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

Okiro EA, Hay SI, Gikandi PW, Sharif SK, Noor AM, Peshu N, Marsh K, Snow RW - Malar. J. (2007)

Bottom Line: Paediatric admission data were assembled over 8.25 years from three District Hospitals; Kilifi, Msambweni and Malindi, situated along the Kenyan Coast.This trend was observed against a background of rising or constant non-malaria admissions and unaffected by long-term rainfall throughout the surveillance period.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.

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Affiliation: 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.

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Map showing the three study districts and the location of the metrological station in relation to the hospital facility. Inset is a map of Kenya showing location of three districts.
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Figure 1: Map showing the three study districts and the location of the metrological station in relation to the hospital facility. Inset is a map of Kenya showing location of three districts.

Mentions: Three district hospitals were selected purposively along a 170 km stretch of the Kenyan coast at Malindi, Kilifi and Msambweni (located in Kwale district). They are located in three different districts of Coast Province, and all serve populations who share similar climatic, ecological and economic characteristics (Figure 1).


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

Okiro EA, Hay SI, Gikandi PW, Sharif SK, Noor AM, Peshu N, Marsh K, Snow RW - Malar. J. (2007)

Map showing the three study districts and the location of the metrological station in relation to the hospital facility. Inset is a map of Kenya showing location of three districts.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2194691&req=5

Figure 1: Map showing the three study districts and the location of the metrological station in relation to the hospital facility. Inset is a map of Kenya showing location of three districts.
Mentions: Three district hospitals were selected purposively along a 170 km stretch of the Kenyan coast at Malindi, Kilifi and Msambweni (located in Kwale district). They are located in three different districts of Coast Province, and all serve populations who share similar climatic, ecological and economic characteristics (Figure 1).

Bottom Line: Paediatric admission data were assembled over 8.25 years from three District Hospitals; Kilifi, Msambweni and Malindi, situated along the Kenyan Coast.This trend was observed against a background of rising or constant non-malaria admissions and unaffected by long-term rainfall throughout the surveillance period.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.

View Article: PubMed Central - HTML - PubMed

Affiliation: 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.

Show MeSH
Related in: MedlinePlus