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

2006; Centers for Disease Control and Prevention; Volume: 12; Issue: 10 Linguagem: Inglês

10.3201/eid1210.060540

1080-6059

Francesco Checchi, Jonathan Cox, Suna Balkan, Abiy Tamrat, Gérardo Priotto, Kathryn Alberti, Dejan Zurovac, Jean‐Paul Guthmann,

Vibrio bacteria research studies

Abstract Quantitative data on the onset and evolution of malaria epidemics are scarce. We review case studies from recent African Plasmodium falciparum epidemics (Kisii and Gucha Districts, Kenya, 1999; Kayanza Province, Burundi, 2000–2001; Aweil East, southern Sudan, 2003; Gutten and Damot Gale, Ethiopia, 2003–2004). We highlight possible epidemic risk factors and review delays in epidemic detection and response (up to 20 weeks), essentially due to poor case reporting and analysis or low use of public facilities. Epidemics lasted 15–36 weeks, and patients' age profiles suggested departures from classical notions of epidemic malaria everywhere but Burundi. Although emergency interventions were mounted to expand inpatient and outpatient treatment access, we believe their effects were lessened because of delays, insufficient evaluation of disease burden, lack of evidence on how to increase treatment coverage in emergencies, and use of ineffective drugs.