Our aim was to assess whether a combination of seasonal climate forecasts, monitoring of meteorological conditions, and early detection of cases could have helped to prevent the 2002 malaria emergency in the highlands of western Kenya. Seasonal climate forecasts did not anticipate the heavy rainfall. Rainfall data gave timely and reliable early warnings; but monthly surveillance of malaria out-patients gave no effective alarm, though it did help to confirm that normal rainfall conditions in Kisii Central and Gucha led to typical resurgent outbreaks whereas exceptional rainfall in Nandi and Kericho led to true malaria epidemics. Management of malaria in the highlands, including improved planning for the annual resurgent outbreak, augmented by simple central nationwide early warning, represents a feasible strategy for increasing epidemic preparedness in Kenya.

No abstract

We are currently facing one of the largest and most complex refugee crises in modern times. Conflict and natural disasters have resulted in 22.5 million refugees worldwide, more than half are children. As the world struggles to respond to this massive displacement of people, how is this affecting child refugees' development and what is being done about it? In this commentary, we explore answers to these central questions. First, we review the situation of child refugees in numbers, exploring their geographic concentration. Second, we review child refugees' access to basic services, including early childhood development, with a special emphasis on community-based programs and initiatives that have proven to be particularly effective in addressing the needs of resettled child refugees. We find in particular that early childhood development activities in emergency contexts have seen remarkable improvements with critical benefits for the development of the youngest child refugees. Our aim is to bring attention to the particular difficulties child refugees must endure and to highlight those practices and approaches that are helping child refugees reach their full potential.

Stronger accountability is key

No abstract