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

Journal article

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.

Authors: Okiro, E; Hay, S; Gikandi, P; Sharif, S; Noor, A

• Publication status: Published
• Journal: Malaria journal
• Volume: 6
• Issue: 1
• Pages: 151
• Publication date: 2007-01-01
• DOI: 10.1186/1475-2875-6-151
• EISSN: 1475-2875
• ISSN: 1475-2875
• Language: English
• Keywords: Linear Models; Incidence; Kenya; Seasons; Child; Child, Preschool; Humans; Patient Admission; Adolescent; Population Surveillance; Rain; Infant; Hospitals, District; Infant, Newborn; Malaria