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Malar J. 2007 Nov 15;6:151.

The decline in paediatric malaria admissions on the coast of Kenya.

Author information

1
Malaria Public Health & Epidemiology Group, Centre for Geographic Medicine Research - Coast, Kenya Medical Research Institute/Wellcome Trust Research Programme, P,O, Box 43640, 00100 GPO, Nairobi, Kenya. eokiro@nairobi.kemri-wellcome.org

Abstract

BACKGROUND:

There is only limited information on the health impact of expanded coverage of malaria control and preventative strategies in Africa.

METHODS:

Paediatric admission data were assembled over 8.25 years from three District Hospitals; Kilifi, Msambweni and Malindi, situated along the Kenyan Coast. Trends in monthly malaria admissions between January 1999 and March 2007 were analysed using several time-series models that adjusted for monthly non-malaria admission rates and the seasonality and trends in rainfall.

RESULTS:

Since January 1999 paediatric malaria admissions have significantly declined at all hospitals. This trend was observed against a background of rising or constant non-malaria admissions and unaffected by long-term rainfall throughout the surveillance period. By March 2007 the estimated proportional decline in malaria cases was 63% in Kilifi, 53% in Kwale and 28% in Malindi. Time-series models strongly suggest that the observed decline in malaria admissions was a result of malaria-specific control efforts in the hospital catchment areas.

CONCLUSION:

This study provides evidence of a changing disease burden on the Kenyan coast and that the most parsimonious explanation is an expansion in the coverage of interventions such as the use of insecticide-treated nets and the availability of anti-malarial medicines. While specific attribution to intervention coverage cannot be computed what is clear is that this area of Kenya is experiencing a malaria epidemiological transition.

PMID:
18005422
PMCID:
PMC2194691
DOI:
10.1186/1475-2875-6-151
[Indexed for MEDLINE]
Free PMC Article

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