Identification of malaria transmission and epidemic hotspots in the western Kenya highlands : its application to malaria epidemic prediction

Conducted in five sites in the western Kenya highlands, two U-shaped valleys (Iguhu, Emutete), two V-shaped valleys (Marani, Fort-Ternan) and one plateau (Shikondi) for 16 months, this detailed study examines how highlands terrain affects exposure and sensitivity to malaria. It shows that V-shaped ecosystems, and the plateau ecosystem have very low malaria prevalence and few individuals with an immune response to two major malaria antigens. The U-shaped ecosystems are transmission hotspots. However, because V-shaped ecosystems have very low malaria prevalence and few individuals with an immune response, they can be considered as probable epidemic hotspots