3 July

3  Background Information  Objectives  Methodology  Results  Discussion  Conclusion  Recommendation Presentation Outline

3 July Worldwide between one and three million deaths, mostly of children, are attributed to malaria. There is a greater potential risk for malaria epidemics at high altitude in several countries in sub-Saharan Africa. Kenya’s malaria disease burden is demonstrated by about 70 % of the population living in malaria endemic regions and is at risk of infection. This study was conducted to determine malaria incidence and prevalence, and mean parasite densities (MPD) at Kopere village, western Kenya. Malaria prevalence in western Kenya stands at 37% Background Information

3 July This study was conducted to determine malaria incidence and prevalence levels. Establish the Mean Parasite Densities (MPD) at Kopere village, western Kenya

3 July This study was conducted at Kopere village in the sugar belt area of malaria endemic Kano Plain (Fig 1). The area forms a corridor through which malaria emanates to cause epidemics in neighborhood highland district of northern Rift Valley Province of Kenya. Study Area

3 July 2015 The area forms a corridor through which malaria emanates to cause epidemics in neighborhood highland district of northern Rift Valley Province of Kenya. This study was conducted at Kopere village in the sugar belt area of malaria endemic Kano Plain (Fig 1). Fig. 1: The location of study area in Kenya and the cluster of homesteads utilized for data collection

3 July This was a longitudinal survey with study households selected using two-stage sampling procedures. The sampling frame comprised all households in Kopere village. A sample size of 127 volunteers obtained for the study using the formula; n=z²pq/d² (Fisher, 1971). Study Approval -Joint Institutional Research and Ethics Committee (IREC) of School of Medicine-Moi University and MTRH. Volunteers were recruited after consenting to the study by signing consent forms. Methodology

3 July where minors were involved, both assent and consent were obtained before the specimens were taken. Blood smears (BS) were examined at three-monthly intervals. Data was analyzed using Statistical Package for Social Scientists (SPSS) version 12. The incidence rates and MPD compared to identify a more sensitive indicator for monitoring short-term malaria control. Malaria incidences, the MPD, and two-year malaria prevalence were determined. …Methodology

Results Age groupsBSAsexual(%)Gametes(%)MP(%)MPD/ μℓ blood 0-11 months months years years years ≥15 years Total

Results Malaria prevalence of 46.8% (397/848) was obtained from 848 repeat blood smears. Non-uniform significant difference in three-monthly interval incidence rates were detected (t=5.771, df=6, p=0.029). The MPD for children 2-9 years and other age-groups differed significantly (t=3.356, df=6, p=0.015), probably due to differences in immune response to malaria. Children months old were most gametogonic (16.7%, 2/12); While those 2-4 year olds had high prevalence (67.2%; 92/137) and an MPD of 3,744-parasites/µℓ blood.

Discussion 12

Conclusion 13 The Malaria prevalence of about 47% was obtained among asymptomatic population in Kopere village. Mean parasite density determined for children 2-4 years exceeds the critical threshold of 1,000- parasite/µℓ blood, above which gametogony is initiated.

Recommendations Targeted control, which lowers the asexual parasite densities below the critical threshold are required to reduce malaria transmission. We propose that the MPD can be used to evaluate short-term malaria control; However a more controlled study design is required to confirm the ability of MPD as a sensitive tool, which can be used to monitor short-term malaria control.

Acknowledgments Andrew A. Obala Tabitha M. Abongo Helen L. Kutima, Henry D. Nyamogoba Ann W. Mwangi Barasa Khwa-Otsyula John H. Ouma Provincial Administration Kopere village Moi University Research Foundation of SUNY 3 July

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