2009-2018 年肯尼亚内罗毕市区非正规住区基贝拉 10 年期间的死亡率模式。

Mortality patterns over a 10-year period in Kibera, an urban informal settlement in Nairobi, Kenya, 2009-2018.

机构信息

Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.

Epidemiology, Public Health, Implementation & Clinical Development Unit, International Vaccine Institute (IVI), Seoul, South Korea.

出版信息

Glob Health Action. 2023 Dec 31;16(1):2238428. doi: 10.1080/16549716.2023.2238428.

DOI:10.1080/16549716.2023.2238428

PMID:37490025

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10392302/

Abstract

BACKGROUND

Reliable mortality data are important for evaluating the impact of health interventions. However, data on mortality patterns among populations living in urban informal settlements are limited.

OBJECTIVES

To examine the mortality patterns and trends in an urban informal settlement in Kibera, Nairobi, Kenya.

METHODS

Using data from a population-based surveillance platform we estimated overall and cause-specific mortality rates for all age groups using person-year-observation (pyo) denominators and using Poisson regression tested for trends in mortality rates over time. We compared associated mortality rates across groups using incidence rate ratios (IRR). Assignment of probable cause(s) of death was done using the InterVA-4 model.

RESULTS

We registered 1134 deaths from 2009 to 2018, yielding a crude mortality rate of 4.4 (95% Confidence Interval [CI]4.2-4.7) per 1,000 pyo. Males had higher overall mortality rates than females (incidence rate ratio [IRR], 1.44; 95% CI, 1.28-1.62). The highest mortality rate was observed among children aged < 12 months (41.5 per 1,000 pyo; 95% CI 36.6-46.9). All-cause mortality rates among children < 12 months were higher than that of children aged 1-4 years (IRR, 8.5; 95% CI, 6.95-10.35). The overall mortality rate significantly declined over the period, from 6.7 per 1,000 pyo (95% CI, 5.7-7.8) in 2009 to 2.7 (95% CI, 2.0-3.4) per 1,000 pyo in 2018. The most common cause of death was acute respiratory infections (ARI)/pneumonia (18.1%). Among children < 5 years, the ARI/pneumonia deaths rate declined significantly over the study period (5.06 per 1,000 pyo in 2009 to 0.61 per 1,000 pyo in 2018; = 0.004). Similarly, death due to pulmonary tuberculosis among persons 5 years and above significantly declined (0.98 per 1,000 pyo in 2009 to 0.25 per 1,000 pyo in 2018; = 0.006).

CONCLUSIONS

Overall and some cause-specific mortality rates declined over time, representing important public health successes among this population.

摘要

背景

可靠的死亡率数据对于评估卫生干预措施的影响非常重要。然而，关于生活在城市非正规住区的人群的死亡率模式的数据有限。

目的

检查肯尼亚内罗毕基贝拉市一个城市非正规住区的死亡率模式和趋势。

方法

我们使用基于人群的监测平台的数据，使用人年观察（pyo）作为分母，估计了所有年龄组的总死亡率和死因特异性死亡率，并使用泊松回归检验了死亡率随时间的趋势。我们使用发病率比（IRR）比较了不同组之间的相关死亡率。使用 InterVA-4 模型确定可能的死因。

结果

我们记录了 2009 年至 2018 年期间的 1134 例死亡，粗死亡率为每 1000 pyo 4.4（95%置信区间[CI]4.2-4.7）。男性的总死亡率高于女性（发病率比[IRR]，1.44；95%CI，1.28-1.62）。死亡率最高的是年龄<12 个月的儿童（每 1000 pyo 41.5；95%CI 36.6-46.9）。年龄<12 个月儿童的全因死亡率高于 1-4 岁儿童（IRR，8.5；95%CI，6.95-10.35）。总体死亡率在研究期间显著下降，从 2009 年的每 1000 pyo 6.7（95%CI，5.7-7.8）降至 2018 年的每 1000 pyo 2.7（95%CI，2.0-3.4）。最常见的死因是急性呼吸道感染（ARI）/肺炎（18.1%）。在 5 岁以下儿童中，ARI/肺炎死亡率在研究期间显著下降（2009 年每 1000 pyo 5.06，2018 年每 1000 pyo 0.61； = 0.004）。同样，5 岁及以上人群因肺结核导致的死亡也显著下降（2009 年每 1000 pyo 0.98，2018 年每 1000 pyo 0.25； = 0.006）。