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Amesa EG, Kitessa BA, Biyana CF, Wotale TW, Alemayehu Y. Investigating the Determinants of Malaria Outbreak in Nono Benja Woreda, Jimma Zone, Ethiopia: A Case-Control Study. Risk Manag Healthc Policy 2024; 17:1395-1405. [PMID: 38828105 PMCID: PMC11143977 DOI: 10.2147/rmhp.s456958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/22/2024] [Indexed: 06/05/2024] Open
Abstract
Background Malaria is one of the most widespread infections worldwide, particularly in developing countries. Accordingly, Jimma Zone is one of the widely affected areas by malaria in Ethiopia. In 2020 woreda health offices have reported the possible malaria epidemic that needs further investigation. Accordingly, this study aims to characterize the scope, pinpoint determinants connected to the Nono Benja woreda malaria outbreak, and implement suitable public health management measures. Methods A descriptive cross-sectional study was followed by an unmatched case-control study with a 1:1 ratio of cases to controls. The sample size of 136 individuals (68 cases and 68 controls) was used. The collected data was imported into Epi-data version 3.1 and analyzed using SPSS version 25.0. By doing multivariate logistic regression association was determined at 95% confidence intervals P value of 5%. Results A total of 687 instances were identified, giving an overall attack incidence of 1%. The assault rate ranged from 51.6 per 1000 people in Benja rural to 1.1 per 1000 people in Dhokonu Kebele. But there were no recorded deaths. Plasmodium falciparum and Plasmodium vivax were the major types of Plasmodium species reported. From independent variables absence of ITNS [AOR 3.98 (CI = 1.11-24.8)], residing in an unsprayed home [AOR = 3.83 (CI = 1.04-14.08], presence of stagnant water in residential area [AOR = 4.25, CI (1.37-12.24113.10)], and lack of awareness on malaria prevention [AOR = 8.28 (CI 2.31-29.73)] were significantly associated with Malaria outbreak. Conclusion A number of factors, including lack of ITNS, lack of malaria health education, stagnant water, and IRS (indoor residual spray), were significantly linked with the occurrence of malaria outbreaks. The woreda health office should therefore provide ITNS to the community, use indoor residual spray, and disseminate health information regarding efficient and long-lasting malaria preventive and control techniques.
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Affiliation(s)
- Ebsa Gelan Amesa
- Department of Statistics, College of Natural and Computational Science, Mattu University, Mattu, Ethiopia
| | | | - Chaltu Fikru Biyana
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Teramaj Wongel Wotale
- Department of Statistics, College of Natural and Computational Science, Mattu University, Mattu, Ethiopia
| | - Yadeta Alemayehu
- Department of Psychiatry, College of Health Sciences, Mattu University, Mattu, Ethiopia
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File T, Jemal F. Prevalence of Malaria and Associated Factors during the Minor Malaria Season among Febrile Under-Five Children Attending Mohammed Akile Memorial General Hospital. J Parasitol Res 2024; 2024:6365077. [PMID: 38774540 PMCID: PMC11108698 DOI: 10.1155/2024/6365077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 04/13/2024] [Accepted: 04/18/2024] [Indexed: 05/24/2024] Open
Abstract
Malaria is one of the major public health problems in sub-Saharan Africa, including Ethiopia. Children under the age of five are immunologically naive to plasmodium parasites, making them the most vulnerable group to clinical manifestations of malaria infection. Despite the severity of the disease in children under five years of age, most studies on malaria focus on the adult population. In the present study, a cross-sectional study design based on health facilities was used during the minor malaria season from February 18 to May 28, 2023, at Mohammed Akile Memorial General Hospital, in Afar Regional State, district of Amibara located in the town of Berta. The finding revealed that 19.8% prevalence among symptomatic children with 61.04% and 38.96% of P. falciparum and P. vivax, respectively. In the present study area, malaria infection in children under five years of age is significantly associated with the presence of stagnant water in the residential area, inappropriate or no use of insecticide-treated net, and indoor residual spraying (IRS). The prevalence of malaria among symptomatic children under five years of age is higher compared to the national prevalence of malaria among the general population. Therefore, community mobilization through health promotion, aiming to interrupt the transmission of malaria at the community level, is paramount.
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Affiliation(s)
- Temesgen File
- Department of Medical Laboratory Science, Rift Valley University, Adama, Ethiopia
| | - Feysal Jemal
- Department of Public Health, Rift Valley University, Adama, Ethiopia
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Bradley L, Yewhalaw D, Hemming-Schroeder E, Jeang B, Lee MC, Zemene E, Degefa T, Lo E, King C, Kazura J, Yan G. Epidemiology of Plasmodium vivax in Duffy negatives and Duffy positives from community and health centre collections in Ethiopia. Malar J 2024; 23:76. [PMID: 38486245 PMCID: PMC10941426 DOI: 10.1186/s12936-024-04895-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/28/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Malaria remains a significant cause of morbidity and mortality in Ethiopia with an estimated 3.8 million cases in 2021 and 61% of the population living in areas at risk of malaria transmission. Throughout the country Plasmodium vivax and Plasmodium falciparum are co-endemic, and Duffy expression is highly heterogeneous. The public health significance of Duffy negativity in relation to P. vivax malaria in Ethiopia, however, remains unclear. This study seeks to explore the prevalence and rates of P. vivax malaria infection across Duffy phenotypes in clinical and community settings. METHODS A total of 9580 and 4667 subjects from community and health facilities from a malaria endemic site and an epidemic-prone site in western Ethiopia were enrolled and examined for P. vivax infection and Duffy expression from February 2018 to April 2021. Association between Duffy expression, P. vivax and P. falciparum infections were examined for samples collected from asymptomatic community volunteers and symptomatic subjects from health centres. RESULTS Infection rate of P. vivax among Duffy positives was 2-22 fold higher than Duffy negatives in asymptomatic volunteers from the community. Parasite positivity rate was 10-50 fold higher in Duffy positives than Duffy negatives among samples collected from febrile patients attending health centres and mixed P. vivax and P. falciparum infections were significantly more common than P. vivax mono infections among Duffy negative individuals. Plasmodium vivax parasitaemia measured by 18sRNA parasite gene copy number was similar between Duffy positives and Duffy negatives. CONCLUSIONS Duffy negativity does not offer complete protection against infection by P. vivax, and cases of P. vivax in Duffy negatives are widespread in Ethiopia, being found in asymptomatic volunteers from communities and in febrile patients from health centres. These findings offer evidence for consideration when developing control and intervention strategies in areas of endemic P. vivax and Duffy heterogeneity.
