Kenya Malaria Fact Sheet
Kenya Malaria Fact Sheet
Malaria in Kenya at a glance

Malaria is the leading cause of morbidity and mortality in Kenya .
  • 25 million out of a population of 34 million Kenyans are at risk of malaria.
  • It accounts for 30-50% of all outpatient attendance and 20% of all admissions to health facilities.
  • An estimated 170 million working days are lost to the disease each year (MOH 2001).
  • Malaria is also estimated to cause 20% of all deaths in children under five (MOH 2006).
  • The most vulnerable group to malaria infections are pregnant women and children under 5 years of age.

In collaboration with partners, the government has developed the 10-year Kenyan National Malaria Strategy (KNMS) 2009-2017 (link) which was launched 4th november 2009. The goal of the National Malaria Strategy is to reduce morbidity and mortality associated with malaria by 30% by 2009 and to maintain it to 2017.

Strategic Approaches


Case management

This approach deals with the formulation and implementation of malaria treatment policy issues

Management of malaria and Anaemia in Pregnancy (MIP)

The approach addresses the provision of malaria prevention measures and treatment of pregnant women.

Vector control

This approach's intention is to ensure use of insecticide treated nets by at risk communities, to significantly reduce rates of the disease and other methods through Integrated Vector Management.

Epidemic Preparedness and Response (EPR)

This approach is intended to improve epidemic preparedness and response by establishment of malaria early warning systems and carrying out preventive measures such as the Indoor Residue Spraying (IRS) campaigns.

In addition to the four strategic approaches, the NMS outlines two vital cross cutting strategies required to support the above strategic approaches , namely:

Information Education Communication

This strategy is to better arm the public with malaria preventive and treatment knowledge. It is also intended to inform all partners involved so that there is uniformity in the messages disseminated to the communities.

Monitoring and Evaluation (M&E)

M&E and Operational Research are used to provide reliable information on progress in controlling malaria

Achievements in Malaria Control 

Over the period of operationalization of the NMS 2001 €“ 2010, the division has made key achievements in case management. Key to this was the successfully roll-out of the new treatment policy that was launched by the Head of State in September 2006.  

Provision of Prompt and effective treatment

One key achievement was the successful countrywide roll-out of the new treatment policy in September 2006. Treatment guidelines and job aids were produced in 2006 and revised in 2008. Training curricula and manuals for health workers have been produced and more than 12,000 health workers trainedcountrywide on case management with AL. Five hundred new health workers were recruited under the Global Fund round 4 malaria grant in 2006. These workers were formally absorbed into the public service in 2009.   

Prevention of malaria during pregnancy

The proportion of pregnant women using insecticide treated nets rose from 4.4percent in 2003 to 39.7 percent in 2007 while the proportion of women who received at least two doses of IPT rose from 4cpercent in 2002 to 24.5 percent in 2006 in sentinel districts and to 13 percent in all malaria endemic districts in 2007.   

Vector control using insecticide treated nets

Fifteen million ITN and LLIN were distributed between 2001 and 2009. ITN use by children under 5 years rose from 4.6 percent in 2003 to 50.2 percent in 2006 after a free mass insecticide treated net distribution targeting 3.4 million children under five. The mass distribution of ITN in 2006 corrected the inequity against the poor in ITN ownership. The current ITN ownership of 0.8 per household in Kenya is far from universal access defined as 2 nets per household.  

Epidemic Preparedness and Response:

Indoor residual spraying has been used to prevent the occurrence of malaria epidemics in the western highlands. The proportion of targeted structures sprayed, rose from 27.1 percent in 2005 to 63 percent in 2008.   

IEC/BCC

Currently general knowledge in Kenya about malaria transmission is at 95 percent; however only 10 percent know that malaria causes anemia, neonatal and maternal death. Only 40 percent of service providers are able to accurately state the effects of malaria in pregnancy.(PSI Research brief 2006) One major achievement under BCC was the developmentcommunication strategy in 2005.  

Monitoring and Evaluation (M&E)

The DOMC undertook the first Malaria indicator survey (MIS) in 2007 to provide comprehensive information on the progress towards targets for malaria control. The division through the various national and sentinel survey has been able to generate information on performance towards meeting the Abuja Targets, the MDGs as well as other targets within the Annual Operational Plans for the Ministry.            

Dynamics of Malaria transmission in Kenya Plasmodium species  

All four species of human Plasmodium: P. falciparum, P. malariae, P. ovale and P. vivaxoccur in Kenya. P. falciparum which causes the severest form of the disease accounts for 98 percent of all malaria infections. 

