Geo-statistical modelling of malaria mortality and its relationship with anaemia in the Kisumu health and demographic surveillance system, Kenya

Malaria remains a significant health concern globally, with Sub-Saharan Africa, particularly children under five, facing the highest burden. Western Kenya, where malaria causes over a third of outpatient visits, exemplifies this challenge. Despite a decline in malaria cases over the past two decades, progress has stagnated due to data inconsistencies, lack of precise regional estimates, and inadequate monitoring. Effective data management is crucial for informing timely and effective policy decisions.
This PhD focused on the Health and Demographic Surveillance System (HDSS) in western Kenya, a high-malaria-prevalence area, from 2007 to 2015. We investigated the spatio-temporal dynamics of malaria incidence and prevalence, adjusting for climatic, environmental, and socio-economic factors, across all age groups. We also examined the association between malaria, parasitic worms, and anaemia risk.
Our research revealed a significant decline in malaria incidence among children under five, with socio-economic status, altitude, and study area being critical factors. Slight increases in slide positivity rates (SPR) at hospitals strongly indicated higher all-cause and malaria-specific mortality, particularly in children aged 5 -14 years. High anaemia prevalence was noted, especially among the youngest and elderly, with malaria parasitaemia and clinical malaria linked to higher anaemia risk.
These findings underscore the multifaceted nature of malaria and its broader implications on mortality and anaemia, suggesting that SPR is an efficient measure of malaria transmission and impact measurement. Targeted, multi-pronged interventions are essential for combating malaria's complexities, emphasizing the need for specialized attention and effective policy formulation in regions like western Kenya.