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Affiliation(s)
- Lauren Bradley
- Department of Ecology and Evolutionary Biology, School of Biological Sciences, University of California Irvine, Irvine, CA, 92697, USA
| | - Delenasaw Yewhalaw
- Department of Medical Laboratory Sciences and Pathology, College of Health Sciences, Jimma University, 5195, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Centre, Jimma University, Jimma, Ethiopia
| | - Elizabeth Hemming-Schroeder
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, 80523, USA
| | - Brook Jeang
- Department of Ecology and Evolutionary Biology, School of Biological Sciences, University of California Irvine, Irvine, CA, 92697, USA
| | - Ming-Chieh Lee
- Department of Ecology and Evolutionary Biology, School of Biological Sciences, University of California Irvine, Irvine, CA, 92697, USA
| | - Endalew Zemene
- Tropical and Infectious Diseases Research Centre, Jimma University, Jimma, Ethiopia
| | - Teshome Degefa
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Eugenia Lo
- Department of Microbiology and Immunology, Drexel University, Philadelphia, PA, 19104, USA
| | - Christopher King
- Center for Global Health and Disease, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - James Kazura
- Center for Global Health and Disease, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Guiyun Yan
- Department of Ecology and Evolutionary Biology, School of Biological Sciences, University of California Irvine, Irvine, CA, 92697, USA.
- Program in Public Health, College of Health Sciences, University of California at Irvine, Irvine, CA, 92697, USA.
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Weldemariam MG, Weldegeorges DA, Angaw Y, Assefa NE, Welay FT, Werid WM, Gebru TT, Beyene GG, Bitew MT, Mengesha MB. Magnitude and Associated Factors of Maternal Near Miss in Public Hospitals of Tigrai, Northern Ethiopia: A Cross Sectional Study. Clin Nurs Res 2024; 33:138-145. [PMID: 38147002 DOI: 10.1177/10547738211029680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
The purpose of this study was to determine magnitude and associated factors of maternal near miss among women seeking obstetric and gynecologic care. A hospital based cross-sectional study design was implemented in selected public hospitals of Tigrai. Systematic random sampling method was used to select study participants. Data were entered to epi data manager version 4.1 and exported to Statistical Package for social science version 20 for analysis. Bivariate and multivariate logistic regression was used to identify factors associated with maternal near miss. The magnitude of maternal near miss was found to be 7.3%. Regression analysis showed that, mothers who reside in rural area, had distance of greater than 10 km, referred from low level health institution, and mothers had no antenatal care follow up were significantly associated with maternal near miss. Therefore, promoting antenatal care and increasing awareness in rural areas related with maternal health care services is recommended.
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Arikawa S, Tchankoni MK, Gbeasor-Komlanvi FA, Atekpe SP, Atcha-Oubou T, Figueroa-Romero A, Fombah AE, Saute F, Samai M, Menendez C, Gonzalez R, Briand V, Ekouevi DK. Prevalence and risk factors associated with malaria infection in children under two years of age in southern Togo prior to perennial malaria chemoprevention implementation. Malar J 2023; 22:357. [PMID: 37990324 PMCID: PMC10664264 DOI: 10.1186/s12936-023-04793-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/15/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Malaria remains the leading cause of mortality and morbidity in young children in sub-Saharan Africa. To prevent malaria in children living in moderate-to-high malaria transmission areas, the World Health Organization has recommended perennial malaria chemoprevention (PMC). Prior to piloting PMC implementation in southern Togo, a household survey was conducted to estimate malaria infection prevalence in children under 2 years of age (U2). METHODS A cross-sectional community-based household survey was conducted in the Haho district in the Togo Plateaux region. A three-stage random sampling method was used to select study participants aged 10-23 months whose caretakers gave informed consent. The prevalence of Plasmodium infection, defined as a positive rapid diagnostic test (RDT), was estimated with 95% confidence interval (CI). Clinical malaria was defined as having a positive RDT plus fever (≥ 37.5 °C) or history of fever in the last 24 h. Mixed-effects logistic regression models were used to assess the child's, caretaker's, and household's factors associated with malaria infection. RESULTS A total of 685 children were included in the survey conducted January-February in 2022 (dry season). Median age was 17 months (interquartile range: 13-21). About 80% of the children slept under a bed net the night before the interview. Malaria infection prevalence was 32.1% (95% CI 27.7-37.0) with significant area variation (cluster range: 0.0-73.3). Prevalence of clinical malaria was 15.4% (95% CI 12.2-19.2). Children whose caretakers were animist (aOR: 1.71, 95% CI 1.19-2.46) and those living in mother-headed households (aOR: 2.39, 95% CI 1.43-3.99) were more likely to have a positive RDT. Living more than 5 km away from the nearest health facility (aOR: 1.60, 95% CI 1.04-2.44) and presence of two or more under-5-years children in the household (aOR: 1.44, 95% CI 1.01-2.07) were also associated with increased risk of infection. CONCLUSION One-third of the children U2 who participated in this survey had malaria infection, thus PMC could be a promising strategy to reduce malaria burden in young children in Plateaux region. Reinforcement of outreach services and targeting the poorest households should be prioritized to reduce the inequity in malaria prevention in children exposed to the infection.
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Affiliation(s)
- Shino Arikawa
- University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France.
| | - Martin Kouame Tchankoni
- Département de Santé Publique, Université de Lomé, Lomé, Togo
- Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo
| | - Fifonsi A Gbeasor-Komlanvi
- Département de Santé Publique, Université de Lomé, Lomé, Togo
- Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo
| | - Somiabalo P Atekpe
- Ministère de la Santé, de l'Hygiène Publique et de l'Accès Universel Aux Soins (MSHPAUS), District Sanitaire du Haho, Notsé, Togo
| | - Tinah Atcha-Oubou
- Ministère de la Santé, de l'Hygiène Publique et de l'Accès Universel aux Soins (MSHPAUS) Programme National de Lutte contre le Paludisme (PNLP), Lomé, Togo
| | - Antía Figueroa-Romero
- Barcelona Institute for Global Health, Hospital Clinic‑University of Barcelona, Barcelona, Spain
| | - Augustin E Fombah
- Barcelona Institute for Global Health, Hospital Clinic‑University of Barcelona, Barcelona, Spain
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | | | - Mohamed Samai
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Directorate of Research and Training, Ministry of Health, Freetown, Sierra Leone
| | - Clara Menendez
- Barcelona Institute for Global Health, Hospital Clinic‑University of Barcelona, Barcelona, Spain
- Manhiça Health Research Center, Manhiça, Mozambique
| | - Raquel Gonzalez
- Barcelona Institute for Global Health, Hospital Clinic‑University of Barcelona, Barcelona, Spain
- Manhiça Health Research Center, Manhiça, Mozambique
| | - Valérie Briand
- University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France
- Epicentre, Paris, France
| | - Didier K Ekouevi
- University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France
- Département de Santé Publique, Université de Lomé, Lomé, Togo
- Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo
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Sadoine ML, Smargiassi A, Liu Y, Gachon P, Fournier M, Dueymes G, Namuganga JF, Dorsey G, Nasri B, Zinszer K. Differential Influence of Environmental Factors on Malaria Due to Vector Control Interventions in Uganda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7042. [PMID: 37998273 PMCID: PMC10671539 DOI: 10.3390/ijerph20227042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/23/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Few studies have explored how vector control interventions may modify associations between environmental factors and malaria. METHODS We used weekly malaria cases reported from six public health facilities in Uganda. Environmental variables (temperature, rainfall, humidity, and vegetation) were extracted from remote sensing sources. The non-linearity of environmental variables was investigated, and negative binomial regression models were used to explore the influence of indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) on associations between environmental factors and malaria incident cases for each site as well as pooled across the facilities, with or without considering the interaction between environmental variables and vector control interventions. RESULTS An average of 73.3 weekly malaria cases per site (range: 0-597) occurred between 2010 and 2018. From the pooled model, malaria risk related to environmental variables was reduced by about 35% with LLINs and 63% with IRS. Significant interactions were observed between some environmental variables and vector control interventions. There was site-specific variability in the shape of the environment-malaria risk relationship and in the influence of interventions (6 to 72% reduction in cases with LLINs and 43 to 74% with IRS). CONCLUSION The influence of vector control interventions on the malaria-environment relationship need to be considered at a local scale in order to efficiently guide control programs.
