Anemia and malaria at different altitudes in the western highlands of Kenya

Abstract Malaria associated severe anemia in children is the most important complication of Plasmodium falciparum infection in sub-Saharan Africa. To evaluate anemia and malaria in an area with recurrent malaria epidemics in the western highlands of Kenya, we conducted cross-sectional surveys in four “lowland” (1440–1660 m) and two “highland” (1960 and 2040 m) villages in 2002. Among 1314 subjects randomly selected from all age groups, the overall prevalence of anemia (hemoglobin, Hb P. falciparum infection 17%. In children ≤5 years, anemia prevalence ranged from 57% at 1440 m to 11% at 2040 m and correlated with altitude ( r =−0.88, P P. falciparum prevalence ranged from 31 to 0% and correlated with altitude ( r =−0.93, P P Anemia was more prevalent in the lowland villages characterized by high prevalence of P. falciparum infection. We conclude that malaria may also be the main cause of anemia in the highland fringe areas of sub-Saharan Africa. Measures that reduce the prevalence of malaria will consequently reduce anemia in both, young children and adult women and the need for blood transfusions associated with the risk of HIV-transmission.