%0 Journal Article
%T Malaria Parasitemia among Febrile Patients Seeking Clinical Care at an Outpatient Health Facility in an Urban Informal Settlement Area in Nairobi, Kenya
%A Henry N. Njuguna
%A Joel M. Montgomery
%A Joseph O. Oundo
%A Leonard Cosmas
%A Meghna Desai
%A Newton Wamola
%A Robert F. Breiman
%J Archive of "The American Journal of Tropical Medicine and Hygiene".
%D 2016
%R 10.4269/ajtmh.15-0293
%X Nairobi is considered a low-risk area for malaria transmission, but travel can influence transmission of malaria. We investigated the demographic characteristics and travel history of patients with documented fever and malaria in a study clinic in a population-based surveillance system over a 5-year period, January 1, 2007 to December 31, 2011. During the study period, 11,480 (68%) febrile patients had a microscopy test performed for malaria, of which 2,553 (22%) were positive. Malaria was detected year-round with peaks in January, May, and September. Children aged 5¨C14 years had the highest proportion (28%) of positive results followed by children aged 1¨C4 years (23%). Almost two-thirds of patients with malaria reported traveling outside Nairobi; 79% of these traveled to three counties in western Kenya. History of recent travel (i.e., in past month) was associated with malaria parasitemia (odds ratio: 10.0, 95% confidence interval: 9.0¨C11.0). Malaria parasitemia was frequently observed among febrile patients at a health facility in the urban slum of Kibera, Nairobi. The majority of patients had traveled to western Kenya. However, 34% reported no travel history, which raises the possibility of local malaria transmission in this densely populated, urban setting. These findings have important implications for malaria control in large Nairobi settlements
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710415/