A national health facility survey of malaria infection among febrile patients in Kenya, 2014

Malaria Journal

Research

Peter M. Macharia¹  Josephine Malinga¹  Sophie Githinji¹  Robert W. Snow²  Abdisalan M. Noor²  Ahmeddin Omar³  Kiambo Njagi³  Ejersa Waqo³  Rebecca Kiptui³ 

[1] KEMRI-Wellcome Trust Collaborative Programme, Nairobi, Kenya;KEMRI-Wellcome Trust Collaborative Programme, Nairobi, Kenya;Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK;National Malaria Control Programme, Ministry of Health, Nairobi, Kenya;

关键词: Malaria;    Malaria Infection;    Rapid Diagnostic Test;    Public Health Facility;    Malaria Risk;   

DOI  :  10.1186/s12936-016-1638-2

 received in 2016-09-30, accepted in 2016-11-24,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe use of malaria infection prevalence among febrile patients at clinics has a potential to be a valuable epidemiological surveillance tool. However, routine data are incomplete and not all fevers are tested. This study was designed to screen all fevers for malaria infection in Kenya to explore the epidemiology of fever test positivity rates.MethodsRandom sampling was used within five malaria epidemiological zones of Kenya (i.e., high lake endemic, moderate coast endemic, highland epidemic, seasonal low transmission and low risk zones). The selected sample was representative of the number of hospitals, health centres and dispensaries within each zone. Fifty patients with fever presenting to each sampled health facility during the short rainy season were screened for malaria infection using a rapid diagnostic test (RDT). Details of age, pregnancy status and basic demographics were recorded for each patient screened.Results10,557 febrile patients presenting to out-patient clinics at 234 health facilities were screened for malaria infection. 1633 (15.5%) of the patients surveyed were RDT positive for malaria at 124 (53.0%) facilities. Infection prevalence among non-pregnant patients varied between malaria risk zones, ranging from 0.6% in the low risk zone to 41.6% in the high lake endemic zone. Test positivity rates (TPR) by age group reflected the differences in the intensity of transmission between epidemiological zones. In the lake endemic zone, 6% of all infections were among children aged less than 1 year, compared to 3% in the coast endemic, 1% in the highland epidemic zone, less than 1% in the seasonal low transmission zone and 0% in the low risk zone. Test positivity rate was 31% among febrile pregnant women in the high lake endemic zone compared to 9% in the coast endemic and highland epidemic zones, 3.2% in the seasonal low transmission zone and zero in the low risk zone.ConclusionMalaria infection rates among febrile patients, with supporting data on age and pregnancy status presenting to clinics in Kenya can provide invaluable epidemiological data on spatial heterogeneity of malaria and serve as replacements to more expensive community-based infection rates to plan and monitor malaria control.

【 授权许可】

CC BY   
© The Author(s) 2016