caroline, additional, Etyang, Timothy, additional, Aliyan, Nadia, additional, Nyaguara, Amek, additional, Voller, Shirine, additional, Bottomley, Christian, additional, Hammitt, Laura, additional, Adetifa, Ifedayo M. O, additional, and Scott, Anthony, additional

Published
2024
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4. Pregnancy-related mortality up to 1 year postpartum in sub-Saharan Africa : an analysis of verbal autopsy data from six countries

Author

Gazeley, Ursula, Reniers, Georges, Romero-Prieto, Julio E., Calvert, Clara, Jasseh, Momodou, Herbst, Kobus, Khagayi, Sammy, Obor, David, Kwaro, Daniel, Dube, Albert, Dheresa, Merga, Kabudula, Chodziwadziwa W., Kahn, Kathleen, Urassa, Mark, Nyaguara, Amek, Temmerman, Marleen, Magee, Laura A., von Dadelszen, Peter, Filippi, Veronique, Gazeley, Ursula, Reniers, Georges, Romero-Prieto, Julio E., Calvert, Clara, Jasseh, Momodou, Herbst, Kobus, Khagayi, Sammy, Obor, David, Kwaro, Daniel, Dube, Albert, Dheresa, Merga, Kabudula, Chodziwadziwa W., Kahn, Kathleen, Urassa, Mark, Nyaguara, Amek, Temmerman, Marleen, Magee, Laura A., von Dadelszen, Peter, and Filippi, Veronique

Abstract

Objective: To compare the causes of death for women who died during pregnancy and within the first 42 days postpartum with those of women who died between >42 days and within 1 year postpartum. Design: Open population cohort (Health and Demographic Surveillance Systems). Setting: Ten Health and Demographic Surveillance Systems (HDSS) in The Gambia, Kenya, Malawi, Tanzania, Ethiopia and South Africa. Population: 2114 deaths which occurred within 1 year of the end of pregnancy where a verbal autopsy interview was conducted from 2000 to 2019. Methods: InterVA5 and InSilicoVA verbal autopsy algorithms were used to attribute the most likely underlying cause of death, which were grouped according to adapted International Classification of Diseases-Maternal Mortality categories. Multinomial regression was used to compare differences in causes of deaths within 42 days versus 43–365 days postpartum adjusting for HDSS and time period (2000–2009 and 2010–2019). Main outcome measures: Cause of death and the verbal autopsy Circumstances of Mortality Categories (COMCATs). Results: Of 2114 deaths, 1212 deaths occurred within 42 days postpartum and 902 between 43 and 365 days postpartum. Compared with deaths within 42 days, deaths from HIV and TB, other infectious diseases, and non-communicable diseases constituted a significantly larger proportion of late pregnancy-related deaths beyond 42 days postpartum, and health system failures were important in the circumstances of those deaths. The contribution of HIV and TB to deaths beyond 42 days postpartum was greatest in Southern Africa. The causes of pregnancy-related mortality within and beyond 42 days postpartum did not change significantly between 2000–2009 and 2010–2019. Conclusions: Cause of death data from the extended postpartum period are critical to inform prevention. The dominance of HIV and TB, other infectious and non-communicable diseases to (late) pregnancy-related mortality highlights the need for better integration

Published
2024
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7. Modelling the relationship between malaria prevalence as a measure of transmission and mortality across age groups

Author

Sammy Khagayi, Meghna Desai, Nyaguara Amek, Vincent Were, Eric Donald Onyango, Christopher Odero, Kephas Otieno, Godfrey Bigogo, Stephen Munga, Frank Odhiambo, Mary J. Hamel, Simon Kariuki, Aaron M. Samuels, Laurence Slutsker, John Gimnig, and Penelope Vounatsou

Subjects
Malaria, Mortality, Parasite prevalence, Bayesian spatio-temporal, Health and demographic surveillance system, Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Parasite prevalence has been used widely as a measure of malaria transmission, especially in malaria endemic areas. However, its contribution and relationship to malaria mortality across different age groups has not been well investigated. Previous studies in a health and demographic surveillance systems (HDSS) platform in western Kenya quantified the contribution of incidence and entomological inoculation rates (EIR) to mortality. The study assessed the relationship between outcomes of malaria parasitaemia surveys and mortality across age groups. Methods Parasitological data from annual cross-sectional surveys from the Kisumu HDSS between 2007 and 2015 were used to determine malaria parasite prevalence (PP) and clinical malaria (parasites plus reported fever within 24 h or temperature above 37.5 °C). Household surveys and verbal autopsy (VA) were used to obtain data on all-cause and malaria-specific mortality. Bayesian negative binomial geo-statistical regression models were used to investigate the association of PP/clinical malaria with mortality across different age groups. Estimates based on yearly data were compared with those from aggregated data over 4 to 5-year periods, which is the typical period that mortality data are available from national demographic and health surveys. Results Using 5-year aggregated data, associations were established between parasite prevalence and malaria-specific mortality in the whole population (RRmalaria = 1.66; 95% Bayesian Credible Intervals: 1.07–2.54) and children 1–4 years (RRmalaria = 2.29; 1.17–4.29). While clinical malaria was associated with both all-cause and malaria-specific mortality in combined ages (RRall-cause = 1.32; 1.01–1.74); (RRmalaria = 2.50; 1.27–4.81), children 1–4 years (RRall-cause = 1.89; 1.00–3.51); (RRmalaria = 3.37; 1.23–8.93) and in older children 5–14 years (RRall-cause = 3.94; 1.34–11.10); (RRmalaria = 7.56; 1.20–39.54), no association was found among neonates, adults (15–59 years) and the elderly (60+ years). Distance to health facilities, socioeconomic status, elevation and survey year were important factors for all-cause and malaria-specific mortality. Conclusion Malaria parasitaemia from cross-sectional surveys was associated with mortality across age groups over 4 to 5 year periods with clinical malaria more strongly associated with mortality than parasite prevalence. This effect was stronger in children 5–14 years compared to other age-groups. Further analyses of data from other HDSS sites or similar platforms would be useful in investigating the relationship between malaria and mortality across different endemicity levels.

