The burden of common XXXX at the clinic and household level from population-based surveillance in rural and urban Kenya.

@entity1 @entity11127 @entity3156 @entity294 @entity166 @entity221
BACKGROUND: Characterizing infectious disease burden in Africa is important for prioritizing and targeting limited resources for curative and preventive services and monitoring the impact of interventions. METHODS: From June 1, 2006 to May 31, 2008, we estimated rates of @entity11127 ( @entity11127 ), @entity294 and @entity221 ( @entity221 ) among >50,000 @entity1 participating in population-based surveillance in impoverished, rural western Kenya (Asembo) and an informal settlement in Nairobi, Kenya (Kibera). Field workers visited households every two weeks, collecting recent illness information and performing limited exams. @entity1 could access free high-quality care in a designated referral clinic in each site. Incidence and longitudinal prevalence were calculated and compared using Poisson regression. RESULTS: INCIDENCE RATES RESULTING IN CLINIC VISITATION WERE THE FOLLOWING: @entity11127 --0.36 and 0.51 episodes per year for @entity1 <5 years and 0.067 and 0.026 for @entity1 >=  5 years in Asembo and Kibera, respectively; @entity3156 per year for @entity1 <5 years and 0.09 and 0.062 for @entity1 >=  5 years in Asembo and Kibera, respectively; @entity221 --0.17 and 0.09 episodes per year for @entity1 <5 years and 0.03 and 0.015 for @entity1 >=  5 years in Asembo and Kibera, respectively. Annually, based on household visits, @entity1 <5 years in Asembo and Kibera had 60 and 27 cough days, 10 and 8 @entity294 days, and 37 and 11 fever days, respectively. Household-based rates were higher than clinic rates for @entity294 and @entity221 , this difference being several-fold greater in the rural than urban site. CONCLUSIONS: Individuals in poor Kenyan communities still suffer from a high burden of @entity166 , which likely hampers their development. Urban slum and rural disease incidence and clinic utilization are sufficiently disparate in Africa to warrant data from both settings for estimating burden and focusing interventions.
