Deaths of children from pneumonia and other respiratory infections in Kibera slum have dropped sharply by 88 per cent from 2011, an analysis by Kenya Medical Research Institute shows.
However, many of the survivors are later felled by diarrhoea, TB , HIV and malaria.
Kemri experts attributed the drop in acute respiratory infections and pneumonia deaths to the introduction of the pneumococcal vaccine in 2011.
The vaccine prevents pneumonia and other respiratory bacteria. This represents one of Kenya's biggest public health successes and shows the importance of vaccinating children.
“The introduction of the 10-valent pneumococcal conjugate vaccine (PCV10) in Kenya in January 2011 likely contributed to that reduction, particularly for vaccine-specific serotypes,” researchers said.
The study was co-authored by researchers from South Korea’s International Vaccine Institute, US Centers for Disease Control and Prevention, and the Emory Global Health Institute of Atlanta, USA.
The final paper, “Mortality patterns over a 10-year period in Kibera, an urban informal settlement in Nairobi, Kenya, 2009–2018,” was published in the Global Health Action journal last week.
The success of the PCV10 vaccine has been observed in other regions as well. Studies conducted in Brazil and South Africa have reported declines in childhood pneumonia mortality attributable to the vaccine.
Despite the progress made, pneumonia/ARI remained a leading cause of mortality among children under five years in Kibera, underscoring the need for continued efforts to improve housing conditions and reduce indoor air pollution in the region.
The study spanned from 2009 to 2018 and registered a total of 1,134 deaths.
Males had higher overall mortality rates than females, with the highest mortality rate observed among children aged under 12 months.
However, the researchers said deaths caused by HIV/AIDS and tuberculosis (TB) persisted among persons aged five years and above.
“Despite this progress, we observed a persistent burden of deaths due to infectious diseases such as HIV/Aids and pneumonia in adults, and malaria, diarrhoea and HIV/Aids in young children,” the authors said.
This means despite surviving pneumonia, many children do not escape other communicable and non-communicable diseases in the slum.
HIV/Aids and TB were identified as leading causes of death among older individuals, with a significant decline in TB deaths but no significant change in HIV/AIDS deaths over the study period.
Malaria stood out as an important cause of death among children aged below five years despite Nairobi being considered a low-risk area for malaria transmission.
The researchers noted 64 per cent of malaria cases reported travel outside Nairobi in the past month, most of them to western Kenya areas with a high malaria burden.
“Therefore, malaria deaths occurring in Kibera most likely reflect infections acquired outside of Nairobi,” they said.
The researchers said respiratory neoplasm, the abnormal growth or tumour in the lungs, is also a major contributor to mortality related to NCDs among older children and adults.
“These deaths combined with high number of ARI/pneumonia related deaths may suggest household air pollution and smoking as important risk factors in this setting,” they said.
“Several studies conducted to assess air quality have reported high levels of fine particulate matters (PM2.5) in similar settings in Kenya,” the authors noted.
