The decline in paediatric malaria admissions on the coast of Kenya

Malar J. 2007 Nov 15;6:151. doi: 10.1186/1475-2875-6-151.

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 types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Hospitals, District
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Kenya / epidemiology
  • Linear Models
  • Malaria / diagnosis
  • Malaria / epidemiology*
  • Patient Admission / statistics & numerical data*
  • Population Surveillance
  • Rain
  • Seasons