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Pre- and during -COVID-19 pandemic mortality trends and drivers in rural, coastal Kenya: findings from the Kaloleni–Rabai Health and Demographic Surveillance System

Article scientifique 2025 Anglais

Résumé

BACKGROUND: There is contradicting information regarding the effect of COVID-19 on mortality in African settings. Knowledge of the complete direct and indirect burden of COVID-19 on mortality is heavily reliant on the availability of a population-based surveillance system. Here we provide robust data on the effect of COVID-19 on mortality trends in a rural, coastal, Kenyan community. METHODS: A historical cohort study using data from the Kaloleni Rabai Health and Demographic Surveillance System was conducted with special focus on two discernible time periods representing the pre-COVID-19 (2018-2019) and COVID-19 (2020-2021) periods. Mortality rates were estimated as the total number of deaths divided by the person-time (years) at risk, accounting for attrition, and calculated separately for the two periods. A cox proportional hazards model was used to estimate the impact of COVID-19 on mortality. RESULTS: 1191 deaths occurred between 2018 and 2021. There was no significant change in overall mortality rates between pre-COVID-19 and COVID-19 periods (3.7 and 3.6 per 1000 person years at risk respectively, p = 0.74). Older age was significantly associated with mortality (a_HR: 1.05, 95% CI: 1.05-1.06; p < 0.001). However, an interaction term between age and time-period appeared to reverse this association (a_HR: 0.99, 95% CI: 0.99-1.00; p < 0.001). CONCLUSIONS: Our findings suggest that although overall COVID-19 did not directly impact mortality rates within this rural population, the onset of the pandemic did appear to reverse and/or attenuate the impact of several risk factors on mortality. It is possible that COVID-19 brought health and wellness into sharp focus, making people more vigilant about their health, hygiene and associated preventive measures.

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Iseme, R., Ogero, M., Odhiambo, R., Barr, B., Kabudula, C., Bashingwa, J., Ngugi, A. (2025). Pre- and during -COVID-19 pandemic mortality trends and drivers in rural, coastal Kenya: findings from the Kaloleni–Rabai Health and Demographic Surveillance System. https://doi.org/10.1186/s12963-025-00434-5

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Auteur(s)

Rosebella Alungata Iseme Morris Ogero Rachael Odhiambo Beth A. Tippett Barr Chodziwadziwa Kabudula Jean Juste Harrisson Bashingwa Anthony Ngugi

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