Abstract
Recent epidemics of Plasmodium falciparum malaria have been observed in high-altitude areas of East Africa. Increased malaria incidence in these areas of unstable malaria transmission has been attributed to a variety of changes including global warming. To determine whether the reemergence of malaria in western Kenya could be attributed to changes in meteorologic conditions, we tested for trends in a continuous 30-year monthly malaria incidence dataset (1966–1995) obtained from complete hospital registers at a Kenyan tea plantation. Contemporary monthly meteorologic data (1966–1995) that originated from the tea estate meteorologic station and from global climatology records were also tested for trends. We found that total hospital admissions (malaria and nonmalaria) remained unchanged while malaria admissions increased significantly during the period. We also found that all meteorologic variables showed no trends for significance, even when combined into a monthly suitability index for malaria transmission. We conclude that climate changes have not caused the highland malaria resurgence in western Kenya.
Highlights
Recent epidemics of Plasmodium falciparum malaria have been observed in high-altitude areas of East Africa
We investigated whether climate changes could be implicated in the reemergence of malaria in a unique 30-year malaria and meteorologic time series, collected from the health-care system on a tea plantation in the western highlands of Kenya
Epidemic malaria was first recorded on the Kericho tea estates during World War II and was eventually controlled by a combination of mass administration of proguanil and residual insecticide spraying during the late 1940s [2]
Summary
Recent epidemics of Plasmodium falciparum malaria have been observed in high-altitude areas of East Africa. To determine whether the reemergence of malaria in western Kenya could be attributed to changes in meteorologic conditions, we tested for trends in a continuous 30-year monthly malaria incidence dataset (1966–1995) obtained from complete hospital registers at a Kenyan tea plantation. Increased malaria incidence in unstable transmission areas has been variously attributed to changes in land-use patterns [5]; population migration [6,7]; changes in mosquito vector populations [8]; breakdown in provision of health services [9], especially insecticide spraying [10,11]; drug resistance [12,13,14,15,16]; and meteorologic changes [17,18], global warming [19,20,21,22,23,24,25]. Our previous studies have examined various aspects of the epidemiology of malaria in the Kenyan highlands [29,30]
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