Ondari, Peter Nyabuto2013-03-202013-03-202013-03-20http://ir-library.ku.ac.ke/handle/123456789/6519Malaria is a mosquito-borne infectious disease of humans and other animals caused by protists' of the genus Plasmodium. Malaria is responsible for high morbidity and mortality rates among children under five years and pregnant women. Recent climatic changes leading to global warming has resulted in the emergence of malaria in highlands in Africa where malaria never existedbefore. In Kenya, highland malaria is very rampant in Nyanza, Gucha District and some parts of Rift Valley province where it occurs as epidemics. Annually Malaria in Kenya claims thelives of 26,000 children aged less than five years old with an average death of 72 children per day.In order to curb these epidemics, prevention and control measures should be intensified. The strengthening of malaria surveillance and monitoring needs to be given priority in parallel with effortsto control the malaria vector. This will involve a combination of environmental, physical and chemical control measures, through joint efforts of both governmental and nongovernmental agencies. A/cross sectional descriptive study was carried out aimed at collecting bothqualitative and quantitative data on knowledge on factors contributing to highland malaria outbreak and available control and preventive factors in Gucha District, Kenya. Data were collectedusing structured open-ended questionnaires, focus group discussions and desk reviews of health records and data at Gucha District hospital and some rural health facilities in Gucha District.The sample size was four hundred respondents. The study population consisted of adult patientsand patient attendants aged 18 years and above who sought health care in Gucha district hospital and some rural facilities in Gucha District. Fifteen study sites were selected for representative coverage of the district. Data analysis was carried out by use of GraphPad InStat softwareand utilized one-way analysis of variance and Tukey-Kramer test. The study revealed that over 90% of Gucha District residents had completed secondary level education and over 78%of the respondents did not live in modern houses. Fever and feeling chilly were the most common symptoms of malaria infection reported by 51% and 20% of the respondents respectively.Plasmodium was cited by 55% while a combination of bites by mosquitoes and existenceof stagnant waters were cited by 20% of the respondents as the main causes of malaria. Twentynine percent of the respondents bought drugs from local sources while only 15.75% visitedhospital for treatment against malaria. Forty four percent and 31% of the respondents reporteda combination of bush clearing and drainage of stagnant waters and use of mosquito netsrespectively as the most important mosquito control methods. Twenty eight percent of the respondentsate goats offal while the rest burnt various herbal plants as traditional methods for controlof malaria. Hospital records data .did not show any significant difference in malaria morbiditycases for the period from 1998-2006 (P = 0.0546) while higher number of children of 5 years or below were significantly infected with malaria compared to other age groups (P = 0.0001).There was no difference in mean monthly temperatures (0.8659), rainfall (0.6124) or humidity(0.5322) recorded between 2002 and 2006. The study concludes that although Gucha District residents are educated and do not use improved methods for control of malaria. Furthermore, majority of the people only go to hospital for malaria treatment following failure of selfmedication. The findings of this study are of high value to the ministry of health and other stakeholdersin the fight against highland malaria in Kenya. Local people should be educated on properenvironmental management to create unfavorable conditions for mosquito breeding. They shouldbe educated on: bush clearing, draining of stagnant waters, planting food crops away from houses,proper construction of houses to eliminate cracks on walls and open eaves and filling up depressionscreated during brick making among other methods.enThesis