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Identification of malaria transmission and epidemic hotspots in the western Kenya highlands: its application to malaria epidemic prediction.

Wanjala CL, Waitumbi J, Zhou G, Githeko AK - Parasit Vectors (2011)

Bottom Line: The study was conducted in five sites in the western Kenya highlands, two U-shaped valleys (Iguhu, Emutete), two V-shaped valleys (Marani, Fort-Ternan) and one plateau (Shikondi) for 16 months among 6-15 years old children.The plateau ecosystem has a similar infection and immune response to the V-shaped ecosystems.The U-shaped ecosystems are transmission hotspots.

View Article: PubMed Central - HTML - PubMed

Affiliation: Climate and Human Health Research Unit, Centre for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya. ludwin_kristen@yahoo.com

ABSTRACT

Background: Malaria in the western Kenya highlands is characterized by unstable and high transmission variability which results in epidemics during periods of suitable climatic conditions. The sensitivity of a site to malaria epidemics depends on the level of immunity of the human population. This study examined how terrain in the highlands affects exposure and sensitivity of a site to malaria.

Methods: The study was conducted in five sites in the western Kenya highlands, two U-shaped valleys (Iguhu, Emutete), two V-shaped valleys (Marani, Fort-Ternan) and one plateau (Shikondi) for 16 months among 6-15 years old children. Exposure to malaria was tested using circum-sporozoite protein (CSP) and merozoite surface protein (MSP) immunochromatographic antibody tests; malaria infections were tested by microscopic examination of thick and thin smears, the children's homes were georeferenced using a global positioning system. Paired t-test was used to compare the mean prevalence rates of the sites, K-function was use to determine if the clustering of malaria infections was significant.

Results and discussion: The mean antibody prevalence was 22.6% in Iguhu, 24% in Emutete, 11.5% in Shikondi, 8.3% in Fort-Ternan and 9.3% in Marani. The mean malaria infection prevalence was 23.3% in Iguhu, 21.9% in Emutete, 4.7% in Shikondi, 2.9% in Fort-Ternan and 2.4% in Marani. There was a significant difference in the antibodies and malaria infection prevalence between the two valley systems, and between the two valley systems and the plateau (P < 0.05). There was no significant difference in the antibodies and malaria infection prevalence in the two U-shaped valleys (Iguhu and Emutete) and in the V-shaped valleys (Marani and Fort Ternan) (P > 0.05). There was 8.5- fold and a 2-fold greater parasite and antibody prevalence respectively, in the U-shaped compared to the V-shaped valleys. The plateau antibody and parasite prevalence was similar to that of the V-shaped valleys. There was clustering of malaria antibodies and infections around flat areas in the U-shaped valleys, the infections were randomly distributed in the V-shaped valleys and less clustered at the plateau.

Conclusion: This study showed that the V-shaped ecosystems have very low malaria prevalence and few individuals with an immune response to two major malaria antigens and they can be considered as epidemic hotspots. These populations are at higher risk of severe forms of malaria during hyper-transmission seasons. The plateau ecosystem has a similar infection and immune response to the V-shaped ecosystems. The U-shaped ecosystems are transmission hotspots.

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The map of the five study sites; Iguhu, Emutete, Fort Ternan, Marani and Shikondi in Western Kenya.
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Figure 2: The map of the five study sites; Iguhu, Emutete, Fort Ternan, Marani and Shikondi in Western Kenya.

Mentions: This study was conducted in five sites, two U-shaped valleys (Iguhu and Emutete), two V-shaped valleys (Marani and Fort Ternan) and one plateau (Shikondi). Iguhu (0°17'N, 34°74'E, and elevation 1,450-1,580 m above sea level) is located in Kakamega district, western Kenya. The slow flowing river Yala runs through the flood prone flat valley. Emutete village (34°64 E, 00°22 N, elevation 1,463 - 1,603 m above the sea level) is located in Emuhaya district in Western Kenya. The area is characterized by large flat bottomed valley with slow running streams. Marani (34°48 E, 00°02 N and elevation 1,520-1,700 m above the sea level) is located on the highland plateau adjacent to the Lake Victoria Basin and 17 km north of Kisii town. The fast flowing Marani river runs along the shallow gorge. Fort Ternan (00°12 S 35°21 E, elevation 1,500 m - 1,600 m above the sea level) is located in Kericho District. River Kipchorian bisects the hills and runs a long a deep gorge. Shikondi (0.192300 N, 34.763000 E, and elevation 1,533 m - 1,576 m above the sea level) is a plateau located 4 Km from Iguhu in Kakamega district, western Kenya (Figure 2)


Identification of malaria transmission and epidemic hotspots in the western Kenya highlands: its application to malaria epidemic prediction.

