Burden of disease in adults admitted to hospital in a rural region of coastal Kenya: an analysis of data from linked clinical and demographic surveillance systems
Background: Estimates of the burden of disease in adults in sub-Saharan Africa largely rely on models of sparse data. We aimed to measure the burden of disease in adults living in a rural area of coastal Kenya with use of linked clinical and demographic surveillance data. Methods: We used data from...
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| Format: | Article |
| Language: | English |
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Elsevier
2014-04-01
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| Series: | The Lancet Global Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214109X14700233 |
| _version_ | 1811250478896381952 |
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| author | Dr. Anthony O Etyang, MMed Kenneth Munge, MPH Erick W Bunyasi, MBChB Lena Matata, MSc Carolyne Ndila, MSc Sailoki Kapesa, DCM Maureen Owiti, MMed Iqbal Khandwalla, MMed Andrew J Brent, PhD Benjamin Tsofa, MSc Pamela Kabibu, DN Susan Morpeth, FRACP Evasius Bauni, PhD Mark Otiende, BSc John Ojal, MSc Philip Ayieko, PhD Maria D Knoll, PhD Prof. Liam Smeeth, FRCGP Prof. Thomas N Williams, MRCP Ulla K Griffiths, PhD Prof. J Anthony G Scott, FRCP |
| author_facet | Dr. Anthony O Etyang, MMed Kenneth Munge, MPH Erick W Bunyasi, MBChB Lena Matata, MSc Carolyne Ndila, MSc Sailoki Kapesa, DCM Maureen Owiti, MMed Iqbal Khandwalla, MMed Andrew J Brent, PhD Benjamin Tsofa, MSc Pamela Kabibu, DN Susan Morpeth, FRACP Evasius Bauni, PhD Mark Otiende, BSc John Ojal, MSc Philip Ayieko, PhD Maria D Knoll, PhD Prof. Liam Smeeth, FRCGP Prof. Thomas N Williams, MRCP Ulla K Griffiths, PhD Prof. J Anthony G Scott, FRCP |
| author_sort | Dr. Anthony O Etyang, MMed |
| collection | DOAJ |
| description | Background: Estimates of the burden of disease in adults in sub-Saharan Africa largely rely on models of sparse data. We aimed to measure the burden of disease in adults living in a rural area of coastal Kenya with use of linked clinical and demographic surveillance data.
Methods: We used data from 18 712 adults admitted to Kilifi District Hospital (Kilifi, Kenya) between Jan 1, 2007, and Dec 31, 2012, linked to 790 635 person-years of observation within the Kilifi Health and Demographic Surveillance System, to establish the rates and major causes of admission to hospital. These data were also used to model disease-specific disability-adjusted life-years lost in the population. We used geographical mapping software to calculate admission rates stratified by distance from the hospital.
Findings: The main causes of admission to hospital in women living within 5 km of the hospital were infectious and parasitic diseases (303 per 100 000 person-years of observation), pregnancy-related disorders (239 per 100 000 person-years of observation), and circulatory illnesses (105 per 100 000 person-years of observation). Leading causes of hospital admission in men living within 5 km of the hospital were infectious and parasitic diseases (169 per 100 000 person-years of observation), injuries (135 per 100 000 person-years of observation), and digestive system disorders (112 per 100 000 person-years of observation). HIV-related diseases were the leading cause of disability-adjusted life-years lost (2050 per 100 000 person-years of observation), followed by non-communicable diseases (741 per 100 000 person-years of observation). For every 5 km increase in distance from the hospital, all-cause admission rates decreased by 11% (95% CI 7–14) in men and 20% (17–23) in women. The magnitude of this decline was highest for endocrine disorders in women (35%; 95% CI 22–46) and neoplasms in men (30%; 9–45).
Interpretation: Adults in rural Kenya face a combined burden of infectious diseases, pregnancy-related disorders, cardiovascular illnesses, and injuries. Disease burden estimates based on hospital data are affected by distance from the hospital, and the amount of underestimation of disease burden differs by both disease and sex.