Published
2019
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9. Symptom prevalence and secondary attack rate of SARS‐CoV‐2 in rural Kenyan households: A prospective cohort study

Author

Gallagher, Katherine E., primary, Nyiro, Joyce, additional, Agoti, Charles N., additional, Maitha, Eric, additional, Nyagwange, James, additional, Karani, Angela, additional, Bottomley, Christian, additional, Murunga, Nickson, additional, Githinji, George, additional, Mutunga, Martin, additional, Ochola‐Oyier, Lynette Isabella, additional, Kombe, Ivy, additional, Nyaguara, Amek, additional, Kagucia, E. Wangeci, additional, Warimwe, George, additional, Agweyu, Ambrose, additional, Tsofa, Benjamin, additional, Bejon, Philip, additional, Scott, J. Anthony G., additional, and Nokes, David James, additional

Published
2023
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10. SARS‐CoV‐2 seroprevalence and implications for population immunity: Evidence from two Health and Demographic Surveillance System sites in Kenya, February–December 2022

Author

Kagucia, E. Wangeci, primary, Ziraba, Abdhala K., additional, Nyagwange, James, additional, Kutima, Bernadette, additional, Kimani, Makobu, additional, Akech, Donald, additional, Ng'oda, Maurine, additional, Sigilai, Antipa, additional, Mugo, Daisy, additional, Karanja, Henry, additional, Gitonga, John, additional, Karani, Angela, additional, Toroitich, Monica, additional, Karia, Boniface, additional, Otiende, Mark, additional, Njeri, Anne, additional, Aman, Rashid, additional, Amoth, Patrick, additional, Mwangangi, Mercy, additional, Kasera, Kadondi, additional, Ng'ang'a, Wangari, additional, Voller, Shirine, additional, Ochola‐Oyier, Lynette I., additional, Bottomley, Christian, additional, Nyaguara, Amek, additional, Munywoki, Patrick K., additional, Bigogo, Godfrey, additional, Maitha, Eric, additional, Uyoga, Sophie, additional, Gallagher, Katherine E., additional, Etyang, Anthony O., additional, Barasa, Edwine, additional, Mwangangi, Joseph, additional, Bejon, Philip, additional, Adetifa, Ifedayo M. O., additional, Warimwe, George M., additional, Scott, J. Anthony G., additional, and Agweyu, Ambrose, additional

Published
2023
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11. Pregnancy‐related mortality up to 1 year postpartum in sub‐Saharan Africa: an analysis of verbal autopsy data from six countries

Author

Gazeley, Ursula, primary, Reniers, Georges, additional, Romero‐Prieto, Julio E., additional, Calvert, Clara, additional, Jasseh, Momodou, additional, Herbst, Kobus, additional, Khagayi, Sammy, additional, Obor, David, additional, Kwaro, Daniel, additional, Dube, Albert, additional, Dheresa, Merga, additional, Kabudula, Chodziwadziwa W., additional, Kahn, Kathleen, additional, Urassa, Mark, additional, Nyaguara, Amek, additional, Temmerman, Marleen, additional, Magee, Laura A., additional, von Dadelszen, Peter, additional, and Filippi, Veronique, additional

Published
2023
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17. Symptom prevalence and Secondary Attack Rate of SARS-CoV-2 in Rural Kenyan Households: a prospective cohort study

Author

Gallagher, Katherine, primary, Nyiro, Joyce, additional, Agoti, Charles, additional, Nyagwange, James, additional, Karani, Angela, additional, Bottomley, Christian, additional, Murunga, Nickson, additional, Githinji, George, additional, Mutunga, Martin, additional, Ochola-Oyier, Lynette, additional, Kombe, Ivy, additional, Nyaguara, Amek, additional, Kagucia, E Wangeci, additional, Warimwe, George, additional, Agweyu, Ambrose, additional, Tsofa, Benjamin, additional, Bejon, Philip, additional, Scott, J, additional, and Nokes, David, additional

Published
2023
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18. Pregnancy-related mortality up to 1 year postpartum in sub-Saharan Africa : an analysis of verbal autopsy data from six countries

Author

Gazeley, Ursula, Reniers, Georges, Romero-Prieto, Julio E., Calvert, Clara, Jasseh, Momodou, Herbst, Kobus, Khagayi, Sammy, Obor, David, Kwaro, Daniel, Dube, Albert, Dheresa, Merga, Kabudula, Chodziwadziwa W., Kahn, Kathleen, Urassa, Mark, Nyaguara, Amek, Temmerman, Marleen, Magee, Laura A., von Dadelszen, Peter, Filippi, Veronique, Gazeley, Ursula, Reniers, Georges, Romero-Prieto, Julio E., Calvert, Clara, Jasseh, Momodou, Herbst, Kobus, Khagayi, Sammy, Obor, David, Kwaro, Daniel, Dube, Albert, Dheresa, Merga, Kabudula, Chodziwadziwa W., Kahn, Kathleen, Urassa, Mark, Nyaguara, Amek, Temmerman, Marleen, Magee, Laura A., von Dadelszen, Peter, and Filippi, Veronique

Abstract

Objective: To compare the causes of death for women who died during pregnancy and within the first 42 days postpartum with those of women who died between >42 days and within 1 year postpartum. Design: Open population cohort (Health and Demographic Surveillance Systems). Setting: Ten Health and Demographic Surveillance Systems (HDSS) in The Gambia, Kenya, Malawi, Tanzania, Ethiopia and South Africa. Population: 2114 deaths which occurred within 1 year of the end of pregnancy where a verbal autopsy interview was conducted from 2000 to 2019. Methods: InterVA5 and InSilicoVA verbal autopsy algorithms were used to attribute the most likely underlying cause of death, which were grouped according to adapted International Classification of Diseases-Maternal Mortality categories. Multinomial regression was used to compare differences in causes of deaths within 42 days versus 43–365 days postpartum adjusting for HDSS and time period (2000–2009 and 2010–2019). Main outcome measures: Cause of death and the verbal autopsy Circumstances of Mortality Categories (COMCATs). Results: Of 2114 deaths, 1212 deaths occurred within 42 days postpartum and 902 between 43 and 365 days postpartum. Compared with deaths within 42 days, deaths from HIV and TB, other infectious diseases, and non-communicable diseases constituted a significantly larger proportion of late pregnancy-related deaths beyond 42 days postpartum, and health system failures were important in the circumstances of those deaths. The contribution of HIV and TB to deaths beyond 42 days postpartum was greatest in Southern Africa. The causes of pregnancy-related mortality within and beyond 42 days postpartum did not change significantly between 2000–2009 and 2010–2019. Conclusions: Cause of death data from the extended postpartum period are critical to inform prevention. The dominance of HIV and TB, other infectious and non-communicable diseases to (late) pregnancy-related mortality highlights the need for better integration

Published
2023
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19. Observational study: 27 years of severe malaria surveillance in Kilifi, Kenya

