Treating malaria in Kenya
13 February 2002
Malaria: facts and figures
An estimated 8.2 million cases of malaria are reported every year in Kenya, for a total population of 30 million.
Malaria is responsible for the greatest number of consultations (30% of new cases in medical centres within the public health service) and is most common reason for hospital admission (22,000 cases per year in public hospitals).
Every year, malaria kills 26,000 children younger than five - 72 children a day.
Resistance rates and treatment protocol
Resistance to chloroquine: 66-87%
Resistance to Fansidar®: 27-40% (resistance is present primarily in the West - in other regions, resistance to Fansidar® is lower or even non-existant).
Treatment protocol: Fansidar® for first-line treatment, quinine or amodiaquine for second-line.
MSF: Fighting the malaria epidemic in Kissi in 1999
Treating malaria is an integral part of MSF's programmes throughout the country. From June to September 1999, responding to a sharp increase in cases of malaria, MSF worked in Kissi and several districts in Gucha, in the South-West of the country. MSF supported three overburdened health centres by taking care of the most severe malaria cases and setting up mobile clinics. The spread of the epidemic can be attributed to the ineffective use of chloroquine treatment as well as favourable climatic conditions (rains, temperature, etc.).
In collaboration with the Ministry of Health, MSF treated almost 3,000 severe malaria cases in three hospitals and over 30,000 uncomplicated cases. MSF teams used artemether for severe cases and a combination of artesunate and Fansidar® (SP) for uncomplicated cases (one day treatment).
At the start of 2000, MSF set up an epidemiological surveillance system in the Gucha district, which has a population of 100,000 people. The aim was to ensure early detection of another epidemic and implement an artemisinin-containing combination treatment (three day treatment of Artesunate and Fansidar®) in order to reduce mortality and halt the spread of the epidemic. To avoid the emergence of resistance and to keep costs to a minimum, only confirmed malaria cases were to be treated.
At the same time, the Kenyan Ministry of Health changed its first-line treatment protocol from chloroquine to Fansidar®, and mosquito control programmes were implemented nation-wide. Thanks to the combination of these strategies and favourable climatic conditions, there were no malaria epidemics in 2000 and 2001.