ABSTRACT
In the East African countries, malaria is ranked as the primary cause of morbidity and mortality in both children and adults. It causes about 40,000 infant deaths in Kenya each year; in Uganda annual cases of malaria range between 6 to 7 million, with 6500 to 8500 fatalities, and in Tanzania the annual death toll is between 70,000 and 125,000 and accounts for 19 per cent of health expenditure (De Savigny et al, 2004a and b). In the case of cholera, the first epidemic in Africa was reported as far back as 1836 (Rees, 2000). Major outbreaks were next reported in 1970 and affected West Africa (Guinea), the horn of Africa (Ethiopia, Somalia and Sudan) and Kenya (Waiyaki, 1996). The most severe cholera outbreak on the African continent was in 1998, accounting for more than 72 per cent of the global total number of cholera cases and acutely affecting the Democratic Republic of Congo, Kenya, Mozambique, Uganda and the United Republic of Tanzania. Cholera outbreaks in East Africa have been reported to the World Health Organization (WHO) since 1972. In
the Lake Victoria region of East Africa both malaria and cholera are common, with malaria endemic in the lowlands and epidemic in the highland areas and cholera endemic in the basin since the early 1970s (Rees, 2000).
