title: Community-based malaria control in Saradidi, Kenya: description of the programme and impact on parasitaemia rates and antimalarial antibodies.
abstract: A community-based malaria control programme initiated in Saradidi, Kenya in 1982 is described. Antimalarial treatment provided by volunteer community health workers was made available in each village. Malaria was holoendemic. Parasitaemia rates by age were high and did not change after the control programme began. Plasmodium falciparum was the most common species and was present alone or mixed in 98.2% of 8105 infections. Virtually all (98.5%) of 2040 blood samples collected in May 1981 were positive (reciprocal titre greater than or equal to 80) to P. falciparum by the indirect fluorescent antibody (IFA) test. Seropositivity rates to P. falciparum in the IFA test or the enzyme-linked immunosorbent assay (ELISA) were high in all age groups and did not change significantly in longitudinal surveys or in a cohort of children zero to nine years old followed at intervals. While the malaria control programme was successful in bringing treatment to each village, malaria prevalence was not reduced. Parasitologic and serologic studies alone were not adequate to describe the impact of the community-based malaria control programme in Saradidi. Morbidity and mortality rates caused by malaria can decline, significantly improving the health of the population, in the absence of any decrease in parasitaemia rates.
authors.affiliation: Kenya Medical Research Institute, Clinical Research Centre, Nairobi.
authors.forename: H C
authors.initials: HC
authors.lastname: Spencer
authors.forename: D C
authors.initials: DC
authors.lastname: Kaseje
authors.forename: W E
authors.initials: WE
authors.lastname: Collins
authors.forename: M G
authors.initials: MG
authors.lastname: Shehata
authors.forename: A
authors.initials: A
authors.lastname: Turner
authors.forename: P S
authors.initials: PS
authors.lastname: Stanfill
authors.forename: A Y
authors.initials: AY
authors.lastname: Huong
authors.forename: J M
authors.initials: JM
authors.lastname: Roberts
authors.forename: M
authors.initials: M
authors.lastname: Villinski
authors.forename: D K
authors.initials: DK
authors.lastname: Koech
mesh_terms: D000818:Animals; D000906:Antibodies / Q000032:analysis; D002738:Chloroquine / Q000627:therapeutic use; D003153:Community Health Services / Q000458:organization & administration*; D004351:Drug Resistance; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007630:Kenya; D008288:Malaria / Q000276:immunology / Q000469:parasitology / Q000517:prevention & control*; D010963:Plasmodium falciparum / Q000187:drug effects / Q000302:isolation & purification*; D011320:Primary Health Care / Q000458:organization & administration*; D012423:Rural Health
chemical_list: D000906:Antibodies; D002738:Chloroquine