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Malaria is reemerging in the highlands of Kenya.
ATLANTA—The number of malaria cases at high elevations in Kenya is increasing, according to M.A. Malakooti in an article to be published in an upcoming issue of Emerging Infectious Diseases.
Malaria is caused by a blood parasite, Plasmodium falciparum. The parasite is carried from person to person by mosquitoes. The three factors required for spread of malaria are infectious agents (parasites), vectors (mosquitoes), and hosts (humans).
The malaria parasite can only survive in the narrow temperature range of 18°C (64°F) to 35°C (95°F). Malaria, therefore, is not expected at high altitudes where the temperature is cooler. However, by examining records from a highland hospital in Kenya (elevation 5,840 to 7,300 feet), Dr. Malakooti and colleagues found that malaria epidemics have been occurring almost annually in 1990 to 1997, especially from May to July.
Because few (8%) of these malaria patients had traveled outside the highlands to areas where malaria is prevalent, it is likely that they are becoming infected in these high-altitude areas. "Contrary to previous belief," says Dr. Malakooti, "it appears that there is efficient local transmission of malaria in this highland area, with increasing numbers of cases each year."
To explain the growing number of malaria cases, the research team looked for changes in rainfall, temperature, travel, health care, and number of susceptible persons; none of these factors has varied much in the past 20 years. One factor that has changed, however, is increasing resistance of the malaria parasite to drugs. "The increasing malaria incidence may be due to the failure of current drug regimens to cure infections," says Dr. Malakooti.
Until more effective drugs become available, he recommends increasing insecticide use to better combat the mosquito vector and perhaps giving malaria medication to persons to prevent the epidemics that appear to follow months with heavy rainfall. "While the increase in drug resistance may be the major factor in the increase of epidemic malaria," he says, "the causes are undoubtedly multifactorial and include vector, host, and environmental factors."
For more information, contact Dr. Malakooti by phone: 757-444-7671; fax: 757-444-1191; or e-mail: malakooti@pol.net.
Access the full article at http://www.cdc.gov/ncidod/EID/vol4no4/malakooti.htm. All material in Emerging Infectious Diseases is in the public domain and may be used without special permission; proper citation, however, is appreciated.
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