Age Group Shift of Fever as a Predictor of Malaria as Transmission Decreases in Western Kenya

Abstract

Over 1 billion episodes of febrile infections occur each year, and they are the primary cause of medical visits among those living in underdeveloped areas. Most of these non-malarial febrile fevers are presumptively treated with antibiotics, and this could lead to long-term unwanted consequences such as drug resistance. We examined and determined the incidence and predictors of non-malarial febrile illnesses in a Kenyan area of unstable, low malaria transmission. A 5-year (2013–2017) retrospective study was carried out at two health facilities in the Kenyan highlands of Kipsamoite and Kapsisiywa, Nandi County. The patients who presented to any of the health facilities within the study area with fever were tested for clinical malaria and classified as having malarial fever or non-malarial febrile. Frequency distribution tables were generated to show the prevalence of non-malarial fever in the context of place, person, and time. A confidence interval (CI) of 95% was used to assess statistical significance. The incidence of non-malarial febrile illnesses remained relatively low in children under 5 years of age. During the 5-year period, there was a general drop in the cases of non-malarial fever in December of each year. A total of 644(50%) of participants presented with fever. Of these, 12 (2%) had febrile malaria. This means that 632 (50.1%) of the individuals were suffering from a non-malarial febrile illness. The prevalence and incidence of malaria were generally very low (2%) during the five-year period. The highest incidence for children under the age of 5 and those 5–15 years of age was recorded in July 2013, while individuals above 15 years had the highest incidence in May 2017. It was observed that there was no consistency in the incidence of fever, as shown by the peaks, over time. During the 5-year period, there is a general drop in the cases of non-malarial fever in December of each year. Only two peaks (May 2017 and September 2017) of the incidence of non – malarial fever match with incidence of fever for > 15 years. Only two peaks (July 2013 and May 2017) of the incidence of non – malarial fever match with incidence of fever for 5 – 15 years. None of the peaks for the incidence of non – malarial fever match with incidence of fever for < 5 years.