Main VectorsThe major malaria vectors in Kenya are members of An. gambiae complex and An.funestus.Kenya has four malaria epidemiological zones·         

Endemic €“ Areas of stable malaria have altitudes ranging from 0 to 1300 meters around Lake Victoria in western Kenya and in the coastal regions. Rainfall, temperature and humidity are the determinants of the perennial transmission of malaria. The vector life cycle is usually short with high survival rate due to the suitable climatic conditions. Transmission is intense throughout the year with annual entomological inoculation rates between 30 and 100.·         

Seasonal malaria transmission- this epidemiological zone in arid and semi-arid areas of northern and south-eastern parts of the country experiences short periods of intense malaria transmission during the rainfall seasons. Temperatures are usually high and water pools created during the rainy season provide the malaria vectors breeding sites. Extreme climatic conditions like el Niño southern oscillation lead to flooding in these areas leading to epidemic outbreaks with high morbidity rates due to low immune status of the population. ·         

Malaria epidemic prone areas of western highlands of Kenya - Malaria transmission in the western highlands of Kenya is seasonal, with considerable year-to-year variation. The epidemic phenomenon is experienced when climatic conditions favour sustainability of minimum temperatures around 180 C. This increase in minimum temperatures during the long rains period favours and sustains vector breeding resulting in increased intensity of malaria transmission.The whole population is vulnerable and case fatality rates during an epidemic can be up to tentimes greater than what is experienced in regions where malaria occurs regularly.·         

Low risk malaria areas €“ this zone covers the central highlands of Kenya including Nairobi. The temperatures are usually too low to allow completion of the sporogonic cycle of the malaria parasite in the vector. However with increasing temperatures and changes in the hydrological cycle associated with climate change are likely to increase the areas suitable for malaria vector breeding with introduction of malaria transmission in areas it never existed.DOMC, with support from various partners, has been monitoring the burden of malaria through several channels including health information data from hospitals and clinics, sentinel sites surveys of communities and health facilities in 4 districts and national surveys including the Kenya Demographic Health Survey. Evidence from these sources now points towards increased coverage of interventions with a downward trend in disease burden demonstrated by community reported cases of malaria, hospital admissions and deaths due to malaria and childhood deaths from the diseases. There is believed to be 44% reduction in childhood mortality.

Scaling up of malaria control interventions, notably distribution of ITNs has contributed towards reversing the declining health trends in the country specifically between 2002-2007. In year 2006 there was mass distribution of LLITNS in 46 districts. Others have been distributed through clinics and social marketing. The graphs below depict some of the other achievements. 

 

Source: HMIS and IDSR

Routine data from Health Management Information System and the weekly reports from intergrated Disease survillance and Response (IDSR) show a gradual decrease in malaria cases in the country.

Partner Support


Implementation of the National Malaria Strategy is spearheaded by the Ministry of Health and co-coordinated by the Division of Malaria Control. There is broad partnership in the scaling up of Malaria control interventions, involving the private sector, NGOs/FBOs, bilateral and multilateral partners. The Malaria programme has received tremendous technical and financial support from WHO, MSH, UNICEF, the KEMRI/Wellcome Trust Programme, DFID, PSI, RBM, and other partners.

Kenya Malaria Control Budget

  2006 €“ 2007 Budget ( Kenya Shillings) 2006 €“ 2007 Budget ( Kenya Shillings)
Required 6.9 billion 7.5 billion
Allocated 4.7 billion 5.2 billion
Expenditure 4.4 billion -
Gap 2.2 billion 2.3 billion
Conclusion
  • Kenya is making progress towards malaria related MDGs and Abuja targets
  • Continued partnership is required to meet MDGs & Abuja targets




Source: HMIS and IDSR

Routine data from Health Management Information System and the weekly reports from Intergrated Disease Survillance and Response show a gradual decrease in malaria cases in the country.

Partner Support


Implementation of the National Malaria Strategy is spearheaded by the Ministry of Health and co-coordinated by the Division of Malaria Control. There is broad partnership in the scaling up of Malaria control interventions, involving the private sector, NGOs/FBOs, bilateral and multilateral partners. The Malaria programme has received tremendous technical and financial support from WHO, MSH, UNICEF, the KEMRI/Wellcome Trust Programme, DFID, PSI, RBM, and other partners.

Kenya Malaria Control Budget
  2006 €“ 2007 Budget ( Kenya Shillings) 2006 €“ 2007 Budget ( Kenya Shillings)
Required 6.9 billion 7.5 billion
Allocated 4.7 billion 5.2 billion
Expenditure 4.4 billion -
Gap 2.2 billion 2.3 billion
 Conclusion
  • Kenya is making progress towards malaria related MDGs and Abuja targets
  • Continued partnership is required to meet MDGs & Abuja targets

 

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