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. 2009 Dec;15(12):1917-24.
doi: 10.3201/eid1512.090627.

Possible interruption of malaria transmission, highland Kenya, 2007-2008

Chandy C John  1 , Melissa A Riedesel, Ng'wena G Magak, Kim A Lindblade, David M Menge, James S Hodges, John M Vulule, Willis Akhwale
Affiliations

Possible interruption of malaria transmission, highland Kenya, 2007-2008

Chandy C John et al. Emerg Infect Dis. 2009 Dec.

Abstract

Highland areas where malaria transmission is unstable are targets for malaria elimination because transmission decreases to low levels during the dry season. In highland areas of Kipsamoite and Kapsisiywa, Kenya (population approximately 7,400 persons), annual household indoor residual spraying with a synthetic pyrethroid was performed starting in 2005, and artemether/lumefantrine was implemented as first-line malaria treatment in October 2006. During April 2007-March 2008, no microscopy-confirmed cases of malaria occurred at the sites. In 4 assessments of asymptomatic persons during May 2007-April 2008, a total of <0.3% of persons were positive for asexual Plasmodium falciparum by microscopy or PCR at any time, and none were positive by PCR at the last 2 sample collections. Our findings show that in such areas, interruption and eventual elimination of malaria transmission may be achievable with widespread annual indoor residual spraying of households and artemisinin combination therapy.

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Figures

Figure 1
Figure 1
Malaria incidence and number of patients seen at health dispensaries in 2 highland areas of western Kenya, April 2003–March 2008. A) Monthly incidence of malaria/1,000 persons in Kipsamoite. B) Monthly incidence of malaria/1,000 persons in Kapsisiywa. C) No. patients who came to the Kipsamoite health dispensary. D) No. patients who came to the Kapsisiywa health dispensary. Gaps in panels A and B indicate that no data were collected during these periods. Arrows indicate when indoor residual spraying was conducted in the 2 areas.
Figure 2
Figure 2
Temperature, rainfall, and vector density in 2 highland areas of western Kenya, April 2003–May 2008. A) Average daily temperature (°C) in Kipsamoite. B) Monthly rainfall (mm) in Kipsamoite. C) Median biweekly vector density (no. Anopheles spp. mosquitoes/household) in Kapsisiywa (red line) and Kipsamoite (black line). Gaps in panels indicate that no data were collected during these periods. Arrows indicate times when indoor residual spraying was conducted.
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