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Abstract
Highland areas where malaria transmission is unstable are targets for malaria elimination because transmission decreases to low levels during the dry season. In highland areas of Kipsamoite and Kapsisiywa, Kenya (population approximately 7,400 persons), annual household indoor residual spraying with a synthetic pyrethroid was performed starting in 2005, and artemether/lumefantrine was implemented as first-line malaria treatment in October 2006. During April 2007-March 2008, no microscopy-confirmed cases of malaria occurred at the sites. In 4 assessments of asymptomatic persons during May 2007-April 2008, a total of <0.3% of persons were positive for asexual Plasmodium falciparum by microscopy or PCR at any time, and none were positive by PCR at the last 2 sample collections. Our findings show that in such areas, interruption and eventual elimination of malaria transmission may be achievable with widespread annual indoor residual spraying of households and artemisinin combination therapy.
Highlights
We have conducted malaria epidemiology studies in the adjoining highland areas of Kipsamoite and Kapsisiywa, Nandi Hills District, Kenya, since 2003
The present study documents the changes in malaria transmission that occurred during the period of these interventions and provides evidence that malaria transmission was interrupted during April 2007–March 2008
ITNs were distributed per Ministry of Health policy to pregnant women and their children
Summary
We have conducted malaria epidemiology studies in the adjoining highland areas of Kipsamoite and Kapsisiywa, Nandi Hills District, Kenya, since 2003. Starting in 2005, the Ministry of Health of Kenya introduced new interventions to reduce malaria transmission and improve malaria treatment in these areas. Interventions introduced included IRS, distribution of ITNs to pregnant women and their children
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