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Volume 12, Number 10—October 2006

Perspective

Malaria Epidemics and Interventions, Kenya, Burundi, Southern Sudan, and Ethiopia, 1999–2004

Francesco Checchi*†Comments to Author , Jonathan Cox†, Suna Balkan‡, Abiy Tamrat§, Gerardo Priotto*, Kathryn Alberti*, Dejan Zurovac‡¶#, and Jean-Paul Guthmann*
Author affiliations: *Epicentre, Paris, France; †London School of Hygiene and Tropical Medicine, London, United Kingdom; ‡Médecins Sans Frontières, Paris, France; §Médecins Sans Frontières, Geneva, Switzerland; ¶Kenya Medical Research Institute/Wellcome Trust Research Laboratories, Nairobi, Kenya; #University of Oxford, Oxford, United Kingdom

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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.

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