Declining adult mortality in Nairobi slums is due to fall in HIV/AIDS-related mortality

Adult mortality in sub-Saharan Africa is very high and has been rising in the last two decades. Vital registration systems as main sources of adult mortality data are poorly developed in Kenya and many African countries. This paper explores adult mortality using data from the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) in two slums in Nairobi. These data are used to estimate levels, trends, causes of and factors associated with adult mortality. Using survival analysis and standard life table methodologies, mortality is estimated over a period of 5 years. A total of 1,513 adult deaths occurred.

Life expectancy and adult mortality estimates indicate a high risk of adult death in the slums with a mortality disadvantage for women. Life expectancy at 15 at the Nairobi DSS is lower than that many of the other surveillance sites. There were mortality differentials by slum of residence, gender, wealth status, ethnicity and education. Like it has been reported in some other populations affected by HIV/AIDS, adult mortality is higher among women contrary to expectation. HIV/AIDS and injuries are leading cause of death in women and men respectively. The decline in mortally over the years is real particularly among women and is attributable to reduction in HIV/AIDS-related deaths.