Author

Njuguna, Patricia, Maitland, Kathryn, Nyaguara, Amek, Mwanga, Daniel, Mogeni, Polycarp, Mturi, Neema, Mohammed, Shebe, Mwambingu, Gabriel, Ngetsa, Caroline, Awuondo, Kenedy, Lowe, Brett, Adetifa, Ifedayo, Scott, J. Anthony G., Williams, Thomas N., Atkinson, Sarah, Osier, Faith, Snow, Robert W., Marsh, Kevin, Tsofa, Benjamin, Peshu, Norbert, Hamaluba, Mainga, Berkley, James A., Newton, Charles R. J., Fondo, John, Omar, Anisa, and Bejon, Philip

Published
2019
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20. Mortality in rural coastal Kenya measured using the Kilifi Health and Demographic Surveillance System: a 16-year descriptive analysis

Author

Otiende, Mark, primary, Bauni, Evasius, additional, Nyaguara, Amek, additional, Amadi, David, additional, Nyundo, Christopher, additional, Tsory, Emmanuel, additional, Walumbe, David, additional, Kinuthia, Michael, additional, Kihuha, Norbert, additional, Kahindi, Michael, additional, Nyutu, Gideon, additional, Moisi, Jennifer, additional, Deribew, Amare, additional, Agweyu, Ambrose, additional, Marsh, Kevin, additional, Tsofa, Benjamin, additional, Bejon, Philip, additional, Bottomley, Christian, additional, Williams, Thomas N., additional, and Scott, J. Anthony G., additional

Published
2023
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23. Sero-surveillance for IgG to SARS-CoV-2 at antenatal care clinics in three Kenyan referral hospitals: Repeated cross-sectional surveys 2020–21

Author

Lucinde, Ruth K., primary, Mugo, Daisy, additional, Bottomley, Christian, additional, Karani, Angela, additional, Gardiner, Elizabeth, additional, Aziza, Rabia, additional, Gitonga, John N., additional, Karanja, Henry, additional, Nyagwange, James, additional, Tuju, James, additional, Wanjiku, Perpetual, additional, Nzomo, Edward, additional, Kamuri, Evans, additional, Thuranira, Kaugiria, additional, Agunda, Sarah, additional, Nyutu, Gideon, additional, Etyang, Anthony O., additional, Adetifa, Ifedayo M. O., additional, Kagucia, Eunice, additional, Uyoga, Sophie, additional, Otiende, Mark, additional, Otieno, Edward, additional, Ndwiga, Leonard, additional, Agoti, Charles N., additional, Aman, Rashid A., additional, Mwangangi, Mercy, additional, Amoth, Patrick, additional, Kasera, Kadondi, additional, Nyaguara, Amek, additional, Ng’ang’a, Wangari, additional, Ochola, Lucy B., additional, Namdala, Emukule, additional, Gaunya, Oscar, additional, Okuku, Rosemary, additional, Barasa, Edwine, additional, Bejon, Philip, additional, Tsofa, Benjamin, additional, Ochola-Oyier, L. Isabella, additional, Warimwe, George M., additional, Agweyu, Ambrose, additional, Scott, J. Anthony G., additional, and Gallagher, Katherine E., additional

Published
2022
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25. Bayesian spatio-temporal modeling of mortality in relation to malaria incidence in Western Kenya.

Author

Sammy Khagayi, Nyaguara Amek, Godfrey Bigogo, Frank Odhiambo, and Penelope Vounatsou

Subjects
Medicine, Science
Abstract

The effect of malaria exposure on mortality using health facility incidence data as a measure of transmission has not been well investigated. Health and demographic surveillance systems (HDSS) routinely capture data on mortality, interventions and other household related indicators, offering a unique platform for estimating and monitoring the incidence-mortality relationship in space and time.Mortality data from the HDSS located in Western Kenya collected from 2007 to 2012 and linked to health facility incidence data were analysed using Bayesian spatio-temporal survival models to investigate the relation between mortality (all-cause/malaria-specific) and malaria incidence across all age groups. The analysis adjusted for insecticide-treated net (ITN) ownership, socio-economic status (SES), distance to health facilities and altitude. The estimates obtained were used to quantify excess mortality due to malaria exposure.Our models identified a strong positive relationship between slide positivity rate (SPR) and all-cause mortality in young children 1-4 years (HR = 4.29; 95% CI: 2.78-13.29) and all ages combined (HR = 1.55; 1.04-2.80). SPR had a strong positive association with malaria-specific mortality in young children (HR = 9.48; 5.11-37.94), however, in older children (5-14 years), it was associated with a reduction in malaria specific mortality (HR = 0.02; 0.003-0.33).SPR as a measure of transmission captures well the association between malaria transmission intensity and all-cause/malaria mortality. This offers a quick and efficient way to monitor malaria burden. Excess mortality estimates indicate that small changes in malaria incidence substantially reduce overall and malaria specific mortality.

Published
2017
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26. SARS-CoV-2 seroprevalence in three Kenyan health and demographic surveillance sites, December 2020-May 2021

Author

Etyang, Anthony O., primary, Adetifa, Ifedayo, additional, Omore, Richard, additional, Misore, Thomas, additional, Ziraba, Abdhalah K., additional, Ng’oda, Maurine A., additional, Gitau, Evelyn, additional, Gitonga, John, additional, Mugo, Daisy, additional, Kutima, Bernadette, additional, Karanja, Henry, additional, Toroitich, Monica, additional, Nyagwange, James, additional, Tuju, James, additional, Wanjiku, Perpetual, additional, Aman, Rashid, additional, Amoth, Patrick, additional, Mwangangi, Mercy, additional, Kasera, Kadondi, additional, Ng’ang’a, Wangari, additional, Akech, Donald, additional, Sigilai, Antipa, additional, Karia, Boniface, additional, Karani, Angela, additional, Voller, Shirine, additional, Agoti, Charles N., additional, Ochola-Oyier, Lynette I., additional, Otiende, Mark, additional, Bottomley, Christian, additional, Nyaguara, Amek, additional, Uyoga, Sophie, additional, Gallagher, Katherine, additional, Kagucia, Eunice W., additional, Onyango, Dickens, additional, Tsofa, Benjamin, additional, Mwangangi, Joseph, additional, Maitha, Eric, additional, Barasa, Edwine, additional, Bejon, Philip, additional, Warimwe, George M., additional, Scott, J. Anthony G., additional, and Agweyu, Ambrose, additional

Published
2022
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28. Efficiency of transplacental transfer of respiratory syncytial virus (RSV) specific antibodies among pregnant women in Kenya

Author

Nyiro, Joyce U., primary, Bukusi, Elizabeth, additional, Mwaengo, Dufton, additional, Nyaguara, Amek, additional, Nyawanda, Bryan, additional, Otieno, Nancy, additional, Bigogo, Godfrey, additional, Murunga, Nickson, additional, Widdowson, Marc-Alain, additional, Verani, Jennifer R., additional, Chaves, Sandra S., additional, Mwangudza, Hope, additional, Odundo, Calleb, additional, Berkley, James A., additional, Nokes, D James, additional, and Munywoki, Patrick K., additional

