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The decline in paediatric malaria admissions on the coast of Kenya

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.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1186/1475-2875-6-151

Authors

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Institution:
"Kenya Medical Research Institute/ Wellcome Trust Research Programme, Nairobi, Kenya"
Department:
Malaria Public Health & Epidemiology Group,Centre for Geographic Medicine Research - Coast
Role:
Author
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Institution:
"Kenya Medical Research Institute/ Wellcome Trust Research Programme, Nairobi, Kenya", "University of Oxford"
Research group:
Spatial ecology and epidemiology
Department:
Mathematical,Physical & Life Sciences Division - Zoology
Role:
Author
More by this author
Institution:
"Kenya Medical Research Institute/ Wellcome Trust Research Programme, Nairobi, Kenya"
Department:
Malaria Public Health & Epidemiology Group,Centre for Geographic Medicine Research - Coast
Role:
Author
More by this author
Institution:
"Ministry of Health, Nairobi, Kenya"
Role:
Author
More by this author
Institution:
"Kenya Medical Research Institute/ Wellcome Trust Research Programme, Nairobi, Kenya"
Department:
Malaria Public Health & Epidemiology Group,Centre for Geographic Medicine Research - Coast
Role:
Author


Publisher:
BioMed Central
Journal:
Malaria Journal More from this journal
Volume:
6
Article number:
151
Publication date:
2007-11-01
Edition:
Publisher's version
DOI:
ISSN:
1475-2875


Language:
English
Keywords:
Subjects:
UUID:
uuid:9cf358e9-8fd2-4ec3-8164-50e5a3f19ab6
Local pid:
ora:2407
Deposit date:
2008-10-29
ARK identifier:

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