By Peter Orengo and Maureen Odiwuor
Kenya has a long history of malaria, dating back to 1918, characterised with epidemics.
The last recorded malaria epidemic in Kenya was in 1998-1999, occurring during January-March as a result of the El Nino induced excessive rainfall of October-December 1997.
The country now plans that by 2017, to have reduced morbidity and mortality caused by malaria in the various epidemiological zones by two-thirds.
Currently malaria presents a major public health challenge in Kenya, with 30 per cent of outpatients and 15 per cent of inpatients suffer from the disease, with a three to five per cent of deaths.
Some of the government interventions in the last few years include vector control, access to prompt and effective diagnosis and treatment. Others include strengthening malaria epidemic preparedness and containing outbreaks.
According to the 2010 Kenya Malaria Indicator Survey, although malaria prevalence has remained low in most parts of the country, there has been little or no change in the household ownership and use of insecticide-treated nets. Perhaps this may account for the small increase in the overall prevalence of malaria in children less than five years of age, particularly in Western Kenya.
“We put an elaborate control plan that involved the use of Insecticide Treated Nets (ITNs). Mass distribution of bed nets targeting 10.6 million nets is on-going in epidemic prone and endemic regions, with over eight million already distributed,” said Head of Disease Prevention and Control, Dr Willis Akhwale.
He said the intervention led to malaria prevalence reduction from six per cent in 2003, 21 per cent in 2010 and 80 per cent in 2012, in Western, Nyanza and Rift Valley.
According to a research conducted in 2008 by several organisation in the United States, there is misconception that Insecticide Treated Mosquito Nets (ITNs) is purely a Western intervention.
The report also disagrees that there is wide spread misuse of nets in African countries. It says the number still remain negligible and that mostly long-lasting insecticide-treated nets typically wear out after two to three years. By this time, they are usually worn out and their use diverted.
There are, however, a few negligible cases of people who don’t use the nets due to myths. They believe that sleeping under treated mosquito nets is like being in a coffin, and this causes them to have night mares when using a mosquito net
Some also don’t use the nets because they are not in a position to hang them. Even so, in March this year, three organisations managed to advocate for usage of mosquito nets in over 200,000 homes in 36 districts.
Population Service International (PSI) in partnership with Kenya Scouts Association and Division for Malaria Control realised that most people were not using mosquito nets because they lacked knowledge on how to hang them.
Maternal and Child Health Director Anthony Gitau says they found out that at least every home owns a mosquito net around the country. In the Lake Region, however, only 51 per cent owned a net and 61 per cent in the entire country use the nets for malaria prevention.
“We gathered that some people either kept the nets or use them for other purposes because they don’t know how to mount the nets,” said Gitau.
They therefore trained 20 scouts pupils per school with each assigned between seven to ten households in the project that costs Sh9 million.
An ongoing mass net distribution has seen more than 11 million nets distributed across the country. This has been with support from USAID-PMI, UKAID, World Bank and other partners.
Key achievements included:
1. Ownership of nets in households has doubled according to the Kenya Malaria Indicator Survey (KMIS) 2010, leveling out net ownership across the wealth quintiles.
2. Universal coverage has been achieved by 70 per cent, where in every household, two members use a net.
There has been an increase of three per cent in net usage between 2007 and 2010. That is from 39.2 per cent to 41.1 per cent according to KMIS. Net use amongst pregnant women also increased from 39.8 per cent in 2007 to 41.1 per 2010.
However, a lag still remains between net ownership and net usage. Net usage averages 40 per cent. The targets now is for net use to reach 80 per cent,
Factors being addressed in Communication
KMIS 2010 showed that people do not feel that they are at risk of Malaria. Some of the reasons for this are; the season of the year, their age, the fact that they don’t see mosquitoes in their house, their gender among other factors.
Rapid diagnostic tests
Need for testing before treating for malaria is important. This is because not all cases of fever mean one has malaria.