title: Age-specific malaria mortality rates in the KEMRI/CDC health and demographic surveillance system in western Kenya, 2003-2010.
abstract: Recent global malaria burden modeling efforts have produced significantly different estimates, particularly in adult malaria mortality. To measure malaria control progress, accurate malaria burden estimates across age groups are necessary. We determined age-specific malaria mortality rates in western Kenya to compare with recent global estimates. We collected data from 148,000 persons in a health and demographic surveillance system from 2003-2010. Standardized verbal autopsies were conducted for all deaths; probable cause of death was assigned using the InterVA-4 model. Annual malaria mortality rates per 1,000 person-years were generated by age group. Trends were analyzed using Poisson regression. From 2003-2010, in children <5 years the malaria mortality rate decreased from 13.2 to 3.7 per 1,000 person-years; the declines were greatest in the first three years of life. In children 5-14 years, the malaria mortality rate remained stable at 0.5 per 1,000 person-years. In persons ≥15 years, the malaria mortality rate decreased from 1.5 to 0.4 per 1,000 person-years. The malaria mortality rates in young children and persons aged ≥15 years decreased dramatically from 2003-2010 in western Kenya, but rates in older children have not declined. Sharp declines in some age groups likely reflect the national scale up of malaria control interventions and rapid expansion of HIV prevention services. These data highlight the importance of age-specific malaria mortality ascertainment and support current strategies to include all age groups in malaria control interventions.
authors.affiliation: Kenya Medical Research Institute/Centers for Disease Control and Prevention (KEMRI/CDC) Research and Public Health Collaboration, Kisumu, Kenya; Division of Parasitic Diseases and Malaria (DPDM), Center for Global Health (CGH), CDC, Atlanta, Georgia, United States of America.
authors.forename: Meghna
authors.initials: M
authors.lastname: Desai
authors.affiliation: President's Malaria Initiative - Kenya, DPDM, CGH, CDC, Nairobi, Kenya.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Buff
authors.affiliation: KEMRI/CDC Research and Public Health Collaboration and KEMRI Center for Global Health Research, Kisumu, Kenya.
authors.forename: Sammy
authors.initials: S
authors.lastname: Khagayi
authors.affiliation: WHO Collaborating Centre for Verbal Autopsy, Umeå Centre for Global Health Research, Umeå, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Byass
authors.affiliation: KEMRI/CDC Research and Public Health Collaboration and KEMRI Center for Global Health Research, Kisumu, Kenya.
authors.forename: Nyaguara
authors.initials: N
authors.lastname: Amek
authors.affiliation: Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
authors.forename: Annemieke
authors.initials: A
authors.lastname: van Eijk
authors.affiliation: Division of Parasitic Diseases and Malaria (DPDM), Center for Global Health (CGH), CDC, Atlanta, Georgia, United States of America.
authors.forename: Laurence
authors.initials: L
authors.lastname: Slutsker
authors.affiliation: KEMRI Center for Global Health Research, Kisumu, Kenya.
authors.forename: John
authors.initials: J
authors.lastname: Vulule
authors.affiliation: KEMRI/CDC Research and Public Health Collaboration and KEMRI Center for Global Health Research, Kisumu, Kenya.
authors.forename: Frank O
authors.initials: FO
authors.lastname: Odhiambo
authors.affiliation: Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Kenya Medical Research Institute/Centers for Disease Control and Prevention (KEMRI/CDC) Research and Public Health Collaboration, Kisumu, Kenya.
authors.forename: Penelope A
authors.initials: PA
authors.lastname: Phillips-Howard
authors.affiliation: Division of Parasitic Diseases and Malaria (DPDM), Center for Global Health (CGH), CDC, Atlanta, Georgia, United States of America.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Lindblade
authors.affiliation: Kenya Medical Research Institute/Centers for Disease Control and Prevention (KEMRI/CDC) Research and Public Health Collaboration, Kisumu, Kenya; Center for Global Health, CDC, Atlanta, Georgia, United States of America.
authors.forename: Kayla F
authors.initials: KF
authors.lastname: Laserson
authors.affiliation: Division of Parasitic Diseases and Malaria (DPDM), Center for Global Health (CGH), CDC, Atlanta, Georgia, United States of America.
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Hamel
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D035843:Biomedical Research; D002423:Cause of Death; D002487:Centers for Disease Control and Prevention, U.S.; D003710:Demography; D062665:Epidemiological Monitoring; D006306:Health Surveys; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008288:Malaria / Q000401:mortality*; D014481:United States