Transactions of the Royal Society of Tropical Medicine and Hygiene
Volume 94, Issue 3 , Pages 253-255, May 2000

Changing patterns of clinical malaria since 1965 among a tea estate population located in the Kenyan highlands☆☆☆

  • G.D. Shanks

      Affiliations

    • Corresponding Author InformationAuthors for correspondence: G. D. Shanks, USAMC, AFRIMS, 315/6 Rajvithi Road, Bangkok 10400, Thailand; phone +66 2 644 6691, fax +66 2 247 6030.
    • US Army Medical Research Unit-Kenya, Box 401, Unit 64109, APOAE 09831-4109, USA
    • ,
  • K. Biomndo

      Affiliations

    • Brooke Bond Central Hospital, Kericho, Kenya
    • Deceased.
    • ,
  • S.I. Hay

      Affiliations

    • TALA Research Group, Department of Zoology, University of Oxford, Oxford, UK
    • ,
  • R.W. Snow

      Affiliations

    • Kenya Medical Research Institute/Wellcome Trust Collaborative Programme, P.O. Box 43640, Nairobi, Kenya
    • Department of Tropical Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK

Received 27 August 1999; received in revised form 25 October 1999; accepted 9 November 1999.

Abstract 

The changing epidemiology of clinical malaria since 1965 among hospitalized patients was studied at a group of tea estates in the western highlands of Kenya. These data indicate recent dramatic increases in the numbers of malaria admissions (6·5 to 32·5% of all admissions), case fatality (1.3 to 6%) and patients originating from low-risk, highland areas (34 to 59%). Climate change, environmental management, population migration, and breakdown in health service provision seem unlikely explanations for this changing disease pattern. The coincident arrival of chloroquine resistance during the late 1980s in the sub-region suggests that drug resistance is a key factor in the current pattern and burden of malaria among this highland population.

Keywords:  malaria, Plasmodium falciparum, epidemiology, highlands, drug resistance, climate change, Kenya

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☆ This paper is not in copyright.

☆☆ Disclaimer. The views of this paper are those of the authors and do not purport to reflect official policy of the US Army or Department of Defense.

PII: S0035-9203(00)90310-9

Transactions of the Royal Society of Tropical Medicine and Hygiene
Volume 94, Issue 3 , Pages 253-255, May 2000

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