Published
2022
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29. Maintaining laboratory quality assurance and safety in a pandemic: Experiences from the KEMRI-Wellcome Trust Research Programme laboratory’s COVID-19 response

Author

Gumba, Horace, primary, Opiyo, Michael, additional, Musyoki, Jennifer, additional, Mutunga, Martin, additional, Ngetsa, Caroline, additional, Mwarumba, Salim, additional, Mosobo, Moses, additional, Njuguna, Susan, additional, Kai, Oscar, additional, Lambisia, Arnold W., additional, Kimani, Domtila, additional, Cheruiyot, Robinson, additional, Kiyuka, Patience, additional, Lewa, Clement, additional, Gicheru, Elijah, additional, Tendwa, Metrine, additional, Said Mohammed, Khadija, additional, Osoti, Victor, additional, Makale, Johnstone, additional, Tawa, Brian, additional, Odundo, Calleb, additional, Cheruiyot, Wesley, additional, Nyamu, Wilfred, additional, Gumbi, Wilson, additional, Mwacharo, Jedidah, additional, Nyamako, Lydia, additional, Otieno, Edward, additional, Amadi, David, additional, Ouma, Nelson, additional, Karia, Boniface, additional, Thoya, Janet, additional, Karani, Angela, additional, Mugo, Daisy, additional, Gichuki, Bonface M., additional, Riako, Debra, additional, Mutua, Shadrack, additional, Gitonga, John N., additional, Ominde, Kelly, additional, Wanjiku, Perpetual, additional, Mutiso, Agnes, additional, Mwanzu, Alfred, additional, Sein, Yiakon, additional, Bartilol, Brian, additional, Mwangi, Shaban, additional, Omuoyo, Donwilliams O., additional, Morobe, John M., additional, de Laurent, Zaydah R., additional, Mitsanze, Fredrick, additional, Mwakubia, Alfred, additional, Rono, Martin, additional, Nyaguara, Amek, additional, Tsofa, Benjamin, additional, Bejon, Philip, additional, Agoti, Charles N., additional, and Ochola-Oyier, Lynette Isabella, additional

Published
2022
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30. Comparing verbal autopsy cause of death findings as determined by physician coding and probabilistic modelling: a public health analysis of 54 000 deaths in Africa and Asia

Author

Peter Byass, Kobus Herbst, Edward Fottrell, Mohamed M. Ali, Frank Odhiambo, Nyaguara Amek, Mary J. Hamel, Kayla F. Laserson, Kathleen Kahn, Chodziwadziwa Kabudula, Paul Mee, Jon Bird, Robert Jakob, Osman Sankoh, and Stephen M. Tollman

Subjects
verbal autopsy, physician coding, InterVA–4, comparison, Medicine, Public aspects of medicine, RA1-1270
Abstract

Background: Coverage of civil registration and vital statistics varies globally, with most deaths in Africa and Asia remaining either unregistered or registered without cause of death. One important constraint has been a lack of fit–for–purpose tools for registering deaths and assigning causes in situations where no doctor is involved. Verbal autopsy (interviewing care–givers and witnesses to deaths and interpreting their information into causes of death) is the only available solution. Automated interpretation of verbal autopsy data into cause of death information is essential for rapid, consistent and affordable processing. Methods: Verbal autopsy archives covering 54182 deaths from five African and Asian countries were sourced on the basis of their geographical, epidemiological and methodological diversity, with existing physician–coded causes of death attributed. These data were unified into the WHO 2012 verbal autopsy standard format, and processed using the InterVA–4 model. Cause–specific mortality fractions from InterVA–4 and physician codes were calculated for each of 60 WHO 2012 cause categories, by age group, sex and source. Results from the two approaches were assessed for concordance and ratios of fractions by cause category. As an alternative metric, the Wilcoxon matched–pairs signed ranks test with two one–sided tests for stochastic equivalence was used. Findings: The overall concordance correlation coefficient between InterVA–4 and physician codes was 0.83 (95% CI 0.75 to 0.91) and this increased to 0.97 (95% CI 0.96 to 0.99) when HIV/AIDS and pulmonary TB deaths were combined into a single category. Over half (53%) of the cause category ratios between InterVA–4 and physician codes by source were not significantly different from unity at the 99% level, increasing to 62% by age group. Wilcoxon tests for stochastic equivalence also demonstrated equivalence. Conclusions: These findings show strong concordance between InterVA–4 and physician–coded findings over this large and diverse data set. Although these analyses cannot prove that either approach constitutes absolute truth, there was high public health equivalence between the findings. Given the urgent need for adequate cause of death data from settings where deaths currently pass unregistered, and since the WHO 2012 verbal autopsy standard and InterVA–4 tools represent relatively simple, cheap and available methods for determining cause of death on a large scale, they should be used as current tools of choice to fill gaps in cause of death data.

Published
2015
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31. Impact of Intermittent Presumptive Treatment for Malaria in Pregnancy on Hospital Birth Outcomes on the Kenyan Coast.

Author

Kamau, Alice, Musau, Moses, Mwakio, Stella, Amadi, David, Nyaguara, Amek, Bejon, Philip, Seale, Anna C, Berkley, James A, and Snow, Robert W

Subjects
MALARIA prevention, COMBINATION drug therapy, CONFIDENCE intervals, MULTIPLE regression analysis, PREVENTIVE health services, PREGNANCY outcomes, RISK assessment, LOW birth weight, PERINATAL death, SULFANILAMIDES, PREGNANCY complications, DESCRIPTIVE statistics, ANTIMALARIALS, ODDS ratio, SECONDARY analysis, PREGNANCY
Abstract

Background Intermittent preventive treatment (IPTp) for pregnant women with sulfadoxine–pyrimethamine (SP) is widely implemented for the prevention of malaria in pregnancy and adverse birth outcomes. The efficacy of SP is declining, and there are concerns that IPTp may have reduced impact in areas of high resistance. We sought to determine the protection afforded by SP as part of IPTp against adverse birth outcomes in an area with high levels of SP resistance on the Kenyan coast. Methods A secondary analysis of surveillance data on deliveries at the Kilifi County Hospital between 2015 and 2021 was undertaken in an area of low malaria transmission and high parasite mutations associated with SP resistance. A multivariable logistic regression model was developed to estimate the effect of SP doses on the risk of low birthweight (LBW) deliveries and stillbirths. Results Among 27 786 deliveries, 3 or more doses of IPTp-SP were associated with a 27% reduction in the risk of LBW (adjusted odds ratio [aOR], 0.73; 95% confidence interval [CI],.64–.83; P <.001) compared with no dose. A dose-response association was observed with increasing doses of SP from the second trimester linked to increasing protection against LBW deliveries. Three or more doses of IPTp-SP were also associated with a 21% reduction in stillbirth deliveries (aOR, 0.79; 95% CI,.65–.97; P =.044) compared with women who did not take any dose of IPTp-SP. Conclusions The continued significant association of SP on LBW deliveries suggests that the intervention may have a non-malaria impact on pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Published
2023
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32. Mortality in rural coastal Kenya measured using the Kilifi Health and Demographic Surveillance System: a 16-year descriptive analysis

