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 subregion suggests that drug resistance is a key factor in the current pattern and burden of malaria among this highland population.

Original publication

DOI

10.1016/s0035-9203(00)90310-9

Type

Journal article

Journal

Transactions of the Royal Society of Tropical Medicine and Hygiene

Publication Date

05/2000

Volume

94

Pages

253 - 255

Addresses

US Army Medical Research Unit-Kenya. shanksdg@thai.amedd.army.mil

Keywords

Humans, Malaria, Falciparum, Hospitalization, Incidence, Prevalence, Altitude, Drug Resistance, Tea, Kenya