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Summaryobjectives To assess malaria-related knowledge, attitude and practices (KAP) among primary caregivers, to identify associations between primary caregiversÕ characteristics and positive KAP towards malaria, and to identify independent predictors of childhood malaria incidence in an urban setting.methods Children aged 6 months to 5 years living in Kampala, Uganda were enrolled as part of a longitudinal study on antimalarial therapy. Primary caregivers of 307 children were interviewed and information was collected on demographics, malaria-related KAP, environmental and household factors. Malaria incidence was measured prospectively using passive surveillance.results A total of 90% of respondents reported mosquitoes and/or malaria as the cause of fever.Caregivers reported that if their child had fever, 63% would go to a clinic or hospital as their first action and 97% as their first or second action. Only 38% knew that chloroquine was the recommended firstline treatment for malaria and 29% knew the correct dose. Preventive measures for malaria were reported in 45% of households but only 25% reported using bednets. Higher levels of education for the caregiver were associated with positive malaria-related KAP. Malaria incidence varied widely. The following were independent predictors of malaria incidence: (1) Children aged 24-41 months at enrolment had a higher incidence of malaria. (2) Reported bednet or chemoprophylaxis use reduced the incidence of malaria. (3) A child's place of residence was associated with incidence. (4) Children from households using open water sources had a higher incidence than those using closed sources.conclusion Primary caregivers were knowledgeable about malaria and used modern health care facilities but knew less about the proper administration of antimalarials and had limited use of preventive measures. Malaria incidence was associated with child's age at enrolment, geography, source of water and the use of preventive measures.

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The nutrition status of Samburu tribesmen of northern Kenya and the potential nutritional effects of a food-for-work programme were assessed by anthropometric and dietary surveys over a period of five weeks. The investigations were carried out at four input localities, where the programme had provided a daily average of 173 kcal and 5 g protein per capita over the preceding year, and a fifth control area. Compared with Kenya as a whole, the Samburu community showed an unexpectedly high prevalence of wasting: 74% of the surveyed individuals were below 90% of the NCHS weight-for-height median, and 34% were below 80%. Relative wasting was especially prevalent among school-age children, of whom 86% were below 90% and 44% were below 80% of the standard, and among elders, with 88% and 64% below these thresholds respectively. Mid-upper arm circumferences were lowest among school-age children (mean 14.6 cm). Haematocrits were low in all age and social groups. Aside from three preschool children with xerophthalmia, a number of both preschool and school-age children had clinical histories suggestive of earlier vitamin A deficiency. Goitre was more prevalent among the older generations than among school-age or preschool children, suggesting a periodic but not uninterrupted availability of iodized salt. In the input locations, both anthropometric and haematocrit values among the most vulnerable members of the communities, preschool children and women of reproductive age, were significantly higher than those for comparable groups in the control location. Overall, the food-for-work programme was judged to be a worthwhile effort to help Samburus to be once again self-sufficient.