Prevalence and determinants of low birthweight among the children born in 1987 in Mombasa and Khale Districts of Kenya

Abstract

Low birth weight is a major associated cause of perinatal and infant mortality, and young childhood morbidity. Several studies/surveys show that LBW is a major problem in many Kenyan rural districts. Kwale district is among the top 10 with respect to LBW in Kenya. This district l'I8.S found to have a childhood mortality of 200 per 1,000 births by a UNICEF study in 1987. The present study was cafried out in 1988, using medical records for the calendar year 1887, with the following aims: 1. To determine the prevalence of LBW in the neighbouring districts of ~fombasa and Kwa Le , on the Kenyan Coast, and its relation to rainfall and malaria infection. 2. To identify,' using a case control methodology, some of the factors that contribute to low birth weight. Knowledge of such factors will facilitate possible interventions through exi st.Lng MCH-FP programm~s. 3. The outcome of pregnancy in these districts in relation to the determinants of LBW, and other maternal and obstetric factors. The records of all documented births in 1987 kept in health xii facilities in Mombasa and Kwale were used to extract the relevant information for the prevalence study. Maternity files from two hospitals in Kwale District and Lady Grigg Maternity in Mombasa were used to identify cases of LBW and their controls from these institutions. These files provided the information on contributory factors to LBW in the districts under study. Climatic conditions during the year were obtained from records at the Meteorological DepartDe~t headquarters in Nairobi. Records of malaria parasitaemia for Mombasa and Kinango were o~tained from DVBD section of t.he National Public Health Laboratory Services offices in Nairobi for the year 1987. The study showed that the prevalence of LBW in 1987 was 14.1% 1n Mombasa and 22.5% in Kwale. There was a peak LBW period during the third quarter of the year (July-September) in brith districts; a time lag of 2-3 months existed between rainfall and LBW in both areas. The important risk factors associated with LBW in the two districts were identified using logistic regression analysis. They were: gestation of 36 weeks or less; maternal anaemia; malaria infection during pregnancy; primigravid pregnancy; female sex; maternal age at or below 17 years; Nombasa District delivery,

The outcome of pregnancy was found to be worse in Kwale tha. in Mombasa for both cases and controls. The possible reasons fo this are discussed.