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Affiliation(s)
- Margaux L. Sadoine
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, QC H3N 1X9, Canada
- Center for Public Health Research, Université de Montréal, Montreal, QC H3N 1X9, Canada
| | - Audrey Smargiassi
- Center for Public Health Research, Université de Montréal, Montreal, QC H3N 1X9, Canada
- Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, Montreal, QC H3T 1A8, Canada
| | - Ying Liu
- Center for Public Health Research, Université de Montréal, Montreal, QC H3N 1X9, Canada
- Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, Montreal, QC H3T 1A8, Canada
| | - Philippe Gachon
- ESCER (Étude et Simulation du Climat à l’Échelle Régionale) Centre, Université du Québec à Montréal, Montreal, QC H2L 2C4, Canada
| | - Michel Fournier
- Montreal Regional Department of Public Health, Montreal, QC H2L 1M3, Canada
| | - Guillaume Dueymes
- ESCER (Étude et Simulation du Climat à l’Échelle Régionale) Centre, Université du Québec à Montréal, Montreal, QC H2L 2C4, Canada
| | | | - Grant Dorsey
- Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - Bouchra Nasri
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, QC H3N 1X9, Canada
- Center for Public Health Research, Université de Montréal, Montreal, QC H3N 1X9, Canada
| | - Kate Zinszer
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, QC H3N 1X9, Canada
- Center for Public Health Research, Université de Montréal, Montreal, QC H3N 1X9, Canada
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Getachew H, Demissew A, Abossie A, Habtamu K, Wang X, Zhong D, Zhou G, Lee MC, Hemming-Schroeder E, Bradley L, Degefa T, Hawaria D, Tsegaye A, W Kazura J, Koepfli C, Yan G, Yewhalaw D. Asymptomatic and submicroscopic malaria infections in sugar cane and rice development areas of Ethiopia. Malar J 2023; 22:341. [PMID: 37940948 PMCID: PMC10634149 DOI: 10.1186/s12936-023-04762-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/22/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Water resource development projects, such as dams and irrigation schemes, have a positive impact on food security and poverty reduction. However, such projects could increase prevalence of vector borne disease, such as malaria. This study investigate the impact of different agroecosystems and prevalence of malaria infection in Southwest Ethiopia. METHODS Two cross-sectional surveys were conducted in the dry and wet seasons in irrigated and non-irrigated clusters of Arjo sugarcane and Gambella rice development areas of Ethiopia in 2019. A total of 4464 and 2176 study participants from 1449 households in Arjo and 546 households in Gambella enrolled in the study and blood samples were collected, respectively. All blood samples were microscopically examined and a subset of microscopy negative blood samples (n = 2244) were analysed by qPCR. Mixed effect logistic regression and generalized estimating equation were used to determine microscopic and submicroscopic malaria infection and the associated risk factors, respectively. RESULTS Prevalence by microscopy was 2.0% (88/4464) in Arjo and 6.1% (133/2176) in Gambella. In Gambella, prevalence was significantly higher in irrigated clusters (10.4% vs 3.6%) than in non-irrigated clusters (p < 0.001), but no difference was found in Arjo (2.0% vs 2.0%; p = 0.993). On the other hand, of the 1713 and 531 samples analysed by qPCR from Arjo and Gambella the presence of submicroscopic infection was 1.2% and 12.8%, respectively. Plasmodium falciparum, Plasmodium vivax, and Plasmodium ovale were identified by qPCR in both sites. Irrigation was a risk factor for submicroscopic infection in both Arjo and Gambella. Irrigation, being a migrant worker, outdoor job, < 6 months length of stay in the area were risk factors for microscopic infection in Gambella. Moreover, school-age children and length of stay in the area for 1-3 years were significant predictors for submicroscopic malaria in Gambella. However, no ITN utilization was a predictor for both submicroscopic and microscopic infection in Arjo. Season was also a risk factor for microscopic infection in Arjo. CONCLUSION The study highlighted the potential importance of different irrigation practices impacting on submicroscopic malaria transmission. Moreover, microscopic and submicroscopic infections coupled with population movement may contribute to residual malaria transmission and could hinder malaria control and elimination programmes in the country. Therefore, strengthening malaria surveillance and control by using highly sensitive diagnostic tools to detect low-density parasites, screening migrant workers upon arrival and departure, ensuring adequate coverage and proper utilization of vector control tools, and health education for at-risk groups residing or working in such development corridors is needed.
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Affiliation(s)
- Hallelujah Getachew
- Department of Medical Laboratory Technology, Arbaminch College of Health Sciences, Arbaminch, Ethiopia.
