AN EVALUATION OF SURVEILLANCE OF MALARIA AT PRIMARY HEALTH-CARE LEVELIN KENYA

As less than twenty five per cent of persons suffering from malaria se ek formal treatment in most of sub-Saharan Africa, facility-based morb idity statistics are inadequate for monitoring malaria control program mes, This explorative study assessed whether a health centre equipped with a microscope and trained personnel could monitor malaria transmis sion within its catchment area, The study was conducted at Chemase Hea lth Centre in Nandi District in Kenya, an area holoendemic for malaria with Anopheles gambiae as the main vector and Plasmodium falciparum a s the commonest cause of malaria, From first August to 31 October 1991 , first seven children under five years of age on each working day acc ompanied by their mothers to the maternal and child health clinic were stud led, A general examination was performed by a Registered Clinica l Officer (Medical Assistant) and thin and thick blood smears made, st ained with Giemsa stain and examined for malaria parasites by a Medica l Laboratory Technologist, Mothers were interviewed by enrolled commun ity nurses on antimalarial measures they were using in their homes, Fo ur hundred and fifty five children mostly under five years of age, con sisting of 48.1% males and 51.9% females, were studied. Malaria parasi tes were present in 209 (45.9%) blood smears of the children, The perc entage of blood smears positive for malaria parasites was high in chil dren below 36 months of age, There was a tendency for low percentage o f blood smears positive for malaria in children whose mothers reported using mosquito nets or insecticide sprays, The study did not interrup t the routine of the health centre, periodic monitoring of new malaria illnesses and percentage of blood smears positive for malaria parasit es in children aged 0 to 35 months should be introduced into health ce ntre practice in Kenya, This catchment area approach could be used to monitor malaria control programmes as well as predicting malaria epide mics.