Funding: The Wellcome Trust, GAVI Alliance. |
| first_indexed | 2024-04-12T16:04:25Z |
| format | Article |
| id | doaj.art-5f84df91c74c4398bef2e1c02b495108 |
| institution | Directory Open Access Journal |
| issn | 2214-109X |
| language | English |
| last_indexed | 2024-04-12T16:04:25Z |
| publishDate | 2014-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Global Health |
| spelling | doaj.art-5f84df91c74c4398bef2e1c02b4951082022-12-22T03:26:06ZengElsevierThe Lancet Global Health2214-109X2014-04-0124e216e22410.1016/S2214-109X(14)70023-3Burden of disease in adults admitted to hospital in a rural region of coastal Kenya: an analysis of data from linked clinical and demographic surveillance systemsDr. Anthony O Etyang, MMed0Kenneth Munge, MPH1Erick W Bunyasi, MBChB2Lena Matata, MSc3Carolyne Ndila, MSc4Sailoki Kapesa, DCM5Maureen Owiti, MMed6Iqbal Khandwalla, MMed7Andrew J Brent, PhD8Benjamin Tsofa, MSc9Pamela Kabibu, DN10Susan Morpeth, FRACP11Evasius Bauni, PhD12Mark Otiende, BSc13John Ojal, MSc14Philip Ayieko, PhD15Maria D Knoll, PhD16Prof. Liam Smeeth, FRCGP17Prof. Thomas N Williams, MRCP18Ulla K Griffiths, PhD19Prof. J Anthony G Scott, FRCP20KEMRI-Wellcome Trust Research Programme, Kilifi, KenyaKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaKilifi District Hospital, Kilifi, KenyaKilifi District Hospital, Kilifi, KenyaKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaKilifi District Hospital, Kilifi, KenyaKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USALondon School of Hygiene & Tropical Medicine, London, UKKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaLondon School of Hygiene & Tropical Medicine, London, UKKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaBackground: Estimates of the burden of disease in adults in sub-Saharan Africa largely rely on models of sparse data. We aimed to measure the burden of disease in adults living in a rural area of coastal Kenya with use of linked clinical and demographic surveillance data. Methods: We used data from 18 712 adults admitted to Kilifi District Hospital (Kilifi, Kenya) between Jan 1, 2007, and Dec 31, 2012, linked to 790 635 person-years of observation within the Kilifi Health and Demographic Surveillance System, to establish the rates and major causes of admission to hospital. These data were also used to model disease-specific disability-adjusted life-years lost in the population. We used geographical mapping software to calculate admission rates stratified by distance from the hospital. Findings: The main causes of admission to hospital in women living within 5 km of the hospital were infectious and parasitic diseases (303 per 100 000 person-years of observation), pregnancy-related disorders (239 per 100 000 person-years of observation), and circulatory illnesses (105 per 100 000 person-years of observation). Leading causes of hospital admission in men living within 5 km of the hospital were infectious and parasitic diseases (169 per 100 000 person-years of observation), injuries (135 per 100 000 person-years of observation), and digestive system disorders (112 per 100 000 person-years of observation). HIV-related diseases were the leading cause of disability-adjusted life-years lost (2050 per 100 000 person-years of observation), followed by non-communicable diseases (741 per 100 000 person-years of observation). For every 5 km increase in distance from the hospital, all-cause admission rates decreased by 11% (95% CI 7–14) in men and 20% (17–23) in women. The magnitude of this decline was highest for endocrine disorders in women (35%; 95% CI 22–46) and neoplasms in men (30%; 9–45). Interpretation: Adults in rural Kenya face a combined burden of infectious diseases, pregnancy-related disorders, cardiovascular illnesses, and injuries. Disease burden estimates based on hospital data are affected by distance from the hospital, and the amount of underestimation of disease burden differs by both disease and sex. Funding: The Wellcome Trust, GAVI Alliance.http://www.sciencedirect.com/science/article/pii/S2214109X14700233 |
| spellingShingle | Dr. Anthony O Etyang, MMed Kenneth Munge, MPH Erick W Bunyasi, MBChB Lena Matata, MSc Carolyne Ndila, MSc Sailoki Kapesa, DCM Maureen Owiti, MMed Iqbal Khandwalla, MMed Andrew J Brent, PhD Benjamin Tsofa, MSc Pamela Kabibu, DN Susan Morpeth, FRACP Evasius Bauni, PhD Mark Otiende, BSc John Ojal, MSc Philip Ayieko, PhD Maria D Knoll, PhD Prof. Liam Smeeth, FRCGP Prof. Thomas N Williams, MRCP Ulla K Griffiths, PhD Prof. J Anthony G Scott, FRCP Burden of disease in adults admitted to hospital in a rural region of coastal Kenya: an analysis of data from linked clinical and demographic surveillance systems The Lancet Global Health |
| title | Burden of disease in adults admitted to hospital in a rural region of coastal Kenya: an analysis of data from linked clinical and demographic surveillance systems |
| title_full | Burden of disease in adults admitted to hospital in a rural region of coastal Kenya: an analysis of data from linked clinical and demographic surveillance systems |
| title_fullStr | Burden of disease in adults admitted to hospital in a rural region of coastal Kenya: an analysis of data from linked clinical and demographic surveillance systems |
| title_full_unstemmed | Burden of disease in adults admitted to hospital in a rural region of coastal Kenya: an analysis of data from linked clinical and demographic surveillance systems |
| title_short | Burden of disease in adults admitted to hospital in a rural region of coastal Kenya: an analysis of data from linked clinical and demographic surveillance systems |
| title_sort | burden of disease in adults admitted to hospital in a rural region of coastal kenya an analysis of data from linked clinical and demographic surveillance systems |
| url | http://www.sciencedirect.com/science/article/pii/S2214109X14700233 |
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