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia.
| | - Assalif Demissew
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ashenafi Abossie
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Arbaminch University, Arbaminch, Ethiopia
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| | - Kassahun Habtamu
- Menelik II Medical & Health Science College, Addis Ababa, Ethiopia
- Department of Microbial, Cellular & Molecular Biology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Xiaoming Wang
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Daibin Zhong
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Guofa Zhou
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Ming-Chieh Lee
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Elizabeth Hemming-Schroeder
- Center for Vector Born Infectious Diseases (CVID), Department of Microbiology Immunology and Pathology, Colorado State University, Fort Collins, USA
| | - Lauren Bradley
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Teshome Degefa
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Dawit Hawaria
- School of Environmental Health, Hawassa University, Hawassa, Ethiopia
| | - Arega Tsegaye
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Department of Biology, College of Natural Science, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| | - James W Kazura
- Biomedical Research Case Western Reserve University, Cleveland, OH, USA
- Center for Global Health & Disease School of Medicine Case, Western Reserve University, Cleveland, OH, USA
| | - Cristian Koepfli
- Department of Biological Sciences 319 Galvin Life Sciences, Eck Institute for Global Health, University of Notre Dame, Notre Dame, USA
| | - Guiyun Yan
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Delenasaw Yewhalaw
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
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Amanuel M, Tadesse S, Tamene A. House-wall modification after indoor residual spraying in Shashogo district, southern Ethiopia. Malar J 2023; 22:328. [PMID: 37907947 PMCID: PMC10619287 DOI: 10.1186/s12936-023-04759-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 10/18/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Indoor residual spraying has been a key national malaria prevention and control strategy in Ethiopia. However, there is a gap in monitoring and evaluation of house-wall modification after indoor residual spraying before the end of residual lifespan. This study has determined the prevalence of house-wall modification after indoor residual spraying and identified the associated factors in Shashogo district, southern Ethiopia. METHODS A community-based cross-sectional study was conducted from April to May 2022. Data were collected from 640 randomly selected households using a pre-tested questionnaire and an observational checklist. The binary logistic regression models were used to identify factors associated with house-wall modification after indoor residual spraying before the end of the potency period. RESULTS The prevalence of house-wall modification after indoor residual spraying was found to be 30.4% (95% CI 27.4-34.2%). Educational status of could not read and write [AOR = 1.76, 95% CI (1.16, 2.68)], monthly income of more than birr 3000 [AOR = 3.27, 95% CI (1.78, 6.01)], low level of knowledge about indoor residual spraying [AOR = 3.81, 95% CI (2.39, 6.06)], lack of information within two weeks before spraying [AOR = 2.23, 95% CI (1.44, 3.46)], absence of supervision after spraying [AOR = 1.79, 95% CI (1.14, 2.81)], absence of stagnant water near house [AOR = 3.36, 95% CI (2.13, 5.39)], and thatched roof [AOR = 1.82, 95% CI (1.04, 3.16)] were factors significantly associated with house-wall modification after indoor residual spraying. CONCLUSION This study has revealed that the prevalence of house-wall modification after indoor residual spraying before the end of the residual lifespan in the study area was higher compared to other studies in developing countries. Therefore, special emphasis should be given to providing community education about indoor residual spraying, conducting regular supervision before and after residual spraying, enforcing some legislative strategies for modifying the house-wall before six months after spraying, and improving environmental and housing conditions.
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Affiliation(s)
| | - Sebsibe Tadesse
- National Data Management and Analytics Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Aiggan Tamene
- School of Public Health, Wachemo University, Hossana, Ethiopia
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Fola AA, Feleke SM, Mohammed H, Brhane BG, Hennelly CM, Assefa A, Crudal RM, Reichert E, Juliano JJ, Cunningham J, Mamo H, Solomon H, Tasew G, Petros B, Parr JB, Bailey JA. Plasmodium falciparum resistant to artemisinin and diagnostics have emerged in Ethiopia. Nat Microbiol 2023; 8:1911-1919. [PMID: 37640962 PMCID: PMC10522486 DOI: 10.1038/s41564-023-01461-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/26/2023] [Indexed: 08/31/2023]
Abstract
Diagnosis and treatment of Plasmodium falciparum infections are required for effective malaria control and are pre-requisites for malaria elimination efforts; hence we need to monitor emergence, evolution and spread of drug- and diagnostics-resistant parasites. We deep sequenced key drug-resistance mutations and 1,832 SNPs in the parasite genomes of 609 malaria cases collected during a diagnostic-resistance surveillance study in Ethiopia. We found that 8.0% (95% CI 7.0-9.0) of malaria cases were caused by P. falciparum carrying the candidate artemisinin partial-resistance kelch13 (K13) 622I mutation, which was less common in diagnostic-resistant parasites mediated by histidine-rich proteins 2 and 3 (pfhrp2/3) deletions than in wild-type parasites (P = 0.03). Identity-by-descent analyses showed that K13 622I parasites were significantly more related to each other than to wild type (P < 0.001), consistent with recent expansion and spread of this mutation. Pfhrp2/3-deleted parasites were also highly related, with evidence of clonal transmissions at the district level. Of concern, 8.2% of K13 622I parasites also carried the pfhrp2/3 deletions. Close monitoring of the spread of combined drug- and diagnostic-resistant parasites is needed.
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Affiliation(s)
- Abebe A Fola
- Center for Computational Molecular Biology, Brown University, Providence, RI, USA
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | | | | | | | - Christopher M Hennelly
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
| | - Ashenafi Assefa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
| | - Rebecca M Crudal
- Center for Computational Molecular Biology, Brown University, Providence, RI, USA
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Emily Reichert
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Jonathan J Juliano
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
| | - Jane Cunningham
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Hassen Mamo
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Geremew Tasew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Beyene Petros
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jonathan B Parr
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
| | - Jeffrey A Bailey
- Center for Computational Molecular Biology, Brown University, Providence, RI, USA.
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA.
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Ma X, Fan X, Youssaou KC, Zhang J, Wang X, Zheng G, Tian S, Gao Y. Clinical and Biological Characteristics of Severe Malaria in Children under 5 Years Old in Benin. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:5516408. [PMID: 37771844 PMCID: PMC10533293 DOI: 10.1155/2023/5516408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 08/16/2023] [Accepted: 08/30/2023] [Indexed: 09/30/2023]
Abstract
Background Malaria is a global public health concern, mainly occurring in sub-Saharan Africa. Children infected with malaria are more likely to develop severe disease, which can be fatal. During COVID-19 in 2020, diagnosing and treating malaria became difficult. We analyzed the clinical characteristics and laboratory indicators of children with severe malaria in Benin to provide important information for designing effective prevention and treatment strategies to manage pediatric cases. Methods Clinical characteristics of pediatric patients with severe malaria admitted to two hospitals in Benin (Central Hospital of Lokossa and Regional Hospital of Natitingou, located ∼650 kilometers apart) were collected from January to December 2020. Patients were grouped according to age (group A: 4-12 months old, group B: 13-36 months old, and group C: 37-60 months old), and clinical and laboratory indicators were compared. The incidences of severe pediatric malaria in both hospitals in 2020 were calculated. Inclusion, exclusion, and blood transfusion criteria were identified. Results We analyzed 236 pediatric cases. The main clinical symptoms among all patients were severe anemia, vomiting, prostration, poor appetite, dysphoria, and dyspnea. Over 50% of patients in group A experienced vomiting and severe anemia. Most patients in group B had severe anemia and prostration. Delirium affected significantly more patients in group C than in groups A and B. In group C, the hemoglobin and hematocrit levels were significantly higher (p < 0.05), and the leukocyte count was significantly lower (p < 0.01) than in groups A and B. Parasitemia was significantly higher in group C than in group A (p < 0.01). Twelve deaths occurred. Conclusions Severe pediatric malaria is seasonal in Benin. The situation in children under 5 years old is poor. The main problems are severe disease conditions and high fatality rates. Effective approaches such as prevention and early and appropriate treatment are necessary to reduce the malaria burden in pediatric patients.