Author

Otiende, Mark, primary, Bauni, Evasius, additional, Nyaguara, Amek, additional, Amadi, David, additional, Nyundo, Christopher, additional, Tsory, Emmanuel, additional, Walumbe, David, additional, Kinuthia, Michael, additional, Kihuha, Norbert, additional, Kahindi, Michael, additional, Nyutu, Gideon, additional, Moisi, Jennifer, additional, Deribew, Amare, additional, Agweyu, Ambrose, additional, Marsh, Kevin, additional, Tsofa, Benjamin, additional, Bejon, Philip, additional, Bottomley, Christian, additional, Williams, Thomas N., additional, and Scott, J. Anthony G., additional

Published
2021
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33. Deaths ascribed to non-communicable diseases among rural Kenyan adults are proportionately increasing: evidence from a health and demographic surveillance system, 2003-2010.

Author

Penelope A Phillips-Howard, Kayla F Laserson, Nyaguara Amek, Caryl M Beynon, Sonia Y Angell, Sammy Khagayi, Peter Byass, Mary J Hamel, Anne M van Eijk, Emily Zielinski-Gutierrez, Laurence Slutsker, Kevin M De Cock, John Vulule, and Frank O Odhiambo

Subjects
Medicine, Science
Abstract

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.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

Published
2014
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34. Age-specific malaria mortality rates in the KEMRI/CDC health and demographic surveillance system in western Kenya, 2003-2010.

Author

Meghna Desai, Ann M Buff, Sammy Khagayi, Peter Byass, Nyaguara Amek, Annemieke van Eijk, Laurence Slutsker, John Vulule, Frank O Odhiambo, Penelope A Phillips-Howard, Kimberly A Lindblade, Kayla F Laserson, and Mary J Hamel

Subjects
Medicine, Science
Abstract

Recent global malaria burden modeling efforts have produced significantly different estimates, particularly in adult malaria mortality. To measure malaria control progress, accurate malaria burden estimates across age groups are necessary. We determined age-specific malaria mortality rates in western Kenya to compare with recent global estimates. We collected data from 148,000 persons in a health and demographic surveillance system from 2003-2010. Standardized verbal autopsies were conducted for all deaths; probable cause of death was assigned using the InterVA-4 model. Annual malaria mortality rates per 1,000 person-years were generated by age group. Trends were analyzed using Poisson regression. From 2003-2010, in children

Published
2014
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35. Anti-Severe Acute Respiratory Syndrome Coronavirus 2 Immunoglobulin G Antibody Seroprevalence Among Truck Drivers and Assistants in Kenya

Author

Kagucia, E Wangeci, Gitonga, John N, Kalu, Catherine, Ochomo, Eric, Ochieng, Benard, Kuya, Nickline, Karani, Angela, Nyagwange, James, Karia, Boniface, Mugo, Daisy, Karanja, Henry K, Tuju, James, Mutiso, Agnes, Maroko, Hosea, Okubi, Lucy, Maitha, Eric, Ajuck, Hossan, Mukabi, David, Moracha, Wycliffe, Bulimu, David, Andanje, Nelson, Aman, Rashid, Mwangangi, Mercy, Amoth, Patrick, Kasera, Kadondi, Ng'ang'a, Wangari, Nyaguara, Amek, Voller, Shirine, Otiende, Mark, Bottomley, Christian, Agoti, Charles N, Ochola-Oyier, Lynette I, Adetifa, Ifedayo MO, Etyang, Anthony O, Gallagher, Katherine E, Uyoga, Sophie, Barasa, Edwine, Bejon, Philip, Tsofa, Benjamin, Agweyu, Ambrose, Warimwe, George M, Scott, J Anthony G, and Magarini Sub-County TDA SARS-CoV-2 Serosurveillance Team, The Bu

Subjects
viruses, virus diseases, human activities
Abstract

In October 2020, anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G seroprevalence among truck drivers and their assistants (TDA) in Kenya was 42.3%, higher than among healthcare workers and blood donors. Truck drivers and their assistants transport essential supplies during the coronavirus disease 2019 pandemic, placing them at increased risk of being infected and of transmitting SARS-CoV-2 over a wide geographical area.

Published
2021

36. Maintaining laboratory quality assurance and safety in a pandemic: Experiences from the KEMRI-Wellcome Trust Research Programme laboratory’s COVID-19 response

Author

Gumba, Horace, primary, Opiyo, Michael, additional, Musyoki, Jennifer, additional, Mutunga, Martin, additional, Ngetsa, Caroline, additional, Mwarumba, Salim, additional, Mosobo, Moses, additional, Njuguna, Susan, additional, Kai, Oscar, additional, Lambisia, Arnold W., additional, Kimani, Domtila, additional, Cheruiyot, Robinson, additional, Kiyuka, Patience, additional, Lewa, Clement, additional, Gicheru, Elijah, additional, Tendwa, Metrine, additional, Said Mohammed, Khadija, additional, Osoti, Victor, additional, Makale, Johnstone, additional, Tawa, Brian, additional, Odundo, Calleb, additional, Cheruiyot, Wesley, additional, Nyamu, Wilfred, additional, Gumbi, Wilson, additional, Mwacharo, Jedidah, additional, Nyamako, Lydia, additional, Otieno, Edward, additional, Amadi, David, additional, Ouma, Nelson, additional, Karia, Boniface, additional, Thoya, Janet, additional, Karani, Angela, additional, Mugo, Daisy, additional, Gichuki, Bonface M., additional, Riako, Debra, additional, Mutua, Shadrack, additional, Gitonga, John N., additional, Ominde, Kelly, additional, Wanjiku, Perpetual, additional, Mutiso, Agnes, additional, Mwanzu, Alfred, additional, Sein, Yiakon, additional, Bartilol, Brian, additional, Mwangi, Shaban, additional, Omuoyo, Donwilliams O., additional, Morobe, John M., additional, de Laurent, Zaydah R., additional, Mitsanze, Fredrick, additional, Mwakubia, Alfred, additional, Rono, Martin, additional, Nyaguara, Amek, additional, Tsofa, Benjamin, additional, Bejon, Philip, additional, Agoti, Charles N., additional, and Ochola-Oyier, Lynette Isabella, additional

