All-cause mortality among young children in western Kenya. VI: The Asembo Bay Cohort Project

Although all-cause mortality has been used as an indicator of the health st atus of childhood populations, such data are sparse for most rural areas of sub-Saharan Africa, particularly community-based estimates of infant morta lity rates. The longitudinal follow-up of more than 1,500 children enrolled at birth into the Asembo Bay Cohort Project (ABCP) in western Kenya betwee n 1992 and 1996 has provided a fixed birth cohort for estimating all-cause mortality over the first 5 yr of life. We surveyed mothers and guardians of cohort children in early 1999 to determine survival status. A total of 1,2 60 households were surveyed to determine the survival status of 1,556 live births (99.2% of original cohort, n = 1,570). Most mothers (66%) still resi ded but 27.5% had migrated, and 5.5% had died. In early 1999, the overall c umulative incidence of all-cause mortality for the entire 1992-1996 birth c ohort was 26.5% (95%) confidence interval, 24.1-28.9%). Neonatal and infant mortality were 32 and 176 per 1,000 live births, respectively. These commu nity-based estimates of mortality in the ABCP area are substantially higher than for Kenya overall (nationally, infant mortality is 75 per 1,000 live births). The results provide a baseline description of all-cause mortality among children in an area with intense Plasmodium falciparum transmission a nd will be useful in future efforts to monitor changes in death rates attri butable to control programs for specific diseases (e.g., malaria and HIV/AI DS) in Africa.