MALARIA IN KENYA JEREMY arvid ODERA CHEK

KENYA

DEMOGRAPHIC AND SOCIO-ECONOMIC INFORMATION Population a : 32,020,244 (2002) Age structure a : ● 0-14 years 43% ● years 54% ● 65 years and over 3% Population growth rate a : 2.18% ( ) Life expectancy at birth ( ) a : ● Total population 49.3 years ● Male 49.9 years ● Female 48.7 years Infant and child mortality (per 1000 LB) c, d : ● Neonatal mortality rate (1998) 28.4 ● Infant mortality rate (2001) 78 ● Childhood mortality rate (1998) 40.8 ● Under five mortality rate (2001) 122

National Health Indicators (2000) b : ● Per capita GDP in US dollars 1,396 ● Total expenditure on health as % of GDP 8.3 ● Per capita total expenditure on health in 115 ● Per capita government expenditure on 26 ● General Government expenditure on 8.1 health as % of total general government expenditure ● Total national budget for malaria as % of N/A total national health budget Global Fund support to fight Malaria: ● The Global Fund has approved an amount of US$ 10,526,880 for a period of two years for the project submitted by Kenya to address and reduce the impact of malaria. Number of districts in the country: 77 Sources: a United Nation Population Division World Population Prospects: Population Database: The 2002 Revision, b WHO Statistical Information System (WHOSIS): Country Official Health Indicators, c Human Development Report, UNDP (2003) d Demographic and Health Survey in Kenya (1998)

HEALTH PROBLEMS HIV/AIDS MALARIA. Tuberculosis Schistosomiasis Trypanosomiasis Leishmaniasis Cholera Amoebiasis Typhoid Fever Leprosy Onchocerciasis Lymphatic Filariasis

MALARIA EPIDEMIOLOGY: Anopheles Species : Forty one (41) Anopheles species have been documented in the country. The following anopheles species are malaria vectors: An. Merus, An. Nili, An. Gambiae, An. Funestus, An. Coustani, An. Pharoensis, An. Arabiensis, An. Paludis Malaria Parasite Species: The main parasite is Plasmodium falciparum.

Malaria Transmission Season : There are two transmission seasons in Kenya. They vary from one province to another. The first Malaria Transmission Season is from January to December while the second is from October to January but in one area it occurs only in April. Malaria Risk : Population at Risk of malaria 100% Negligible Risk 16% Epidemic Risk 30% Endemic Risk 54%

Precautions Travellers and their advisers should note the four principles of malaria protection: — Be Aware of the risk, the incubation period, and the main symptoms. — Avoid being Bitten by mosquitoes, especially between dusk and dawn. — Take antimalarial drugs (Chemoprophylaxis) when appropriate, to prevent infection from developing into clinical disease. — Immediately seek Diagnosis and treatment if a fever develops one week or more after entering an area where there is a malaria risk, and up to 3 months after departure from a risk area.

CASE MANAGEMENT AND DRUG POLICY : Antimalarial Drug Policy: Sulphadoxine-pyrimethamine is the first line drug for uncomplicated Malaria. It is also used for the prevention of malaria in pregnancy. Amodiaquine is the second-line (treatment failure) drug and Quinine is recommended for Severe Malaria.