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Affiliation(s)
- Xiao Ma
- Department of Emergency, General Hospital, Ningxia Medical University, Yinchuan, China
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
| | - Xin Fan
- Department of Ophthalmology, General Hospital, Ningxia Medical University, Yinchuan, China
| | - Kora Chabi Youssaou
- Department of Internal Medicine, Hospital of Zone of Natitingou (Women's and Children's Hospital), Natitingou, Atacora Province, Benin
| | - Junfei Zhang
- Department of Emergency, General Hospital, Ningxia Medical University, Yinchuan, China
| | - Xingyi Wang
- Department of Emergency, General Hospital, Ningxia Medical University, Yinchuan, China
| | - Guoqiang Zheng
- General Practice, People's Hospital of Ningxia, Yinchuan, China
| | - Shuping Tian
- Department of Pediatric, General Hospital, Ningxia Medical University, Yinchuan, China
| | - Yujing Gao
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
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11
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Hoffman-Hall A, Puett R, Silva JA, Chen D, Bredder A, Shevade V, Han ZY, Han KT, Aung PP, Plowe CV, Nyunt MM, Loboda TV. Comparison of deforestation and forest land use factors for malaria elimination in Myanmar. IJID REGIONS 2023; 8:75-83. [PMID: 37533552 PMCID: PMC10393544 DOI: 10.1016/j.ijregi.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 08/04/2023]
Abstract
Objectives Within the remote region of Ann Township in Myanmar's Rakhine State, malaria prevalence has remained steady at ∼10% of the population from 2016-2019. Previous studies have linked areas of higher malaria prevalence in the region to heavily forested areas, however, little is known about how people live, work, and move through these areas. This work aims to disentangle landscape from land use in regard to malaria exposure. Methods We investigated the roles of forest cover, forest loss, and land use activities with malaria prevalence through the combined use of land use surveys, malaria surveillance, and satellite earth observations. Results Our results confirm previous research that linked areas of high forest cover with high malaria prevalence. However, areas experiencing high levels of deforestation were not associated with malaria prevalence. The land use factors that contribute most significantly to increased malaria risk remained those which put people in direct contact with forests, including conducting forest chores, having an outdoor job, and having a primary occupation in the logging and/or plantation industry. Conclusion Malaria prevention methods in Myanmar should focus on anyone who lives near forests or engages in land use activities that bring them within proximity of forested landscapes, whether through occupation or chores.
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Affiliation(s)
| | - Robin Puett
- University of Maryland, School of Public Health, College Park, USA
| | - Julie A. Silva
- University at Buffalo, Department of Geography, Buffalo, USA
| | - Dong Chen
- University of Maryland, Department of Geographical Sciences, College Park, USA
| | - Allison Bredder
- University of Maryland, Department of Geographical Sciences, College Park, USA
| | - Varada Shevade
- University of Maryland, Department of Geographical Sciences, College Park, USA
| | - Zay Yar Han
- Duke University, Global Health Institute, Durham, USA
| | - Kay Thwe Han
- Department of Medical Research, Myanmar Ministry of Health and Sports, Yangon, Myanmar
| | - Poe Poe Aung
- Malaria Consortium, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | | | - Tatiana V. Loboda
- University of Maryland, Department of Geographical Sciences, College Park, USA
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Debash H, Bisetegn H, Ebrahim H, Tilahun M, Dejazmach Z, Getu N, Feleke DG. Burden and seasonal distribution of malaria in Ziquala district, Northeast Ethiopia: a 5-year multi-centre retrospective study. BMJ Open 2023; 13:e067103. [PMID: 37597861 PMCID: PMC10441121 DOI: 10.1136/bmjopen-2022-067103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 07/19/2023] [Indexed: 08/21/2023] Open
Abstract
OBJECTIVE This study was aimed to determine the 5-year trend of malaria positivity rate in Ziquala district, Northeast Ethiopia. METHODS Review of blood film reports from health institutions' laboratory record books using predesigned checklists was done as part of an institution-based retrospective study to assess the 5-year (2016/2017-2020/2021) trend of malaria. To display data and analyse patterns in the trend of malaria over the course of years, months and seasons, descriptive statistics were used. The results of the data analysis were displayed in tables and figures using SPSS V.26.0. P values under 0.05 were considered as statistically significant for all comparisons. RESULTS A total of 46 365 blood films from malaria suspected individuals were diagnosed using microscopy over the last 5 years. Of the diagnosed individuals, 14 429 (31.1%) were confirmed positive for Plasmodium infection. Plasmodium falciparum (59.7%) and Plasmodium vivax (37.0%) were the dominant species. The positivity rate of mixed infection (P. falciparum and P. vivax) was 3.3%. The maximum (3598; 29.6%) and minimum (2085; 29.1%) number of cases were reported in 2019/2020 and 2020/2021, respectively. Of the total cases, 9206 (63.8%) were in males. Moreover, the highest malaria positivity rate was observed in the age group of 15-45 (4040; 28.0%). Among the six health facilities, Ziquala district hospital had the highest malaria positivity rate (35.8%), followed by Tsitsika health centre (27.3%) and Mishra health centre (14.2%). CONCLUSION With P. falciparum being the most common species, malaria remains a severe public health threat in the district. Therefore, the district health office and other concerned bodies should strengthen and implement evidence-based malaria prevention and control measures.
