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

<p>Background: The 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...

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Main Authors: Githinji, S, Noor, A, Malinga, J, Macharia, P, Kiptui, R, Omar, A, Njagi, K, Waqo, E, Snow, R
Format: Journal article
Published: BioMed Central 2016
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author Githinji, S
Noor, A
Malinga, J
Macharia, P
Kiptui, R
Omar, A
Njagi, K
Waqo, E
Snow, R
author_facet Githinji, S
Noor, A
Malinga, J
Macharia, P
Kiptui, R
Omar, A
Njagi, K
Waqo, E
Snow, R
author_sort Githinji, S
collection OXFORD
description <p>Background: The 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.</p> <p>Methods: Random 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.</p> <p>Results: 10,557 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.</p> <p>Conclusion: Malaria 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.</p>
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spelling oxford-uuid:3a57a6c7-a3ab-4879-b8c6-4d1699a292b22022-03-26T14:01:05ZA national health facility survey of malaria infection among febrile patients in Kenya, 2014Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:3a57a6c7-a3ab-4879-b8c6-4d1699a292b2Symplectic Elements at OxfordBioMed Central2016Githinji, SNoor, AMalinga, JMacharia, PKiptui, ROmar, ANjagi, KWaqo, ESnow, R<p>Background: The 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.</p> <p>Methods: Random 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.</p> <p>Results: 10,557 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.</p> <p>Conclusion: Malaria 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.</p>
spellingShingle Githinji, S
Noor, A
Malinga, J
Macharia, P
Kiptui, R
Omar, A
Njagi, K
Waqo, E
Snow, R
A national health facility survey of malaria infection among febrile patients in Kenya, 2014
title A national health facility survey of malaria infection among febrile patients in Kenya, 2014
title_full A national health facility survey of malaria infection among febrile patients in Kenya, 2014
title_fullStr A national health facility survey of malaria infection among febrile patients in Kenya, 2014
title_full_unstemmed A national health facility survey of malaria infection among febrile patients in Kenya, 2014
title_short A national health facility survey of malaria infection among febrile patients in Kenya, 2014
title_sort national health facility survey of malaria infection among febrile patients in kenya 2014
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