Geospatial distribution and determinants of child mortality in rural western Kenya 2002-2005.

摘要: OBJECTIVE To describe local geospatial variation and risk factors for child mortality in rural western Kenya. METHODS We calculated under-5 rates (U5MR) 217 villages a Health Demographic Surveillance System (HDSS) area Kenya from 1 May 2002 through 31 December 2005. U5MRs by village were mapped. Geographical positioning system coordinates of residences at the time death distances to nearby locations calculated. Multivariable Poisson regression accounting clustering compound level was used evaluate association infants children aged 1-4 years. RESULTS Among 54 057 children, overall U5MR 56.5 per 1000 person-years varied 21 177 person-years. High occurred clusters location remained highest quintile over several In multivariable analysis, controlling maternal age education as well household crowding, higher infant associated with living closer streams further public transport roads. For years, middle elevations (1280-1332 metres), within lower population densities areas, northern section HDSS mortality. CONCLUSIONS Childhood significantly some villages. Several mortality, which might indicate variability access health care or exposure transmission infectious diseases. These results are useful prioritising areas study implementing directed interventions.