Plasmodium falciparum parasite prevalence in East Africa:Updating data for malaria stratification

Alegana, Victor A. and Macharia, Peter M. and Muchiri, Samuel and Mumo, Eda and Oyugi, Elvis and Kamau, Alice and Chacky, Frank and Thawer, Sumaiyya and Molteni, Fabrizio and Rutazanna, Damian and Maiteki-Sebuguzi, Catherine and Gonahasa, Samuel and Noor, Abdisalan M. and Snow, Robert W. (2021) Plasmodium falciparum parasite prevalence in East Africa:Updating data for malaria stratification. PLOS Global Public Health, 1 (12). ISSN 2767-3375

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The High Burden High Impact (HBHI) strategy for malaria encourages countries to use multiple sources of available data to define the sub-national vulnerabilities to malaria risk, including parasite prevalence. Here, a modelled estimate of Plasmodium falciparum from an updated assembly of community parasite survey data in Kenya, mainland Tanzania, and Uganda is presented and used to provide a more contemporary understanding of the sub-national malaria prevalence stratification across the sub-region for 2019. Malaria prevalence data from surveys undertaken between January 2010 and June 2020 were assembled form each of the three countries. Bayesian spatiotemporal model-based approaches were used to interpolate space-time data at fine spatial resolution adjusting for population, environmental and ecological covariates across the three countries. A total of 18,940 time-space age-standardised and microscopy-converted surveys were assembled of which 14,170 (74.8%) were identified after 2017. The estimated national population-adjusted posterior mean parasite prevalence was 4.7% (95% Bayesian Credible Interval 2.6–36.9) in Kenya, 10.6% (3.4–39.2) in mainland Tanzania, and 9.5% (4.0–48.3) in Uganda. In 2019, more than 12.7 million people resided in communities where parasite prevalence was predicted ≥ 30%, including 6.4%, 12.1% and 6.3% of Kenya, mainland Tanzania and Uganda populations, respectively. Conversely, areas that supported very low parasite prevalence (<1%) were inhabited by approximately 46.2 million people across the sub-region, or 52.2%, 26.7% and 10.4% of Kenya, mainland Tanzania and Uganda populations, respectively. In conclusion, parasite prevalence represents one of several data metrics for disease stratification at national and sub-national levels. To increase the use of this metric for decision making, there is a need to integrate other data layers on mortality related to malaria, malaria vector composition, insecticide resistance and bionomic, malaria care-seeking behaviour and current levels of unmet need of malaria interventions.

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Journal Article
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PLOS Global Public Health
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21 Feb 2022 11:40
Last Modified:
17 Sep 2023 03:11