Volume 12, Number 10—October 2006
Perspective
Malaria Epidemics and Interventions, Kenya, Burundi, Southern Sudan, and Ethiopia, 1999–2004
Francesco Checchi*†
, Jonathan Cox†, Suna Balkan‡, Abiy Tamrat§, Gerardo Priotto*, Kathryn Alberti*, Dejan Zurovac‡¶#, and Jean-Paul Guthmann*
, Jonathan Cox†, Suna Balkan‡, Abiy Tamrat§, Gerardo Priotto*, Kathryn Alberti*, Dejan Zurovac‡¶#, and Jean-Paul Guthmann*Table 2
Details of operational response to malaria epidemics by intervention site*
| Factor | Kisii/Gucha, Kenya | Kayanza, Burundi | Aweil East, southern Sudan | Gutten, Ethiopia | Damot Gale, Ethiopia | |
|---|---|---|---|---|---|---|
| Delay of intervention (wks) | 7 | 7 | 3 | >12, probably 19 | 20 | |
| Inpatient care | ||||||
| Expansion in bed capacity | From 310 to 510 beds | From 65 to 125 beds | From ≈80 to ≈120 beds | From 2 to ≈100 beds | From 12 to >100 beds | |
| Treatment | IM/IV quinine, IM artemether | IM/IV quinine | IM artemether | IV quinine | IV/IR quinine | |
| Diagnosis | Presumptive | Blood slide | RDT | RDT | RDT | |
| Fixed outpatient care | ||||||
| Increase in capacity | 2 additional OPDs | Increased capacity in 5 OPDs, 2 additional OPDs | Conversion of nutritional centers, 2 additional OPDs | 1 additional OPD | Supervision and drug supply to 5 OPDs | |
| Treatment | SP | CQ+SP | AS+SP | Quinine (IR if vomited) | SP, quinine | |
| Diagnosis | Presumptive | Presumptive | RDT | RDT | RDT | |
| Mobile clinics | ||||||
| Number | 3 | 6 | 14 | 5 | Not available | |
| Catchment population | 302,000 | Not available | 144,000 | 44,000 | 73,000 | |
| Sites visited | 45 | 10 | 43 | 5 | 14 | |
| Days per site per week (wks of operation) | 0.2–0.3 (7) | 1.2 (22) | 1–2 (15) | 2 (13) | 0.2–0.5 (4) | |
| Treatment | SP, AS+SP (73.4% of cases) | CQ+SP | AS+SP, artemether for severe cases | Quinine | Quinine | |
| Diagnosis | Presumptive | Presumptive | Presumptive | RDT | RDT | |
*IM, intramuscular; IV, intravenous; IR, intrarectal; RDT, rapid diagnostic test; OPD, outpatient department; SP, sulfadoxine-pyrimethamine; CQ, chloroquine; AS, artesunate.
