Human ecology of Malaria in Kenia

Malaria uses almost half of the clinical services in Africa, making its control one of the most important challenges in global public health. Interventions such as the use of insecticide treated nets (ITNs) for people at risk; appropriate antimalarial drugs for people with probable or confirmed malaria and indoor residual spraying (IRS) of insecticides have been at the forefront of global efforts to control the disease. While these measures are important, proven environmental measures that succeeded in eradicating malaria vectors in vast parts of Europe and the Americas in the early 20th century and even in some parts of Africa are largely lacking. This study examined the associations of malaria incidences with micro-ecological, socio-demographic and behavioural aspects in a rural highland epidemic-prone zone in south western Kenya. Location of houses on flat swampy areas, staying outdoors at night, presence of oxen in the compound, sleeping in a house with open eaves and family size greater than four people were significantly associated with increased risk of malaria. On the other hand, having sufficient food supplies throughout the year and keeping medicine at home were significantly associated with reduced risk of malaria. These findings point to the need for holistic approaches that draw connections between behavioural, socioeconomic and micro-ecological factors in malaria control.