Kenya

*The PMI VectorLink Kenya project closed out on September 30, 2021.

Approximately three-quarters of the Kenyan population is at risk for malaria. All four species of the malaria parasite that infect humans occur in Kenya. Plasmodium falciparum, which causes the most severe form of the disease, is the most common species and accounts for nearly all malaria infections in the country. The Kenyan government places a high priority on malaria control and tailors its malaria control efforts according to malaria risk to achieve maximum impact. Recent household surveys show improvements in coverage with malaria prevention and treatment measures and reductions in malaria parasitemia and illness.

Indoor residual spraying (IRS) remains one of the key interventions to reduce the malaria burden in Kenya and improve the epidemic response, as stipulated in the Kenya Malaria Strategy 2019–2023. IRS is implemented in two of Kenya’s 47 counties, Homa Bay and Migori, and is funded by United States Agency for International Development (USAID) through the U.S. President’s Malaria Initiative (PMI).

From 2018 to 2021, the PMI VectorLink Project worked with the Division of National Malaria Program (DNMP), formerly known as the National Malaria Control Program, in Kenya to implement three IRS campaigns in Homa Bay and Migori counties (in 2019, 2020, and 2021). IRS was conducted in a total of 1,441,813 eligible structures , protecting a total of 5,887,532 people against malaria, including 136,220 pregnant women and 706,091 children under age five. In all three years, VectorLink Kenya’s spray coverage rate (number of structures sprayed over the number of structures found) was above 90 percent, exceeding the project objective of 85 percent.

PMI VectorLink used Actellic 300CS in the first two years of spraying, and  piloted SumiShield 50WG in one operation site in the first year. In 2021, for the first time, the program team successfully rotated insecticide, in accordance with Kenya’s Insecticide Resistance Management Plan, by spraying Fludora Fusion.

In addition to the above, PMI VectorLink Kenya:

• Supported and participated in the development of key national IRS documents: IRS Implementation Strategy, Mosquito Surveillance Guidelines, Integrated Vector Control Strategy, and Insecticide Resistance Management Plan.
• Conducted insecticide resistance monitoring in eight malaria endemic counties, evaluating permethrin, deltamethrin, chlorfenapyr, pirimiphos-methyl, alpha-cypermethrin and clothianidin. PBO synergist tests were conducted with permethrin and deltamethrin. The evaluation found that pre-exposure to PBO synergist resulted in substantial increases in mortality for permethrin and deltamethrin in all eight counties. Based on this finding, the vector control committee of experts recommended that PBO nets should be considered for future ITN distribution campaigns across western Kenya.
• Scaled up the use of smartphones for data collection among SOPs from one operations site with 30 SOPs in 2019 to five operations sites in 2020 covering a total of 143 SOPs, 23 team leaders, and their five spray team supervisors.
• Replaced door-to-door mobilization with mass mobilization in 2020. VectorLink Kenya created a new cadre of mobilizers who were embedded with the spray team and worked hand in hand with the teams in the community. The following year, the strategy was modified again, adding assistant chiefs as mobilizers to complement the participating community health volunteers, community health assistants, and village elders. Engagement of these assistant chiefs helped to minimize the number of spray refusals the spray teams encountered.
• Expanded the use of radio stations as part of mobilization campaigns in 2021, since mass mobilization activities were limited due to government-imposed COVID restrictions.
• Established community-based entomological monitoring through community health volunteers in two sites in each of Kakamega and Vihiga counties in western Kenya. Each volunteer conducted trapping using CDC light traps in 20 houses per week for longitudinal monitoring of vector populations.
• Conducted 24 month and 36-month durability monitoring to monitor DawaPlus 2.0 ITNs in Busia sub-county and DuraNet ITNs in Kwale sub-county.

Success stories from PMI VectorLink Kenya:

PMI Prevails in Protection