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Affiliation(s)
- Habtu Debash
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Habtye Bisetegn
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Hussen Ebrahim
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mihret Tilahun
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Zelalem Dejazmach
- Department of Medeical Laboratory Sciences, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Nigatu Getu
- Department of Medical Laboratory Sciences, Ziquala Hospital, Ziquala, Ethiopia
| | - Daniel Getacher Feleke
- Department of Microbiology, Immunology and Parssitology, Addis Ababa University, Addis Ababa, Ethiopia
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Getachew H, Demissew A, Abossie A, Habtamu K, Wang X, Zhong D, Zhou G, Lee MC, Hemming-Schroeder E, Bradley L, Degefa T, Hawaria D, Tsegaye A, Kazura JW, Koepfli C, Yan G, Yewhalaw D. Asymptomatic and submicroscopic malaria infections in sugar cane and rice development areas of Ethiopia. RESEARCH SQUARE 2023:rs.3.rs-2692688. [PMID: 36993196 PMCID: PMC10055656 DOI: 10.21203/rs.3.rs-2692688/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Background Water resource development projects such as dams and irrigation schemes have a positive impact on food security and poverty reduction but might result in increased prevalence of malaria. Methods Two cross-sectional surveys were conducted in the dry and wet seasons in irrigated and non-irrigated clusters of Arjo sugarcane and Gambella rice development areas of Ethiopia in 2019. A total of 4464 and 2176 blood samples were collected from Arjo and Gambella. A subset of 2244 microscopy negative blood samples were analyzed by PCR. Results Prevalence by microscopy was 2.0% (88/4464) in Arjo and 6.1% (133/2176) in Gambella. In Gambella, prevalence was significantly higher in irrigated clusters (10.4% vs 3.6%) than in non-irrigated clusters (p < 0.001), but no difference was found in Arjo (2.0% vs 2.0%; p = 0.993). Level of education was an individual risk factors associated with infection in Arjo [AOR: 3.2; 95%CI (1.27-8.16)] and in Gambella [AOR: 1.7; 95%CI (1.06-2.82)]. While duration of stay in the area for < 6 months [AOR: 4.7; 95%CI (1.84-12.15)] and being a migrant worker [AOR: 4.7; 95%CI (3.01-7.17)] were risk factors in Gambella. Season [AOR: 15.9; 95%CI (6.01-42.04)], no ITN utilization [AOR: 22.3; 95%CI (7.74-64.34)] were risk factors in Arjo, and irrigation [AOR: 2.4; 95%CI (1.45-4.07)] and family size [AOR: 2.3; 95%CI (1.30-4.09)] risk factors in Gambella. Of the 1713 and 531 randomly selected smear negative samples from Arjo and Gambella and analyzed by PCR the presence of Plasmodium infection was 1.2% and 12.8%, respectively. P. falciparum, P. vivax, and P. ovale were identified by PCR in both sites. Conclusion Strengthening malaria surveillance and control in project development areas and proper health education for at-risk groups residing or working in such development corridors is needed.
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Affiliation(s)
- Hallelujah Getachew
- Department of Medical Laboratory Technology, Arbaminch College of Health Sciences, Arbaminch
| | - Assalif Demissew
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Ambo University, Ambo
| | - Ashenafi Abossie
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Arbaminch University, Arbaminch
| | | | - Xiaoming Wang
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Daibin Zhong
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Guofa Zhou
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Ming-Chieh Lee
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Elizabeth Hemming-Schroeder
- Center for Vector Born Infectious Diseases (CVID), Department of Microbiology Immunology and Pathology, Colorado State University
| | - Lauren Bradley
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Teshome Degefa
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma
| | - Dawit Hawaria
- Hawassa University, School of Environmental Health, Hawassa
| | - Arega Tsegaye
- Department of Biology, College of Natural Science, Jimma University
| | - James W Kazura
- Biomedical Research Case Western Reserve University, Cleveland, Ohio
| | - Cristian Koepfli
- Department of Biological Sciences 319 Galvin Life Sciences, Eck Institute for Global Health, University of Notre Dame, Notre Dame
| | - Guiyun Yan
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Delenasaw Yewhalaw
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma
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Olagunju EA. Is the presence of mosquitoes an indicator of poor environmental sanitation? JOURNAL OF WATER AND HEALTH 2023; 21:385-401. [PMID: 37338318 PMCID: wh_2023_280 DOI: 10.2166/wh.2023.280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
The World Health Organization has designated mosquitoes as the most lethal animal since they are known to spread pathogen-transmitting organisms. Understanding the many environmental elements that contribute to the spread of these vectors is one of the many strategies used to stop them. If there are mosquitoes around people, it may indicate that there is not an appropriate environmental sanitation program in place in the community or region. Environmental sanitation involves improving any elements of the physical environment that could have a negative impact on a person's survival, health, or physical environment. Keywords containing 'Aedes,' 'Culex,' 'Anopheles,' 'dengue,' 'malaria,' 'yellow fever,' 'Zika,' 'West Nile,' 'chikungunya,' 'resident,' 'environment,' 'sanitation,' 'mosquito control,' and 'breeding sites' of published articles on PubMed, Google Scholar, and ResearchGate were reviewed. It was discovered that the general population should be involved in mosquito and mosquito-borne disease control. Collaboration between health professionals and the general population is essential. The purpose of this paper is to increase public awareness of environmental health issues related to diseases carried by mosquitoes.
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Affiliation(s)
- Emmanuel Ajibola Olagunju
- Department of Crop and Environmental Protection, Faculty of Agricultural Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria E-mail:
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Noppert GA, Hegde ST, Kubale JT. Exposure, Susceptibility, and Recovery: A Framework for Examining the Intersection of the Social and Physical Environments and Infectious Disease Risk. Am J Epidemiol 2023; 192:475-482. [PMID: 36255177 PMCID: PMC10372867 DOI: 10.1093/aje/kwac186] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 08/30/2022] [Accepted: 10/13/2022] [Indexed: 01/13/2023] Open
Abstract
Despite well-documented evidence that structurally disadvantaged populations are disproportionately affected by infectious diseases, our understanding of the pathways that connect structural disadvantage to the burden of infectious diseases is limited. We propose a conceptual framework to facilitate more rigorous examination and testing of hypothesized mechanisms through which social and environmental factors shape the burden of infectious diseases and lead to persistent inequities. Drawing upon the principles laid out by Link and Phelan in their landmark paper on social conditions (J Health Soc Behav. 1995;(spec no.):80-94), we offer an explication of potential pathways through which structural disadvantage (e.g., racism, sexism, and economic deprivation) operates to produce infectious disease inequities. Specifically, we describe how the social environment affects an individual's risk of infectious disease by 1) increasing exposure to infectious pathogens and 2) increasing susceptibility to infection. This framework will facilitate both the systematic examination of the ways in which structural disadvantage shapes the burden of infectious disease and the design of interventions that can disrupt these pathways.
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Affiliation(s)
- Grace A Noppert
- Survey Research Center, Institute for Social Research, University of Michigan
| | - Sonia T Hegde
- Department of Epidemiology, Johns Hopkins University
| | - John T Kubale
- ICPSR, Institute for Social Research, University of Michigan
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Malaria profile and socioeconomic predictors among under-five children: an analysis of 11 sub-Saharan African countries. Malar J 2023; 22:55. [PMID: 36788541 PMCID: PMC9927033 DOI: 10.1186/s12936-023-04484-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND African region accounts for 95% of all malaria cases and 96% of malaria deaths with under-five children accounting for 80% of all deaths in the region. This study assessed the socioeconomic determinants of malaria prevalence and provide evidence on the socioeconomic profile of malaria infection among under-five children in 11 SSA countries. METHODS This study used data from the 2010 to 2020 Demographic and Health Survey (DHS). The survey used a two-stage stratified-cluster sampling design based on the sampling frame of the population and housing census of countries included. Statistical analyses relied on Pearson's χ2, using the CHAID decision-tree algorithm and logistic regression implemented in R V.4.6. RESULTS Of 8547 children considered, 24.2% (95% confidence interval CI 23.4-25.05%) had malaria infection. Also, the prevalence of malaria infection seems to increase with age. The following variables are statistically associated with the prevalence of malaria infection among under-five children: under-five child's age, maternal education, sex of household head, household wealth index, place of residence, and African region where mother-child pair lives. Children whose mothers have secondary education have about 56% lower risk (odds ratio = 0.44; 95% CI 0.40-0.48) of malaria infection and 73% lower (odds ratio = 0.37; 95% CI 0.32-0.43) among children living in the richest households, compared to children living in the poorest households. CONCLUSIONS The findings of this study provide unique insights on how socioeconomic and demographic variables, especially maternal education level significantly predicts under-five malaria prevalence across the SSA region. Therefore, ensuring that malaria interventions are underpinned by a multisectoral approach that comprehensively tackles the interplay of maternal education and other socioeconomic variables will be critical in attaining malaria prevention and control targets in SSA.
