Leading causes of death and high mortality rates in an HIV endemic setting (Kisumu county, Kenya, 2019)

PLoS Neglected Tropical DiseasesWaruru A, Onyango D, Nyagah L, et al. | January 24, 2022


In resource-limited settings, systematical ascertainment of the underlying causes of death (UCOD) is often lacking, which results in unreliable mortality statistics. In order to establish UCOD for decedents at two high volume mortuaries in Kisumu County, Kenya, medical charts are reviewed herein and ascertained UCOD are compared with those reported to the civil registry.

  • Causes of death were ascertained for 456 decedents admitted to the mortuaries by medical experts trained in COD certification.

  • Screening for HIV was done in decedents with unknown HIV status or who had tested HIV-negative > 90 days before the date of death.

  • HIV/AIDS (102/442 [23.1%]), hypertensive disease (41/442 [9.3%]), other cardiovascular diseases (23/442 [5.2%]), and cancer (20/442 [4.5%]) were identified as the four leading UCOD.

  • All-cause mortality rate of 1,086/100,000 population was estimated.

  • In Kisumu County, there appeared a high mortality from infectious diseases, especially HIV/AIDS, however, a shift has occurred toward higher mortality from noncommunicable diseases, possibly indicating an epidemiologic transition and improving HIV outcomes.

  • Considering the epidemiologic transition, researchers herein emphasize the necessity for increased focus on controlling noncommunicable conditions despite the high communicable disease burden.

  • Because of the weak agreement between notified and ascertained UCOD, substantial inaccuracies in mortality statistics could occur, which wholly depend on death notifications.

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