Cause-specific mortality in the Kombewa health and demographic surveillance systems site, rural Western Kenya from 2011-2015

Glob Health Action. 2018;11(1):1442959. doi: 10.1080/16549716.2018.1442959.


Background: The vast majority of deaths in the health and Kombewa demographic surveillance system (HDSS) study area are not registered and reported through official systems of vital registration. As a result, few data are available regarding causes of death in this population.

Objectives: To describe causes of death among residents of all ages in the Kombewa HDSS, located in rural Western Kenya.

Methods: Verbal autopsy (VA) interviews at the site were conducted using the modified 2007 and later 2012 standardized WHO questionnaires. Assignment of causes of death was made using the InterVA-4 model version 4.02. Cox regression model, adjusted for sex, was built to evaluate the influence of age on mortality.

Results: There were a total of 5196 deaths recorded between 2011 and 2015 at the site. VA interviews were successfully completed for 3903 of these deaths (75.1%). Mortality rates were highest among neonates HR = 38.54 (<0.001) and among Infants HR = 2.07 (<0.006) in the Kombewa HDSS. Among those deaths in which VA was performed, the top causes of death were HIV/AIDS (12.6%), Malaria (10.3%), Pneumonia (10.1%), Acute abdomen (7.0%), Stroke (5.2%) and TB (4.9%) for the whole population in general. Stroke, acute abdomen heart diseases and Pneumonia were common causes of death (CODs) among the elderly over the age of 65.

Conclusions: The analysis established the main CODs among people of all ages within the area served by the Kombewa HDSS. We hope that information generated from this study will help better address preventable deaths in the surveyed community as well as help mitigate negative health impacts in other rural communities throughout the Western Kenya region.

Keywords: INDEPTH network; InterVA-4; Verbal autopsy; cause-specific mortality fraction; rural Kenya.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cause of Death / trends*
  • Child
  • Child, Preschool
  • Female
  • Forecasting
  • Humans
  • Infant
  • Infant, Newborn
  • Kenya
  • Male
  • Middle Aged
  • Mortality / trends*
  • Population Surveillance*
  • Rural Population / statistics & numerical data*
  • Rural Population / trends*
  • Surveys and Questionnaires
  • Young Adult

Grant support

Funding for this study during the reported period was obtained from the Armed Forces Health Surveillance Branch (AFHSB) and it's GEIS (Global Emerging Infections Surveillance and Response) Section.(Proposal number P0114_13_KY and 0008_14_KY). Additional support and funding for the HDSS was provided by PATH-MVI and GSK. Current funding through GSK nested studies.