Breaking: Autopsy reveals how Cyrus Jirongo died
Turkana: Kenya’s new malaria reservoir
Turkana has transformed from a region of seasonal malaria outbreaks to an endemic malaria zone.
Turkana now ranks as Kenya's highest malaria-burden county, according to the latest data from Kenya's National Malaria Control Programme.
The county has since transformed from a region of seasonal malaria outbreaks to an endemic malaria zone, with cases surging by more than 65 percent during rainy seasons since 2017.
With a 39 percent malaria prevalence rate recorded last year, more than six times the national average of six percent, making the county a high malaria burden county, as defined by the Kenya Malaria Strategy.
According to Public Health and Professional Standards Principal Secretary Mary Muthoni, the rain in Turkana is so severe to a point many families often opt to keep the sick in their houses due to bad weather, thereby endangering lives.
Government data also shows that the worst recorded outbreak in Turkana was in 2017 when in just one month, more than 45,000 people tested positive for malaria.
Turkana West Subcounty then recorded the highest burden of malaria cases, with more than 65 percent of the patients tested turning positive.
Ms Muthoni noted that this shift has now made Turkana a major candidate for seasonal malaria chemoprevention (SMC), a highly effective malaria prevention strategy, particularly for children in areas with seasonal malaria transmission.
In 2024, the initial phase of SMC targeted Turkana Central Sub-County, which had recorded 102 thousand cases in 2024, with about 60 percent occurring between May and September.
SMC was rolled out in June 2024 with support from the Catholic Relief Services (CRS),” the PS told Nation while explaining that SMC involves administering monthly doses of antimalarial medication, usually sulfadoxine-pyrimethamine plus amodiaquine (SP+AQ), during the peak transmission season.
“This helps to prevent malaria infections and clear existing ones, thus reducing the burden of the disease. It is done by the World Health Organization (WHO) standards,” she added.
“SMC is typically delivered door-to-door by volunteer community distributors. It is a safe and cost-effective intervention that can be delivered safely at scale,” the Malaria Consortium, a leading implementer of SMC, agrees with PS Muthoni.
“In clinical trials, it has been found to prevent up to 75 percent of malaria cases in children under five.”
PS Muthoni explains that climate change increases malaria risk in Turkana by creating more favourable conditions for mosquito breeding and parasite development.
“Higher temperatures and rainfall, often associated with climate change, can lead to more and larger water sources, which are ideal breeding grounds for malaria-carrying mosquitoes,” she said.
According to a recent peer-reviewed study by Scientists at Georgetown University in the US, malaria’s range has expanded in sub-Saharan Africa in recent decades at a rate of 6.5 metres of additional altitude per year.
They add that mosquitoes and the parasites they carry reproduce faster at higher temperatures, but movement can also be influenced by land use, food availability or the migration of the populations themselves to higher ground.
This is why in 2012, WHO recommended a malaria prevention approach that required administering antimalarial medicines to young children in parts of Africa that see these seasonal spikes in malaria transmission.
At the time, SMC had only been tested in small pilot programmes and many thought it would be too complex and expensive to be feasible at scale.
In 2013, when this programme was developed, seasonal malaria chemoprevention only reached about one million children.
“Last year’s exercise targeted 38,585 under-five children to be administered with the combination sulfadoxine-pyrimethamine + amodiaquine (SP+AQ), to prevent malaria episodes in the target population during the peak transmission season. Five monthly cycles of drug administration were done each separated by 28 days,” PS Muthoni told the Nation.
According to the Health ministry, 71 percent (27,206 children) of the targeted children took the medication in all five cycles.
“The performance of each cycle is as follows; 88 percent (33,820 children), Cycle 1, 101 percent (39,229) Cycle 2, 95 percent (36,741) Cycle 3, 100 percent (38,924) in Cycle 4, and 104 percent (40,123) in Cycle 5,” PS Muthoni said, noting that this year, the second round of SMC in Turkana Central will be done from June and will adopt a digital campaign approach based on the electronic community health information system (eCHIS) platform.
“The results from the two rounds, 2024 and 2025, will inform expansion and implementation approaches for effective deployment and impactful outcomes of the intervention,” she stated.
Unitaid, a global health initiative that works with partners to bring about innovations to prevent, diagnose and treat major diseases in low- and middle-income countries, with an emphasis on tuberculosis, malaria, and HIV/Aids and its deadly co-infections, notes that as of 2023 in the Sahel region, for example, 49 million children benefitted from SMC. Increased medicine supplies were critical to enabling that scale of coverage.
“And child formulations, which are easy-to-swallow, sweet-flavoured versions of medicines, make treatments more effective by making it simpler for caregivers to administer drugs to young children. As a result of these efforts, the cost of delivery of seasonal malaria chemoprevention fell by more than 20 percent throughout the project, helping to stretch available funding to benefit greater numbers of people.”
