Morbidity and mortality situation in Makongeni Estate, Thika Municipality

Abstract

The aim of the study was to investigate morbidity situations in Makongeni Estate in Thika Municipality and also estimate the mortality levels by causes of death and how they compare with the rest of the Municipality. The study was based on data from the Environmental Air Quality Assessment Project undertaken by Kenya Medical Research Institute in collaboration with Kenya Energy and Environmental Organization whose main objective is to establish whether there is an association between air quality and the health problems experienced by the residents of Makongeni Estate in Thika Municipality. Both primary and secondary data was used in this study. Demographic, SOCIOeconomic and morbidity data was obtained through household cross-sectional survey which involved households with under 5 years old children. Mortality data was obtained through review of deaths register for the years 1995 and 1996 in the Thika districts' vital statistic registration office. The analytical techniques used included percentage distribution and cross-tabulation using SPSS/PC. Chi-square statistical test was used to assess the level of association. A total of 1590 households were involved in the cross-sectional household survey. The population size of the selected households was 7,035. The average household size was 4.41 persons with a standard deviation (SQ) of·l~49. The distribution of the population by age was as follows:- 28.2% were under 5 years of age, 13.1 % in the 5 - 9 years age group, 6.9% in 10 -14 years. The population aged >15 years accounted for 52.8% while those.aged > 55 years accounted for 0.27%. The male to female ratio was 1 : 1.1 2. Analysis of the households health status indicated that 3867 episodes had been experienced during a period of one month. This yielded an incidence of 524 episodes (vii) of illness per 1,000 person months. The mean recall period was 11 .4± 8.0 days and ranged between 1 and 30 days. Out of the 3687 episodes of illness, respiratory tract illnesses constituted 64.7%, malaria 10%, gastro-intestinal 8.2% and skin diseases 2.4%. A breakdown of the respiratory tract illnesses by type indicated that common colds and coughing were the predominant presentations. The duration of the reported illnesses ranged from 1 day to 30 days. 80.4% reported a duration of 7 days or less. 13.5% reported a duration of 14 days or less while 5.6% had a duration of illness ranging between 15 to 30 days. The age and gender distribution of these illnesses indicated the highest incidence among the under-5-years-old and a broad peak among females in their reproductive age and a narrower peak among males aged between 25 and 34 years. The age distribution by type of illness or affected system affected showed that 32.3% of those ill were unde.vb-vears old and the predominant illnesses were those affecting the respiratory tract. Review of mortality r-ecords for 1995 and 1996 showed significantly higher deaths among the under-5-years-old and those above 55 years of age. With regard to immediate underlying cause of death, diseases of the respiratory tract system and malaria accounted for 37.8 % and 40.5 % of deaths in Makq.!lseni Estate and the entire Municipality, respectively. Excepting trauma, there were no significant differences in the distribution of causes of deaths among Makongeni Estate residents and those of the other parts of the Municipality. In view of these findings, targeted intervention programmes coupled with a comprehensive primary health care system, would most likely result in much less morbidity and mortality for the population in the Makongeni Estate and the municipality as whole.