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Daba C, Atamo A, Debela SA, Kebede E, Woretaw L, Gebretsadik D, Teshome D, Tefera Y, Gebrehiwot M. A Retrospective Study on the Burden of Malaria in Northeastern Ethiopia from 2015 to 2020: Implications for Pandemic Preparedness. Infect Drug Resist 2023; 16:821-828. [PMID: 36818806 PMCID: PMC9930572 DOI: 10.2147/idr.s399834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/02/2023] [Indexed: 02/12/2023] Open
Abstract
Background Regardless of various prevention and control strategies, malaria continues to be a significant public health problem in Ethiopia. As there are few studies on malaria trend analysis in Northeastern Ethiopia, it hinders the evaluation of ongoing and prioritization of new malaria intervention strategies, particularly during the period of pandemics. Therefore, the present study investigated the trend of malaria prevalence in Northeastern Ethiopia from 2015 to 2020. Methods An institution-based retrospective study was employed to assess the trend of malaria prevalence over a 6-year period (2015-2020) in three districts (Jile tumuga, Aruma fursi, and Dawachefa) of Northeastern Ethiopia. Data were extracted from clinical records of malaria cases by trained medical laboratory technologists. The associations between the prevalence of malaria and independent variables (age group, malaria transmission season, and districts) were assessed using chi-square test. P-values with a cut-off point of 0.05 were used to determine statistically significant associations. Results In our study area, a total of 212,952 malaria suspected patients were diagnosed over the 6 years. Of these, 33,005 (15.5%) were confirmed malaria cases. The identified Plasmodium species were Plasmodium falciparum and P. vivax, accounting for 66.4% and 33.6%, respectively. These with the age of >15 years old were the most affected (41.9%). The highest numbers of malaria cases (34.6%) were recorded during spring season (September to November). The prevalence of Plasmodium species showed a significant association with age (X2=9.7; p=0.002), districts (X2=13.5; p<0.001), and malaria transmission season (X2=16.5; p<0.001). Conclusion In our study area, P. falciparum is the dominant species. We noted that malaria remains a public health concern and fluctuates throughout the years. Therefore, national, regional, zonal, and district health bureaus should strengthen the ongoing and devise appropriate prevention and control strategies even during the period of pandemics.
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Affiliation(s)
- Chala Daba
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia,Correspondence: Chala Daba, Email
| | - Amanuel Atamo
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Abebe Debela
- Department of Public Health, College of Medicine and Health Sciences, Salale University, Fitche, Ethiopia
| | - Edosa Kebede
- Departement of Medical Laboratory Science, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Lebasie Woretaw
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Daniel Gebretsadik
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Daniel Teshome
- Department of Anatomy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yonatal Tefera
- Adelaide Exposure Science and Health, School of Public Health, University of Adelaide, Adelaide, Australia
| | - Mesfin Gebrehiwot
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Balcha F, Menna T, Lombamo F. Prevalence of asymptomatic malaria and associated factors among pregnant women at Boset District in East Shoa Zone, Oromia Region, Ethiopia: a cross-sectional study. Malar J 2023; 22:28. [PMID: 36698185 PMCID: PMC9878930 DOI: 10.1186/s12936-023-04460-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Malaria infection during pregnancy is a significant public health problem that puts pregnant women at risk. Interruption of transmission of asymptomatic malaria among a population remained a challenge and the host serves as a reservoir for the malaria parasite; and is also recognized as a major barrier to malaria elimination. This study aimed to assess the prevalence of asymptomatic malaria and associated factors among pregnant women in the Boset District, East Shoa Zone, Oromia, Ethiopia. METHODS A community-based cross-sectional study was conducted to assess the prevalence of asymptomatic malaria and associated factors in pregnant women from February to March 2022. Using multistage sample techniques, 328 asymptomatic pregnant women were enrolled. Data were collected using a structured questionnaire. A rapid test and Giemsa-stained blood smear microscopy were used to diagnose Plasmodium infections. Epi info version 7 was used to code, enter, and clean data before being uploaded to SPSS version 25.0 for analysis. Bivariable and multivariable binary logistic regression were employed to find the associated factors. Variables in the multivariable model with a p-value < 0.05 were considered significantly associated with asymptomatic malaria. RESULTS Of the total 328 pregnant women who participated in this study, 9(2.74%) and 10(3.05%) were confirmed to be infected with Plasmodium species by microscopy and rapid diagnostic tests, respectively. Asymptomatic malaria during pregnancy was found to be significantly associated with not using an insecticide-treated bed net [(P = 0.002, AOR: 9.61; 95% CI (2.22-41.53)], lack of consultation and health education about malaria prevention during Antenatal care attendance [(P = 0.04, AOR: 4.05; 95% CI (1.02, 16.05)], and living close stagnant water [(P = 0.02, AOR: 4.43; 95% CI (1.17,16.82)]. CONCLUSIONS The current study showed that asymptomatic malaria is prevalent in pregnant women. Not using insecticide-treated bed nets, inadequate health education during antenatal care, and living close to stagnant water are significantly associated with malaria infection. Thus, using insecticide-treated bed nets, health education, and avoiding stagnant water from residential areas could play significant roles in preventing asymptomatic malaria among pregnant women in the study area.
