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Malaria Epidemic Preparedness and Response

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Introduction

Malaria epidemics in Kenya usually occur in the highlands west of the Rift valley spanning Northwards from Narok to the highlands of West Pokot County, and arid/semi-arid regions of Northwestern Kenya, Northern, North Eastern and Some parts of South Eastern Kenya. Currently there are 128 sub-counties in 26 counties classified as prone to malaria epidemics in Kenya (Fig 1). Typically, malaria epidemics occur due to unusual cli mate conditions conducive for rapid vector breeding, such as high rainfall and high temperatures. Malaria epidemics are characterized with heightened incidences of morbidity and mortality among all age groups in prone populations. Efforts to address malaria epidemics prioritize strengthening of vector Control, Prediction, preparedness and timely response within disease surveillance and response frameworks. The primary objective is to minimize morbidity and prevent mortality by early detection outbreaks and rapid timely response for rapid containment.

Key Points

  1. Geographical Distribution: Malaria epidemics are prevalent in the western highlands and arid/semi-arid regions of Kenya.
  2. Environmental Factors: Unusual climatic conditions, including high rainfall and temperatures conducive to vector breeding, contribute to the onset of malaria epidemics.
  3. Severity: Epidemics are characterized by heightened morbidity and mortality rates, necessitating urgent intervention.
  4. Preparedness and Response: Malaria epidemic preparedness and response are integral components of disease surveillance efforts. The main aim is to mitigate the impact of epidemics through early detection and prompt response measures.

By prioritizing proactive measures to detect and respond to malaria epidemics, Kenya aims to minimize the adverse effects of these outbreaks on public health and well-being.

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01. Epidemic preparedness

Activities: Preparedness activities should be stratified by level of care due to their different roles and responsibilities. The broad preparedness activities include the following:

02. Epidemic prevention

The purpose of epidemic prevention is to avert or reduce excess morbidity and prevent mortality due to malaria. The main approach for malaria prevention is timely vector control and effective case management. When an epidemic is predicted, the following should be done:

Malaria Epidemics in Kenya

Malaria EPR is one of the strategies under the surveillance objective of the Kenya Malaria Strategy (2019–2023) (MOH, 2019). The Surveillance, Monitoring, Evaluation, and Operational Research unit in the DNMP is responsible for the development of guidelines, manuals, tools, training, and planning for EPR in Kenya. The Division of Disease Surveillance and Response (DDSR) is nationally responsible for surveillance and response for all epidemic-prone diseases. Malaria EPR is geared towards preparedness and timely and effective response to avoid occurrence of malaria epidemics, thus reducing excess morbidity and mortality. A total of 127 sub-counties spread across 26 counties in the western highlands and seasonal transmission zones of Kenya are classified as malaria epidemic-prone areas (MOH, 2016) as indicated in Figure 1 on the left.

Aim of EPR

To prepare and respond to malaria epidemics in epidemic prone areas in Kenya. Strategies of EPR include:

03. Epidemic response

Epidemic response depends on the stage at which the epidemic is detected.A rapid assessment should be conducted to confirm that an unusual increase in the number of fever cases is due to malaria. The purpose of the rapid assessment is to:

04. Monitoring Malaria Epidemic Preparedness and Response

Monitoring and evaluation is an integral component of enhancing the tracking of input, process, and output indicators effective for management (prevention and containment) of malaria epidemics. Monitoring of ongoing malaria epidemic preparedness and response activities should be implemented at community, health facility, sub-county, county, and national levels. Process indicators should be measured to ensure that all activities are implemented as planned and to identify problems and challenges faced during the implementation. The indicators for malaria EPR should be monitored to ensure that all activities are implemented as planned. Challenges faced during the implementation should be identified and appropriate remedies applied. Table 5 shows the indicators for malaria EPR as stated in the Kenya Malaria.

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