Published
2021
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37. Quantifying Factors Associated With Birth Outcomes and Their Implications on Evaluating the Success of a Maternal Respiratory Syncytial Virus (RSV) Vaccine Program in Kenya

Author

Nyiro, Joyce U., primary, Bukusi, Elizabeth, additional, Mwaengo, Dufton, additional, Walumbe, David, additional, Nyaguara, Amek, additional, Kipkoech, Collins, additional, Nyawanda, Bryan, additional, Bigogo, Godfrey, additional, Otieno, Nancy, additional, Aol, George, additional, Audi, Allan, additional, Murunga, Nickson, additional, Berkley, James A., additional, Nokes, D James, additional, and Munywoki, Patrick, additional

Published
2021
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39. Trauma-related mortality among adults in Rural Western Kenya: characterising deaths using data from a health and demographic surveillance system.

Author

Frank O Odhiambo, Caryl M Beynon, Sheila Ogwang, Mary J Hamel, Olivia Howland, Anne M van Eijk, Robyn Norton, Nyaguara Amek, Laurence Slutsker, Kayla F Laserson, Kevin M De Cock, and Penelope A Phillips-Howard

Subjects
Medicine, Science
Abstract

BackgroundInformation on trauma-related deaths in low and middle income countries is limited but needed to target public health interventions. Data from a health and demographic surveillance system (HDSS) were examined to characterise such deaths in rural western Kenya.Methods and findingsVerbal autopsy data were analysed. Of 11,147 adult deaths between 2003 and 2008, 447 (4%) were attributed to trauma; 71% of these were in males. Trauma contributed 17% of all deaths in males 15 to 24 years; on a population basis mortality rates were greatest in persons over 65 years. Intentional causes accounted for a higher proportion of male than female deaths (RR 2.04, 1.37-3.04) and a higher proportion of deaths of those aged 15 to 65 than older people. Main causes in males were assaults (n=79, 25%) and road traffic injuries (n=47, 15%); and falls for females (n=17, 13%). A significantly greater proportion of deaths from poisoning (RR 5.0, 2.7-9.4) and assault (RR 1.8, 1.2-2.6) occurred among regular consumers of alcohol than among non-regular drinkers. In multivariate analysis, males had a 4-fold higher risk of death from trauma than females (Adjusted Relative Risk; ARR 4.0; 95% CI 1.7-9.4); risk of a trauma death rose with age, with the elderly at 7-fold higher risk (ARR 7.3, 1.1-49.2). Absence of care was the strongest predictor of trauma death (ARR 12.2, 9.4-15.8). Trauma-related deaths were higher among regular alcohol drinkers (ARR 1.5, 1.1-1.9) compared with non-regular drinkers.ConclusionsWhile trauma accounts for a small proportion of deaths in this rural area with a high prevalence of HIV, TB and malaria, preventive interventions such as improved road safety, home safety strategies for the elderly, and curbing harmful use of alcohol, are available and could help diminish this burden. Improvements in systems to record underlying causes of death from trauma are required.

Published
2013
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40. Seroprevalence of Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 Among Healthcare Workers in Kenya

Author

Etyang, Anthony O, primary, Lucinde, Ruth, additional, Karanja, Henry, additional, Kalu, Catherine, additional, Mugo, Daisy, additional, Nyagwange, James, additional, Gitonga, John, additional, Tuju, James, additional, Wanjiku, Perpetual, additional, Karani, Angela, additional, Mutua, Shadrack, additional, Maroko, Hosea, additional, Nzomo, Eddy, additional, Maitha, Eric, additional, Kamuri, Evanson, additional, Kaugiria, Thuranira, additional, Weru, Justus, additional, Ochola, Lucy B, additional, Kilimo, Nelson, additional, Charo, Sande, additional, Emukule, Namdala, additional, Moracha, Wycliffe, additional, Mukabi, David, additional, Okuku, Rosemary, additional, Ogutu, Monicah, additional, Angujo, Barrack, additional, Otiende, Mark, additional, Bottomley, Christian, additional, Otieno, Edward, additional, Ndwiga, Leonard, additional, Nyaguara, Amek, additional, Voller, Shirine, additional, Agoti, Charles N, additional, Nokes, David James, additional, Ochola-Oyier, Lynette Isabella, additional, Aman, Rashid, additional, Amoth, Patrick, additional, Mwangangi, Mercy, additional, Kasera, Kadondi, additional, Ng’ang’a, Wangari, additional, Adetifa, Ifedayo M O, additional, Wangeci Kagucia, E, additional, Gallagher, Katherine, additional, Uyoga, Sophie, additional, Tsofa, Benjamin, additional, Barasa, Edwine, additional, Bejon, Philip, additional, Scott, J Anthony G, additional, Agweyu, Ambrose, additional, and Warimwe, George M, additional

Published
2021
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41. Pathways to Depression and Poor Quality of Life among Adolescents in Western Kenya: Role of Anticipated HIV Stigma, HIV Risk Perception, and Sexual Behaviors

Author

Winnie K. Luseno, Samuel Field, Nyaguara Amek, Daniel Kwaro, Fredrick S. Odongo, Bonita J. Iritani, and Stuart Rennie

Subjects
Adult, medicine.medical_specialty, Social Psychology, genetic structures, Adolescent, Sexual Behavior, Social Stigma, Psychological intervention, Stigma (botany), HIV Infections, Article, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Quality of life, Medicine, Humans, 030212 general & internal medicine, Disease burden, Depression (differential diagnoses), 030505 public health, business.industry, Depression, Public health, Public Health, Environmental and Occupational Health, Kenya, humanities, Risk perception, Health psychology, Infectious Diseases, Quality of Life, Perception, 0305 other medical science, business, Clinical psychology
Abstract

