Nairobi City County Government, Health Services Department, P.O. Box 34349, Nairobi, 00100, Kenya.
Malawi-Liverpool-Wellcome Trust Clinical Research Programme, P.O Box 30096, Blantyre, Malawi.
BMC Infect Dis. 2021 Jul 31;21(1):718. doi: 10.1186/s12879-021-06464-2.
Tuberculosis (TB) remains one of the key public health problems in Africa. Due to multifaceted challenges, its burden is poorly described in informal settlements. We describe tuberculosis mortality in two informal settlements in Nairobi, Kenya.
This is a secondary analysis of 2002-2016 verbal autopsy data from informal settlements in the Nairobi Urban Health Demographic Surveillance System (NUHDSS). A descriptive analysis of deaths assigned as caused by TB was done. Pearson chi-square tests were used to determine differences between socio-demographic factors. Logistic regression was carried out to examine the risk of death from TB within the characteristics.
There were 6218 deaths in the NUHDSS within the period of analysis, of which 930 (14.96%) were deaths from TB. The average number of TB deaths per year was 62(SD 23.9). There was a reduction in TB deaths from 21.2% in 2005 to 1.7% in 2016. Males had 1.39 higher odds of dying from TB than females (AOR 1.39; 95% CI 1.18-1.64; p-value < 0.001). Compared to those aged 30-39 years, the ≥50-year-olds had a 42% lower chance of dying from TB (AOR 0.57; 95% CI 0.47-0.73; p-value < 0.001). Those dying at home had 1.39 odds of dying from TB as compared to those who died in a health facility(AOR 1.93; 95% CI 1.17-1.64; p value< 0.001).
There was a reduction in TB deaths over the study period. Males had the highest risk of death. There is a need to strengthen TB surveillance and access to TB diagnosis and treatment within informal settlements to enhance early diagnosis and treatment.
结核病(TB)仍然是非洲主要的公共卫生问题之一。由于多方面的挑战,其在非正规住区的负担描述不足。我们描述了肯尼亚内罗毕两个非正规住区的结核病死亡率。
这是对内罗毕城市人口动态监测系统(NUHDSS)非正规住区 2002-2016 年口头尸检数据的二次分析。对死因归因于结核病的死亡进行了描述性分析。使用 Pearson 卡方检验确定社会人口因素之间的差异。进行逻辑回归以检查特征内死于结核病的风险。
在分析期间,NUHDSS 中有 6218 人死亡,其中 930 人(14.96%)死于结核病。每年结核病死亡的平均人数为 62(SD 23.9)。结核病死亡人数从 2005 年的 21.2%减少到 2016 年的 1.7%。男性死于结核病的几率比女性高 1.39 倍(优势比 1.39;95%CI 1.18-1.64;p 值<0.001)。与 30-39 岁年龄组相比,≥50 岁年龄组死于结核病的可能性降低了 42%(优势比 0.57;95%CI 0.47-0.73;p 值<0.001)。与在医疗机构死亡的人相比,在家中死亡的人死于结核病的几率高 1.39 倍(优势比 1.93;95%CI 1.17-1.64;p 值<0.001)。
在研究期间,结核病死亡人数有所减少。男性的死亡风险最高。需要加强非正规住区的结核病监测以及结核病诊断和治疗的可及性,以提高早期诊断和治疗。