Malaria hotspot areas in a highland Kenya site are consistent in epidemic and non-epidemic years and are associated with ecological factors

"Background: Malaria epidemics in highland areas of East Africa have caused considerable morbidity and mortality in the past two decades. Knowledge of ""hotspot"" areas of high malaria incidence would allow for focused preventive interventions in resource-poor areas; particularly if the hotspot areas can be discerned during non-epidemic periods and predicted by ecological factors. Methods:To address this issue; spatial distribution of malaria incidence and the relationship of ecological factors to malaria incidence were assessed in the highland area of Kipsamoite; Kenya; from 001-2004. Results: Clustering of disease in a single geographic ""hotspot"" area occurred in epidemic and non-epidemic years; with a 2.6 to 3.2-fold increased risk of malaria inside the hotspot; as compared to outside the area (P 0.001; all 4 years). Altitude and proximity to the forest were independently associated with increased malaria risk in all years; including epidemic and non-epidemic years. Conclusion: In this highland area; areas of high malaria risk are consistent in epidemic and non-epidemic years and are associated with specific ecological risk factors. Ongoing interventions in areas of ecological risk factors could be a cost-effective method of significantly reducing malaria incidence and blunting or preventing epidemics; even in the absence of malaria early warning systems. Further studies should be conducted to see if these findings hold true in varied highland settings."

Epidemiology of hookworm infection in Itagua, Paraguay: a cross sectional study

A cross-sectional study in Itagua, Paraguay tested 192 people for the presence, intensity and species of hookworm infection. Fifty-nine percent of these individuals were found to be infected. Intensity of infection was determined on 92 per cent of infected individuals by quantitative egg counts. The high intensity hookworm infections, which cause the greatest morbidity, were clustered between the ages of five and 14 years. No differences were seen between genders. The species of hookworm was determined for parasites reared from 72 per cent of infected individuals. Both Necator americanus and Ancylostoma duodenale were identified, although the former species predominated. We conclude that hookworm infection continues to be a public health problem in Paraguay, particularly among children and adolescents who suffer from high intensity infections. A. duodenale continues to persist in the Western Hemisphere and has not been completely displaced by N. americanus.