Why malaria still poses great danger despite decline in cases
In November 2023, the Centers for Disease Control and Prevention warned that one of the deadliest mosquito species had traveled by road in containers from Ethiopia to Kenya.
What you need to know:
- Malaria cases have declined in the past one year from 5,447,220 last year to 3,869,709, mostly children, this year.
- Officials attribute the decline to distribution of 15.3 million mosquito nets to 22 out of 24 high risk counties.
Malaria cases have declined due to a nationwide vaccination campaign and mass distribution of mosquito nets but the country has still recorded nearly four million cases this year, the latest data from the Ministry of Health (MoH) shows.
Malaria cases have declined by 1,577,511 in the past one year from 5,447,220 last year to 3,869,709, mostly children, this year.
Officials attribute the decline to distribution of 15.3 million mosquito nets to 22 out of 24 high risk counties and aggressive vaccination of the population.
The State department of public health and professional standards is distributing the nets to the regions which include Busia County that in June 2023 led with 231,307 malaria cases.
Between June last year and this year, the government has expanded its malaria vaccination program to 25 additional sub-counties in the lake endemic regions, according to Public Health PS Mary Muthoni.
“In Kenya, the situation is equally dire as in the last 12 months, the country has reported a total of 3,869,709 malaria cases, predominantly among children. This persistence is due to a few but strong challenges ranging from drug-resistant strains of the parasite such as Anopheles stephensi, and changing mosquito behaviour due to the currently witnessed global and local climate changes,” PS Muthoni highlighted noting that malaria remains a significant global health challenge.
Earlier this month, the health ministry while citing Budalangi observed that cross-border transmissions along the Busia border, drug-resistant malaria parasites and climate change which brings about unpredictability of rain patterns and floods are the key drivers fueling the surge in malaria infections in the country.
Then, data from routine monitoring of insecticide sensitivity and changes as well as continuous generation of evidence on mosquito behaviours shows that insecticide resistance by mosquitoes and change in biting behaviours is another headache the country is dealing with as efforts to eliminate malaria for good intensify.
“The ministry has an elaborate surveillance system that conducts both routine epidemiological and periodic entomological surveillance. Integrated Disease Surveillance System (IDSR) is crucial in detecting malaria upsurges and epidemics for prompt response,” MoH then explained.
According to the PS, the ongoing mass net campaign began in July last year with MoH, through the Division of National Malaria Control Programme aiming to distribute 15.3 million nets across 24 counties with support from Global Fund and USAID/PMI.
“However, the Campaign fell short by about 3.6 Million to meet the overall target of 18.6 million nets needed to cover all targeted populations in the country. Notably, this campaign is the first to utilize a digital platform called Digimal, which is web-based, USSD, as well as application-enabled and has streamlined household registration, mosquito net distribution, and payroll management,” the PS told Nation.Africa.
As at October 25, a total of 14,245,921 mosquito nets (93.87 per cent) had been distributed across 22 counties, reaching 4,445,002 households (91.10 per cent) and covering a population of 27,361,288 (92 per cent) of the target population through the platform, according to the PS.
“This is above 80 per cent WHO recommended LLIN coverage in areas at risk of malaria and the minimum threshold to achieve a significant public health impact by reducing malaria transmission.
In 2021/22, approximately 247 million cases were reported worldwide, and around 619,000 lives were lost due to this deadly disease. Africa accounted for 95 per cent and 96 per cent of the cases and the deaths respectively, with children under 5 years old representing 80 per cent of malaria-related fatalities, according to the PS.
"Since the phased introduction of the malaria vaccine in 2019, over 400,000 children have been vaccinated in the lake endemic counties of Kisumu, Kakamega, Siaya, Homabay, Migori, Busia, Bungoma, and Vihiga, with Vihiga County recording at least 25,000 vaccinated children. The vaccination has led to a substantial reduction in severe malaria, child hospitalizations, and child deaths in these areas,” she said.
"The Kenya Malaria Indicator Survey had shown a reduced malaria prevalence over the past ten years despite the challenges Kenya is grappling with," the PS added.
“We have made significant strides in the fight against malaria over the past few years, with malaria prevalence decreasing from approximately 11 per cent in 2010 to 6 per cent currently. Among the various regions, Lake endemic areas exhibit the highest prevalence rate at 19 per cent. Coastal endemic areas have a prevalence of 5 per cent, followed by seasonal areas at 2 per cent, highland endemic areas at 1 per cent, and low-risk areas with less than 1 per cent transmission,” PS Muthoni explained.
In November last year, the Centers for Disease Control and Prevention (CDC) warned that one of the deadliest mosquito species that can transmit two parasites at the same time had traveled by road in containers from Ethiopia to Kenya and would soar malaria infections in the country.
The Anopheles stephensi (An. Stephensi) mosquito species that is capable of transmitting both Plasmodium falciparum and Plasmodium vivax malaria parasites thereby making it very dangerous and deadly had then been found in Lodwar and Turkana apart from reports of being cited in Marsabit,
The CDC noted that the An stephensi most likely arrived in the country by road from Ethiopia as mosquito sampling in Marsabit conducted in the sub counties of Moyale, Laisamis, and Saku focused on urban and rural settings along the northern transport corridor connecting Kenya and Ethiopia while sampling in Turkana focused on Lodwar, the capital of the county and a major town on the land transport corridor into Kenya.
The most alarming, the characteristics of An. stephensi, such as container breeding and anthropophily, make it particularly adept at exploiting built environments due to climate change in areas with no prior history of malaria risk.
While Plasmodium falciparum is responsible for more deaths, Plasmodium vivax is the most widespread of all of the malaria species and can cause severe, even fatal infections and results in significant global morbidity and mortality according to the World Health Organisation (WHO).
