Altitude was a major driver of malaria transmission in this study area, even across narrow altitude bands.
Rh5 codons 147 and 148 showed heterogeneity at both an individual and population level and may be under some degree of immune selection.
This study found that delivery of IPTp and ITNs through ANC was ineffective and more so for higher-level facilities.
Variations in factors associated with ownership should be acknowledged when constructing messaging and distribution campaigns.
These findings may support the choice of either serology or PCR as markers in the detection of malaria transmission hotspots for targeted interventions.
Despite high coverage, the impact of interventions targeting malaria vectors and human infections on nPCR parasite prevalence was modest, transient, and restricted to the targeted hotspot areas.
These findings show that the burden of P. falciparum parasitaemia, clinical malaria and anaemia among school children is not insignificant, and suggest that malaria control programmes should be expanded to include this age group.
An unusually high frequency of animal and mixed human-animal blood meals in the major malaria vector An. gambiae s.s. was revealed in the western Kenya highlands where bed net coverage is above the WHO target.
Although iMSaT was generally accepted throughout the community, proper sensitization activities—and arguably, a more long-term approach to community engagement—are necessary for dispelling fears, clarifying misconceptions, and educating communities on the consequences of asymptomatic malaria.
This study contributes to the ongoing surveillance of suspected artemisinin resistance parasites in Africa by providing baseline prevalence of k13-propeller mutations in western Kenya with samples collected from a longitudinal study.