In this article, we review the epidemiology of East Coast fever (ECF), a tick-borne infection of cattle, in Kenya. The
major factors associated with epidemiology of ECF include the agro-ecological zone (AEZ), livestock production
system (LPS) and both animal breed and age. These factors appear to influence the epidemiology of ECF through
structured gradients. We further show that the gradients are dynamically shaped by socio-demographic and
environmental processes. For a vector-borne disease whose transmission depends on environmental characteristics
that influence vector dynamics, a change in the environment implies a change in the epidemiology of the disease.
The review recommends that future ECF epidemiological studies should account for these factors and the dynamic
interactions between them. In Kenya, ECF control has previously relied predominantly on tick control using
acaricides and chemotherapy while ECF immunization is steadily being disseminated. We highlight the contribution
of ECF epidemiology and economics in the design of production system and/or geographical area-specific
integrated control strategies based on both the dynamic epidemiological risk of the disease and economic impacts
of control strategies. In all production systems (except marginal areas), economic analyses demonstrate that
integrated control in which ECF immunization is always an important component, can play an important role in the
overall control of the disease. Indeed, Kenya has recently approved ECF immunization in all production systems
(except in marginal areas). If the infrastructure of the vaccine production and distribution can be heightened, large
ECF endemic areas are expected to be endemically stable and the disease controlled. Finally, the review points the
way for future research by identifying scenario analyses as a critical methodology on which to base future
investigations on how both dynamic livestock management systems and patterns of land use influence the
dynamics and complexity of ECF epidemiology and the implications for control.