Volume 12, Number 10—October 2006
Perspective
Malaria Epidemics and Interventions, Kenya, Burundi, Southern Sudan, and Ethiopia, 1999–2004
, Jonathan Cox†, Suna Balkan‡, Abiy Tamrat§, Gerardo Priotto*, Kathryn P. Alberti*, Dejan Zurovac‡¶#, and Jean-Paul Guthmann*
Table 3
Epidemiologic profile of malaria at fixed inpatient, fixed outpatient, and mobile health facilities operated by Médecins Sans Frontières in 5 intervention sites
| Characteristic | Kisii/Gucha, Kenya | Kayanza, Burundi | Aweil East, southern Sudan | Gutten, Ethiopia | Damot Gale, Ethiopia | ||
|---|---|---|---|---|---|---|---|
| Uncomplicated cases | |||||||
| Fixed outpatient centers | |||||||
| All ages | 13,127* | 272,459 | 15,239 | 15,928† | – | ||
| Age <5 y (%) | 2,426 (18.5) | Not available | 7,257 (47.6) | 4,758‡ (29.9) | – | ||
| Mobile clinics | |||||||
| All ages | 29,769 | 46,541 | 34,749 | 7,258 | 467 | ||
| Age <5 y (%) | 5,376 (18.1) | Not available | 17,338 (49.9) | 1,405 (19.4) | 145 (31.0) | ||
| Complicated cases | |||||||
| All ages | 9,773§ | 3,953¶ | 875# | 330** | 1,291 | ||
| Age <5 y (%) | 5078 (52.0) | 761 (19.3) | 683 (78.1) | 175 (53.0) | 595 (46.1) | ||
| No. deaths (CFR [%]) | 397 (4.1) | 108 (2.7) | 50 (5.7) | 34 (10.3) | 62 (4.8) | ||
| No. deaths <5 y (CFR [%]) | 164 (3.2) | 31 (4.1) | 39 (5.7) | 15 (8.6) | 38 (6.4) | ||
| Minimal attack rate (%)†† | 22.2 (complicated, <5 only; 12/15 weeks) | 86.5 (36/36 weeks) | 41.2 (<5 only; 22/22 weeks) | 53.4 (15/33 weeks) | Not available | ||
| P. falciparum prevalence at epidemic peak (%) | 38–49 (community survey) | 80 (random sample in OPD queue) | 52–64 (random sample in OPD‡‡ queue) | Not available | 60 (random sample by community workers) | ||
*Includes data from 3 government clinics (Masimba, Kenyenya, and Etago) for which age breakdown was available.
†Includes 2,061 patients treated with intrarectal quinine in inpatient department.
‡Includes 1,773 patients <5 years of age treated with intrarectal quinine in inpatient department.
§Includes data from Kisii, Keumbu, and Ogembo hospitals, supported by Médecins Sans Frontières and other agencies but operated by the government.
¶Excludes patients treated in the Kayanza government hospital (data not available).
#Excludes 110 severe cases treated by mobile clinics (no age breakdown or outcome available).
**Includes only hospitalized patients who met a strict definition of severe malaria, which probably explains the considerably higher case-fatality ratio (CFR) noted in Gutten.
††Ratio of weeks refers to the number of epidemic weeks from which the attack rate was calculated divided by the total number of epidemic weeks.
‡‡OPD, outpatient department.