Title: The launch and operation of the malaria epidemic early warning system in Kenya
Background The climate based malaria epidemic early warning system for the western Kenya highlands was developed, tested and validated. During this process, it was critically important to involve key stakeholder to ensure a buy-in and institutionalization of the tool. The performance of the tool during a period of malaria intervention and climate variability was required. Methods Three stakeholders’ events were held to brief them on the progress of the tool development. Plasmodium falciparum prevalence data for Kisii and Kakamega, two highland sites were extracted for the period 2002-17. Laboratory confirmed malaria case data were obtained for Mukumu hospital, Kakamega County. The malaria epidemic predictions were compared to the malaria prevalence and clinical case data. Results The involvement of the stakeholders resulted in their full support and institunalization of the epidemic prediction system at the Kenya Department of Meteorology. The tool identified 8 epidemic events between 2011-18 in Kisii and 27 in Kakamega Counties. The malaria interventions prevented epidemics between 2011-14, However, an El Niño event in 2015-17 caused several epidemics in Kakamega and Kisii. Conclusions Due to the stakeholders’ confidence in the tool, its predictions have consistently been used for determining if epidemic interventions are required. The epidemic early warning system indicates that climate variability is a threat to malaria control.