Burden of disease estimates reveal multiple risks for Kilifi adults

Adults in Kilifi face a combined burden of infectious and non-communicable diseases, according to a report published in the Lancet Global Health. Infectious diseases were a major cause of illness among both men and women. Injuries in men and pregnancy related illnesses in women were also found to be major causes of hospitalization. The study was set up in 2007 to measure the burden of disease in a rural setting, where data on disease burden have been lacking.

The study found that average stay in hospital was 3 days, and that 1 in 10 patients admitted to hospital died during the hospitalization. The proportion of patients with specific illnesses who died was highest for those with diseases of the nervous and cardiovascular systems. HIV dominated the infectious disease category contributing to 39% of all deaths in the hospital. Stroke and heart failure contributed to 16% of all deaths in hospital.

Data on burden of disease in adults in Sub- Saharan Africa are uncommon, and yet they are needed for planning health interventions.  The study used linked hospital and population data from the Kilifi Health and Demographic Surveillance System(KHDSS). This enabled the researchers to calculate accurate measures of the burden of disease among adults in Kilifi. 18, 712 adults were admitted to Kilifi District Hospital (KDH) between Jan 1 2007 and Dec 31 2012.  Out of these, 44% were residents of KHDSS.

The rate of admission to hospital was heavily influenced by distance to hospital, gender and, the type of illness suffered. Among women the rate of all cause admission to hospital decreased by 20% for every 5km increase in distance from KDH while in men it fell by 11%. The rate of admission for women with infectious and parasitic disease was double that of men.  The rate of admission with injuries was higher in men than in women.

The researchers also calculated the economic cost of the various illnesses using a measure known as Disability Adjusted Life Years (DALY). HIV related illnesses contributed to the most years lost due to ill-health, disability or early death (2050 DALYs lost per 100,000 people each year). Non-communicable diseases and injuries resulted in 741 DALYs lost among 100,000 people per year. In all the 15 leading illnesses identified, the majority of the DALYS lost were due to years of life lost rather than years lived with disability.

According to Dr Anthony Etyang, an Adult Physician and researcher at KEMRI-WEllcome Trust Research Programme who led the study, this study not only provides important baseline information for guiding public health activities in Kilifi, but it also serves as a model for measuring disease burden in other parts of sub-Saharan Africa. It is important that more surveillance sites are set up in the country so as to give accurate information on disease burden.

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