PEDIATRIC MALARIA AT A RURAL HEALTH CLINIC IN WESTERN KENYA, JUNE 2006-JULY 2010 Public
Shah, Melisa M. (2011)
Published
Abstract
Background: Malaria is an important cause of morbidity and mortality, particularly in Africa which bears the majority of burden from the infection. Clinic-based surveillance of malaria is an important tool to track trends in malaria prevalence in rural Africa.
Objective: This study aims to describe trends and factors associated with malaria positivity among children under five at a rural clinic in Western Kenya from July 2006 to June 2010. The primary objective is to elucidate whether malaria positivity at the clinic varied during the four year study span.
Methods: The International Emerging Infections Program is a clinic-based morbidity surveillance in rural Western Kenya. Demographic and clinical data from this program was obtained for all children under five attending care at the Lwak Referral Center between July 2006 and June 2010. Logistic regression models were conducted to assess the relationship between malaria positivity and year of visit accounting for age, sex, bednet use, rainfall, and distance to clinic.
Results: From July 2006 to June 2010, 18,925 children under five attended Lwak Referral Center for a sick visit. Of all children seeking care, 47.7% were laboratory diagnosed with malaria. When age, sex, bednet use, rainfall, and distance to clinic are accounted for, year of visit was significantly associated with malaria positivity (p<.0001). Children visiting the clinic between July 2008 and June 2009 had the highest odds of malaria positivity of all four year categories when compared to the first year (OR 3.67, 95%CI: 3.21-4.19). Older children, children not sleeping under bednets, children travelling two kilometers or farther, and children visiting the clinic during times of rainfall of 164mm/month of greater, had increased odds of malaria positivity.
Conclusions: Clinic-based surveillance provides an important snapshot of pediatric malaria trends. In rural western Kenya between July 2006 and June 2010, malaria positivity among children under five at a clinic was associated with year of visit, age, bednet use, distance to clinic, and rainfall. In particular, heavy rainfall in the year between July 2008 and June 2009 contributed to increased pediatric malaria clinic diagnoses.
Table of Contents
TABLE OF CONTENTS
1. BACKGROUND
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2. METHODS
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3. RESULTS
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4. DISCUSSION
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5. REFERENCES
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6. TABLES and CHARTS
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7. APPENDICES
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