Causes of mortality among the fishermen in Lake Victoria, Kenya

Abstract

The fishing industry plays an integral role in socio-economic development in Kenya. The working environment of fishermen however is characterized by a wide variety of occupational hazards. Mortality attributed to work related diseases or accidents and injuries are poor reported in Kenya. Most of the reported cases are in the formal sectors, while the informal sectors such as fishing, where most Kenyans are employed, are largely ignored. The objective of the study was to determine the cause of mortality and identify factors that influence mortality among Kenyan fishermen in Lake Victoria. A two-year retrospective mortality survey using verbal autopsy was carried out among fishermen in the eight riparian districts of Lake Victoria, Kenya on fishermen deaths occurring between August 1998 - July 2000. Differences in the proportions of deaths within the riparian districts were determined by using chi square. Descriptive statistics were used to calculate the proportions of mortality by disease. Differences in the associations between categorical variables were assessed using Logistic Regression analysis. The study successfully followed up a total of 3058 deceased fishermen. The mean age at death was 33 years (SD: ± 9.5) and a median of 32 years ranging between 15-54 years with the peak mortality reported among fishermen aged 25-29 years (19.8%) followed by those aged 30-34 years (19.3). The findings reveal that the major causes of death were: HIV - related infections (33.8), drowning (14.3%), pulmonary tuberculosis (12.4%), and malaria (10.4%). Factors influencing HIV -related mortality were: age group (p = 0.0025), districts of residence (Busia, Kisumu, Migori and Suba) all of which had similar p value (< 0.0001). The risk factors associated with deaths due to drowning were: age group (p = < 0.0001), use of a combination of sails and paddles (p = < 0.0001), use of paddle (p = 0.0003), secondary education (p = < 0.0001) and drinking of alcohol (p = 0.0012). Strategies must be identified that would prevent HIV -related infections and drowning among fishing community.