Depression is a major cause of disease burden and is linked to poor quality of life (QOL) among adolescents. We examined the roles of sexual behaviors, HIV risk perception, and anticipated HIV stigma on depressive symptomatology and QOL among 4096 adolescents in a rural region of western Kenya with a high burden of HIV. Participants were aged 15-19 years, had not been tested for HIV in the previous 6 months, and had never been diagnosed with HIV. Anticipated stigma and risk perception were directly associated with depressive symptomatology and QOL. There was evidence of small indirect effects-through stigma-of risk perception on depressive symptomatology and QOL. Gender moderated relationships between sexual behavior and risk perception, depressive symptomatology, and QOL. Results suggest that developing effective gender-based interventions to address stigma, sexual behavior, and risk perception may be important for improving adolescent well-being in high HIV prevalence contexts.La depresión es una de las principales causas de carga de morbilidad y se asocia con una pobre calidad de vida (CdV) de los adolescentes. Nosotros estudiamos el papel de los comportamientos sexuales, la percepción de riesgo del VIH, y el estigma anticipado del VIH en relación con la sintomatología depresiva y la CdV de 4 096 adolescentes provenientes de una región rural del oeste de Kenia con alta carga de VIH. Los participantes, adolescentes de entre 15 y 19 años, no se habían hecho la prueba de detección del VIH en los últimos 6 meses y, además, nunca habían sido diagnosticados con VIH. El estigma anticipado y la percepción de riesgo estaban asociados directamente con la sintomatología depresiva y la CdV. Hubo evidencia de pocos efectos indirectos de percepción de riesgo–generados por el estigma–en la sintomatología depresiva y la CdV. El género moderó las relaciones entre el comportamiento sexual y la percepción de riesgo, la sintomatología depresiva y la CdV. Los resultados sugieren que desarrollar intervenciones con enfoque de género para abordar el tema del estigma, los comportamientos sexuales y la percepción de riesgo, puede ser importante para mejorar el bienestar de los adolescentes que viven en un contexto con alta prevalencia de VIH.

Published
2020

42. 'I think the parent should be there because no one was born alone': Kenyan adolescents’ perspectives on parental involvement in HIV research

Author

Bonita J. Iritani, Fredrick S. Odongo, Stuart Rennie, Denise Dion Hallfors, Allison K. Groves, Daniel Kwaro, Nyaguara Amek, and Winnie K. Luseno

Subjects
Male, Parents, Kenya, Biomedical Research, Adolescent, education, Human immunodeficiency virus (HIV), HIV Infections, Minor (academic), medicine.disease_cause, Article, 03 medical and health sciences, 0302 clinical medicine, Virology, parasitic diseases, medicine, Humans, Parental Consent, 030212 general & internal medicine, 030505 public health, Public Health, Environmental and Occupational Health, HIV, Social Support, General Medicine, Focus Groups, biochemical phenomena, metabolism, and nutrition, adolescent research participation, consent, ethics, human immunodeficiency virus, parents, Infectious Diseases, Female, 0305 other medical science, Psychology, Clinical psychology
Abstract

Despite a pressing need for adolescent HIV research in sub-Saharan Africa, ethical guidance for conducting research among minor adolescents is lacking. One ethical issue is the degree to which parents should be involved in the research process. The existing discourse is predominantly speculative and focuses on negative consequences of parental involvement. We use empirical data to describe the perspectives of Kenyan adolescents on parental involvement in consent and disclosure of HIV test results within a research study context. We conducted two rounds of focus group discussions with 40 adolescents in western Kenya to ask about minor adolescent participation in HIV research. We analysed data using codes and matrices. Kenyan adolescents were largely in favour of parental involvement during the research process. Half felt adolescent minors should solicitparental consent to participate, and nearly all said parents should learn the HIV test results of adolescent minors in order to provide necessary support. From their perspective, involvement of parents in research extends beyond obtaining their consent to providing essential support for youth, regardless of HIV status, both during and beyond the research study. Ethical guidelines that prioritise adolescent autonomy in research must consider reasons to involve parents considered important by adolescents themselves, particularly in low-resource settings.Keywords: adolescent research participation, consent, ethics, human immunodeficiency virus, parents

Published
2018
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43. Seroprevalence of Antibodies to SARS-CoV-2 among Health Care Workers in Kenya

Author

Etyang, Anthony O., primary, Lucinde, Ruth, additional, Karanja, Henry, additional, Kalu, Catherine, additional, Mugo, Daisy, additional, Nyagwange, James, additional, Gitonga, John, additional, Tuju, James, additional, Wanjiku, Perpetual, additional, Karani, Angela, additional, Mutua, Shadrack, additional, Maroko, Hosea, additional, Nzomo, Eddy, additional, Maitha, Eric, additional, Kamuri, Evanson, additional, Kaugiria, Thuranira, additional, Weru, Justus, additional, Ochola, Lucy B., additional, Kilimo, Nelson, additional, Charo, Sande, additional, Emukule, Namdala, additional, Moracha, Wycliffe, additional, Mukabi, David, additional, Okuku, Rosemary, additional, Ogutu, Monicah, additional, Angujo, Barrack, additional, Otiende, Mark, additional, Bottomley, Christian, additional, Otieno, Edward, additional, Ndwiga, Leonard, additional, Nyaguara, Amek, additional, Voller, Shirine, additional, Agoti, Charles, additional, Nokes, David James, additional, Ochola-Oyier, Lynette Isabella, additional, Aman, Rashid, additional, Amoth, Patrick, additional, Mwangangi, Mercy, additional, Kasera, Kadondi, additional, Ng’ang’a, Wangari, additional, Adetifa, Ifedayo, additional, Kagucia, E. Wangeci, additional, Gallagher, Katherine, additional, Uyoga, Sophie, additional, Tsofa, Benjamin, additional, Barasa, Edwine, additional, Bejon, Philip, additional, Scott, J. Anthony G., additional, Agweyu, Ambrose, additional, and Warimwe, George, additional

Published
2021
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44. Seroprevalence of anti-SARS-CoV-2 IgG antibodies among truck drivers and assistants in Kenya

Author

Kagucia, E Wangeci, primary, Gitonga, John N, additional, Kalu, Catherine, additional, Ochomo, Eric, additional, Ochieng, Benard, additional, Kuya, Nickline, additional, Karani, Angela, additional, Nyagwange, James, additional, Karia, Boniface, additional, Mugo, Daisy, additional, Karanja, Henry K, additional, Tuju, James, additional, Mutiso, Agnes, additional, Maroko, Hosea, additional, Okubi, Lucy, additional, Maitha, Eric, additional, Ajuck, Hossan, additional, Bogita, Mary, additional, Mudindi, Richmond, additional, Mukabi, David, additional, Moracha, Wycliffe, additional, Bulimu, David, additional, Andanje, Nelson, additional, Shiraku, Evans, additional, Okuku, Rosemary, additional, Ogutu, Monicah, additional, Aman, Rashid, additional, Mwangangi, Mercy, additional, Amoth, Patrick, additional, Kasera, Kadondi, additional, Ng’ang’a, Wangari, additional, Mariga, Rodgers, additional, Munabi, Tobias, additional, Ramadhan, Susan M, additional, Mwikali, Janet, additional, Nasike, Rose, additional, Andera, Cornelius, additional, Nechesa, Roselyne, additional, Kiplagat, Benson K, additional, Omengo, Julius, additional, Oteba, Simon, additional, Mwangi, Arthur, additional, Mkanyi, Dorcas, additional, Karisa, George, additional, Migosi, Judith K, additional, Msili, Patrick, additional, Mwambire, Samson, additional, Boniface, Anthony M, additional, Nyaguara, Amek, additional, Voller, Shirine, additional, Otiende, Mark, additional, Bottomley, Christian, additional, Agoti, Charles N, additional, Ochola-Oyier, Lynette I, additional, Adetifa, Ifedayo M O, additional, Etyang, Anthony O, additional, Gallagher, Katherine E, additional, Uyoga, Sophie, additional, Barasa, Edwine, additional, Bejon, Philip, additional, Tsofa, Benjamin, additional, Agweyu, Ambrose, additional, Warimwe, George M, additional, and Scott, J Anthony G, additional