Wanjala CL, Waitumbi J, Zhou G, Githeko AK - Parasit Vectors (2011)

The map of the five study sites; Iguhu, Emutete, Fort Ternan, Marani and Shikondi in Western Kenya.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3117811&req=5

Figure 2: The map of the five study sites; Iguhu, Emutete, Fort Ternan, Marani and Shikondi in Western Kenya.
Mentions: This study was conducted in five sites, two U-shaped valleys (Iguhu and Emutete), two V-shaped valleys (Marani and Fort Ternan) and one plateau (Shikondi). Iguhu (0°17'N, 34°74'E, and elevation 1,450-1,580 m above sea level) is located in Kakamega district, western Kenya. The slow flowing river Yala runs through the flood prone flat valley. Emutete village (34°64 E, 00°22 N, elevation 1,463 - 1,603 m above the sea level) is located in Emuhaya district in Western Kenya. The area is characterized by large flat bottomed valley with slow running streams. Marani (34°48 E, 00°02 N and elevation 1,520-1,700 m above the sea level) is located on the highland plateau adjacent to the Lake Victoria Basin and 17 km north of Kisii town. The fast flowing Marani river runs along the shallow gorge. Fort Ternan (00°12 S 35°21 E, elevation 1,500 m - 1,600 m above the sea level) is located in Kericho District. River Kipchorian bisects the hills and runs a long a deep gorge. Shikondi (0.192300 N, 34.763000 E, and elevation 1,533 m - 1,576 m above the sea level) is a plateau located 4 Km from Iguhu in Kakamega district, western Kenya (Figure 2)

Bottom Line: The study was conducted in five sites in the western Kenya highlands, two U-shaped valleys (Iguhu, Emutete), two V-shaped valleys (Marani, Fort-Ternan) and one plateau (Shikondi) for 16 months among 6-15 years old children.The plateau ecosystem has a similar infection and immune response to the V-shaped ecosystems.The U-shaped ecosystems are transmission hotspots.

View Article: PubMed Central - HTML - PubMed

Affiliation: Climate and Human Health Research Unit, Centre for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya. ludwin_kristen@yahoo.com

ABSTRACT

Background: Malaria in the western Kenya highlands is characterized by unstable and high transmission variability which results in epidemics during periods of suitable climatic conditions. The sensitivity of a site to malaria epidemics depends on the level of immunity of the human population. This study examined how terrain in the highlands affects exposure and sensitivity of a site to malaria.

Methods: The study was conducted in five sites in the western Kenya highlands, two U-shaped valleys (Iguhu, Emutete), two V-shaped valleys (Marani, Fort-Ternan) and one plateau (Shikondi) for 16 months among 6-15 years old children. Exposure to malaria was tested using circum-sporozoite protein (CSP) and merozoite surface protein (MSP) immunochromatographic antibody tests; malaria infections were tested by microscopic examination of thick and thin smears, the children's homes were georeferenced using a global positioning system. Paired t-test was used to compare the mean prevalence rates of the sites, K-function was use to determine if the clustering of malaria infections was significant.

Results and discussion: The mean antibody prevalence was 22.6% in Iguhu, 24% in Emutete, 11.5% in Shikondi, 8.3% in Fort-Ternan and 9.3% in Marani. The mean malaria infection prevalence was 23.3% in Iguhu, 21.9% in Emutete, 4.7% in Shikondi, 2.9% in Fort-Ternan and 2.4% in Marani. There was a significant difference in the antibodies and malaria infection prevalence between the two valley systems, and between the two valley systems and the plateau (P < 0.05). There was no significant difference in the antibodies and malaria infection prevalence in the two U-shaped valleys (Iguhu and Emutete) and in the V-shaped valleys (Marani and Fort Ternan) (P > 0.05). There was 8.5- fold and a 2-fold greater parasite and antibody prevalence respectively, in the U-shaped compared to the V-shaped valleys. The plateau antibody and parasite prevalence was similar to that of the V-shaped valleys. There was clustering of malaria antibodies and infections around flat areas in the U-shaped valleys, the infections were randomly distributed in the V-shaped valleys and less clustered at the plateau.

Conclusion: This study showed that the V-shaped ecosystems have very low malaria prevalence and few individuals with an immune response to two major malaria antigens and they can be considered as epidemic hotspots. These populations are at higher risk of severe forms of malaria during hyper-transmission seasons. The plateau ecosystem has a similar infection and immune response to the V-shaped ecosystems. The U-shaped ecosystems are transmission hotspots.

Show MeSH
Related in: MedlinePlus