Impact of COVID-19 on mortality in coastal Kenya: a longitudinal open cohort study.
Otiende M., Nyaguara A., Bottomley C., Walumbe D., Mochamah G., Amadi D., Nyundo C., Kagucia EW., Etyang AO., Adetifa IMO., Brand SPC., Maitha E., Chondo E., Nzomo E., Aman R., Mwangangi M., Amoth P., Kasera K., Ng'ang'a W., Barasa E., Tsofa B., Mwangangi J., Bejon P., Agweyu A., Williams TN., Scott JAG.
The mortality impact of COVID-19 in Africa remains controversial because most countries lack vital registration. We analysed excess mortality in Kilifi Health and Demographic Surveillance System, Kenya, using 9 years of baseline data. SARS-CoV-2 seroprevalence studies suggest most adults here were infected before May 2022. During 5 waves of COVID-19 (April 2020-May 2022) an overall excess mortality of 4.8% (95% PI 1.2%, 9.4%) concealed a significant excess (11.6%, 95% PI 5.9%, 18.9%) among older adults ( ≥ 65 years) and a deficit among children aged 1-14 years (-7.7%, 95% PI -20.9%, 6.9%). The excess mortality rate for January 2020-December 2021, age-standardised to the Kenyan population, was 27.4/100,000 person-years (95% CI 23.2-31.6). In Coastal Kenya, excess mortality during the pandemic was substantially lower than in most high-income countries but the significant excess mortality in older adults emphasizes the value of achieving high vaccine coverage in this risk group.