Published
2021
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46. Clustering of health risk behaviors among adolescents in Kilifi, Kenya, a rural Sub-Saharan African setting

Author

Ssewanyana, Derrick, primary, Abubakar, Amina, additional, Newton, Charles R. J. C., additional, Otiende, Mark, additional, Mochamah, George, additional, Nyundo, Christopher, additional, Walumbe, David, additional, Nyutu, Gideon, additional, Amadi, David, additional, Doyle, Aoife M., additional, Ross, David A., additional, Nyaguara, Amek, additional, Williams, Thomas N., additional, and Bauni, Evasius, additional

Published
2020
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48. Phenotype is sustained during hospital readmissions following treatment for complicated severe malnutrition among Kenyan children: A retrospective cohort study

Author

Gonzales, Gerard Bryan, primary, Ngari, Moses M., additional, Njunge, James M., additional, Thitiri, Johnstone, additional, Mwalekwa, Laura, additional, Mturi, Neema, additional, Mwangome, Martha K., additional, Ogwang, Caroline, additional, Nyaguara, Amek, additional, and Berkley, James A., additional

Published
2020
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49. Modelling the relationship between malaria prevalence as a measure of transmission and mortality across age groups

Author

Chris Odero, Frank Odhiambo, Kephas Otieno, Simon Kariuki, Laurence Slutsker, Aaron M. Samuels, Eric Donald Onyango, Godfrey Bigogo, Meghna Desai, Mary J. Hamel, Nyaguara Amek, Stephen Munga, Penelope Vounatsou, Sammy Khagayi, Vincent Were, John E. Gimnig, APH - Global Health, Graduate School, and AII - Infectious diseases

Subjects
Cross-sectional study, Prevalence, Parasitemia, Bayesian spatio-temporal, 0302 clinical medicine, 030212 general & internal medicine, Child, Aged, 80 and over, education.field_of_study, Incidence, Incidence (epidemiology), 1. No poverty, Middle Aged, 3. Good health, Infectious Diseases, Child, Preschool, Adult, medicine.medical_specialty, lcsh:Arctic medicine. Tropical medicine, Adolescent, lcsh:RC955-962, 030231 tropical medicine, Population, lcsh:Infectious and parasitic diseases, Young Adult, Health and demographic surveillance system, 03 medical and health sciences, parasitic diseases, medicine, Humans, lcsh:RC109-216, Mortality, education, Aged, Parasite prevalence, business.industry, Research, Public health, Infant, Newborn, Infant, Bayes Theorem, medicine.disease, Kenya, Verbal autopsy, Malaria, Cross-Sectional Studies, Tropical medicine, Parasitology, business, Demography
Abstract

Background Parasite prevalence has been used widely as a measure of malaria transmission, especially in malaria endemic areas. However, its contribution and relationship to malaria mortality across different age groups has not been well investigated. Previous studies in a health and demographic surveillance systems (HDSS) platform in western Kenya quantified the contribution of incidence and entomological inoculation rates (EIR) to mortality. The study assessed the relationship between outcomes of malaria parasitaemia surveys and mortality across age groups. Methods Parasitological data from annual cross-sectional surveys from the Kisumu HDSS between 2007 and 2015 were used to determine malaria parasite prevalence (PP) and clinical malaria (parasites plus reported fever within 24 h or temperature above 37.5 °C). Household surveys and verbal autopsy (VA) were used to obtain data on all-cause and malaria-specific mortality. Bayesian negative binomial geo-statistical regression models were used to investigate the association of PP/clinical malaria with mortality across different age groups. Estimates based on yearly data were compared with those from aggregated data over 4 to 5-year periods, which is the typical period that mortality data are available from national demographic and health surveys. Results Using 5-year aggregated data, associations were established between parasite prevalence and malaria-specific mortality in the whole population (RRmalaria = 1.66; 95% Bayesian Credible Intervals: 1.07–2.54) and children 1–4 years (RRmalaria = 2.29; 1.17–4.29). While clinical malaria was associated with both all-cause and malaria-specific mortality in combined ages (RRall-cause = 1.32; 1.01–1.74); (RRmalaria = 2.50; 1.27–4.81), children 1–4 years (RRall-cause = 1.89; 1.00–3.51); (RRmalaria = 3.37; 1.23–8.93) and in older children 5–14 years (RRall-cause = 3.94; 1.34–11.10); (RRmalaria = 7.56; 1.20–39.54), no association was found among neonates, adults (15–59 years) and the elderly (60+ years). Distance to health facilities, socioeconomic status, elevation and survey year were important factors for all-cause and malaria-specific mortality. Conclusion Malaria parasitaemia from cross-sectional surveys was associated with mortality across age groups over 4 to 5 year periods with clinical malaria more strongly associated with mortality than parasite prevalence. This effect was stronger in children 5–14 years compared to other age-groups. Further analyses of data from other HDSS sites or similar platforms would be useful in investigating the relationship between malaria and mortality across different endemicity levels. Electronic supplementary material The online version of this article (10.1186/s12936-019-2869-9) contains supplementary material, which is available to authorized users.

Published
2019
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50. Congenital microcephaly unrelated to flavivirus exposure in coastal Kenya

Author

Barsosio, Hellen C., primary, Gitonga, John N., additional, Karanja, Henry K., additional, Nyamwaya, Doris K., additional, Omuoyo, Donwilliams O., additional, Kamau, Everlyn, additional, Hamaluba, Mainga M., additional, Nyiro, Joyce U., additional, Kitsao, Barnes S., additional, Nyaguara, Amek, additional, Mwakio, Stella, additional, Newton, Charles R., additional, Sang, Rosemary, additional, Wright, Daniel, additional, Sanders, Eduard J., additional, Seale, Anna C., additional, Agoti, Charles N., additional, Berkley, James A., additional, Bejon, Philip, additional, and Warimwe, George M., additional

Published
2019
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