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Background <p>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.</p> Methods <p>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.</p> Results <p>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, <i>p</i> = 0.74). Older age was significantly associated with mortality (a_HR: 1.05, 95% CI: 1.05–1.06; <i>p</i> &lt; 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; <i>p</i> &lt; 0.001).</p> Conclusions <p>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.</p>

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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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月2日

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  • Rosebella Iseme-Ondiek,
  • Morris Ogero,
  • Rachael Odhiambo,
  • Beth Tippett Barr,
  • Chodziwadziwa Kabudula,
  • Jean J. H. Bashingwa,
  • Anthony K. Ngugi

摘要

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.