Changing malaria intervention coverage, transmission and hospitalization in Kenya.

摘要: Reports of declining incidence malaria disease burden across several countries in Africa suggest that the epidemiology continent is transition. Whether this transition directly related to scaling intervention coverage remains a moot point. Paediatric admission data from eight Kenyan hospitals and their catchments have been assembled two three-year time periods: September 2003 August 2006 (pre-scaled intervention) 2009 (post-scaled intervention). Interrupted series (ITS) models were developed adjusting for variations rainfall hospital use by surrounding communities show changes hospitalization over periods. The temporal factors might explain examined sequentially each setting, compared between settings ranked according plausible explanatory factors. In six out sites there was decline Malaria rates with declines 18% 69%. At admissions increased 55% 35%. Results ITS indicate before scaled 2006, significant month-to-month mean at four (trend P < 0.05). point intervention, estimated significantly less pre-scaled period baseline. Following change trend some but not all sites. Plausibility assessment possible drivers pre- versus post-scaled showed inconsistent patterns however, allowing increase second period, suggestion starting transmission intensity scale ITN variation effect size. most where observation periods documented changing free mass distribution prior implementation ACT Kenya. This study provides evidence within location heterogeneity trends burden. Plausible complex combination mechanisms, easily measured retrospectively.