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Affiliation(s)
- Fufa Balcha
- School of Public Health, Adama Hospital Medical College, Adama, Ethiopia
| | - Takele Menna
- grid.460724.30000 0004 5373 1026School of Public Health, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Fantu Lombamo
- grid.460724.30000 0004 5373 1026School of Public Health, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Djoufounna J, Mayi MPA, Bamou R, Foyet JV, Tabue R, Lontsi-Demano M, Achu-Fosah D, Antonio-Nkondjio C, Tchuinkam T. High prevalence of asymptomatic Plasmodium falciparum malaria in Makenene, a locality in the forest-savannah transition zone, Centre Region of Cameroon. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2022; 2:100104. [PMID: 36504597 PMCID: PMC9731883 DOI: 10.1016/j.crpvbd.2022.100104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/13/2022] [Accepted: 11/17/2022] [Indexed: 11/29/2022]
Abstract
Malaria transmission and prevalence is still not well documented across Cameroon particularly in medium-sized cities or localities representing high transit zone. Different risk factors could be associated with persistence malaria transmission such as population movement from high to low transmission settings. A cross-sectional community-based study was carried out to determine malaria prevalence and risk factors in Makenene, a small city in a forest-savannah which is a crossroads between different parts of the country where travellers usually stop-over day and night to rest. Using malaria diagnostic test (mRDTs from SD-BIOLINE) and microscopy (thin and thick blood smears), 406 participants from 237 households were tested for malaria infection. The prevalence of malaria was high irrespective of the detection method: mRDT (41.87%) or microscopy (38.42%). At household level, 46.41% of households had at least one case of malaria with an average of 1.41 infected individuals per household. Parasite density was also high with the majority of infected individuals (64.74%) bearing more than 500 parasites/μl. Only Plasmodium falciparum was found. The chances of being infected with malaria parasites was almost the same for all participants irrespective of the sleeping behavior, bednet usage, house type and environmental factors. The study supports high malaria transmission in the locality and the need for additional studies on vectors bionomics and transmission patterns.
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Affiliation(s)
- Joel Djoufounna
- Vector Borne Diseases Laboratory of the Research Unit for Biology and Applied Ecology (VBID-RUBAE), Department of Animal Biology, Faculty of Science of the University of Dschang, Cameroon
| | - Marie Paul Audrey Mayi
- Vector Borne Diseases Laboratory of the Research Unit for Biology and Applied Ecology (VBID-RUBAE), Department of Animal Biology, Faculty of Science of the University of Dschang, Cameroon
| | - Roland Bamou
- Vector Borne Diseases Laboratory of the Research Unit for Biology and Applied Ecology (VBID-RUBAE), Department of Animal Biology, Faculty of Science of the University of Dschang, Cameroon,Corresponding author.
| | - Juluis Visnel Foyet
- Vector Borne Diseases Laboratory of the Research Unit for Biology and Applied Ecology (VBID-RUBAE), Department of Animal Biology, Faculty of Science of the University of Dschang, Cameroon
| | - Raymond Tabue
- National Malaria Control Programme, Ministry of Public Health, Yaounde, Cameroon
| | - Michel Lontsi-Demano
- Vector Borne Diseases Laboratory of the Research Unit for Biology and Applied Ecology (VBID-RUBAE), Department of Animal Biology, Faculty of Science of the University of Dschang, Cameroon
| | - Dorothy Achu-Fosah
- National Malaria Control Programme, Ministry of Public Health, Yaounde, Cameroon
| | - Christophe Antonio-Nkondjio
- Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), Yaounde, Cameroon
| | - Timoléon Tchuinkam
- Vector Borne Diseases Laboratory of the Research Unit for Biology and Applied Ecology (VBID-RUBAE), Department of Animal Biology, Faculty of Science of the University of Dschang, Cameroon,Corresponding author.
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Malaria among under-five children in Ethiopia: a systematic review and meta-analysis. Malar J 2022; 21:338. [PMID: 36384533 PMCID: PMC9667600 DOI: 10.1186/s12936-022-04370-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background Globally, malaria is among the leading cause of under-five mortality and morbidity. Despite various malaria elimination strategies being implemented in the last decades, malaria remains a major public health concern, particularly in tropical and sub-tropical regions. Furthermore, there have been limited and inconclusive studies in Ethiopia to generate information for action towards malaria in under-five children. Additionally, there is a considerable disparity between the results of the existing studies. Therefore, the pooled estimate from this study will provide a more conclusive result to take evidence-based interventional measures against under-five malaria. Methods The protocol of this review is registered at PROSPERO with registration number CRD42020157886. All appropriate databases and grey literature were searched to find relevant articles. Studies reporting the prevalence or risk factors of malaria among under-five children were included. The quality of each study was assessed using the Newcastle–Ottawa Quality Assessment Scale (NOS). Data was extracted using Microsoft Excel 2016 and analysis was done using STATA 16.0 statistical software. The pooled prevalence and its associated factors of malaria were determined using a random effect model. Heterogeneity between studies was assessed using the Cochrane Q-test statistics and I2 test. Furthermore, publication bias was checked by the visual inspection of the funnel plot and using Egger’s and Begg’s statistical tests. Results Twelve studies with 34,842 under-five children were included. The pooled prevalence of under-five malaria was 22.03% (95% CI 12.25%, 31.80%). Lack of insecticide-treated mosquito net utilization (AOR: 5.67, 95% CI 3.6, 7.74), poor knowledge of child caretakers towards malaria transmission (AOR: 2.79, 95% CI 1.70, 3.89), and living near mosquito breeding sites (AOR: 5.05, 95% CI 2.92, 7.19) were risk factors of under-five malaria. Conclusion More than one in five children aged under five years were infected with malaria. This suggests the rate of under-five malaria is far off the 2030 national malaria elimination programme of Ethiopia. The Government should strengthen malaria control strategies such as disseminating insecticide-treated mosquito nets (ITNs), advocating the utilization of ITNs, and raising community awareness regarding malaria transmission. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04370-9.
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Zewude BT, Debusho LK, Diriba TA. Multilevel logistic regression modelling to quantify variation in malaria prevalence in Ethiopia. PLoS One 2022; 17:e0273147. [PMID: 36174003 PMCID: PMC9521912 DOI: 10.1371/journal.pone.0273147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/03/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Ethiopia has low malaria prevalence compared to most other malaria-endemic countries in Africa. However, malaria is still a major public health problem in the country. The binary logistic regression model has been widely used to analyse malaria indicator survey (MIS) data. However, most MIS have a hierarchical structure which may result in dependent data. Since this model assumes that conditional on the covariates the malaria statuses of individuals are independent, it ignores potential intra-cluster correlation among observations within a cluster and may generate biased analysis results and conclusions. Therefore, the aim of this study was to quantify the variation in the prevalence of malaria between sample enumeration areas (SEAs) or clusters, the effects of cluster characteristics on the prevalence of malaria using the intra-class correlation coefficient as well as to identify significant factors that affect the prevalence of malaria using the multilevel logistic regression modelling in three major regions of Ethiopia, namely Amhara, Oromia and Southern Nations, Nationalities and Peoples’ (SNNP).
Methods
Dataset for three regional states extracted from the 2011 Ethiopian National Malaria Indicator Surveys (EMIS) national representative samples was used in this study. It contains 9272 sample individuals selected from these regions. Various multilevel models with random sample SEA effects were applied taking into account the survey design weights. These weights are scaled to address unequal probabilities of selection within clusters. The spatial clustering of malaria prevalence was assessed applying Getis-Ord statistic to best linear unbiased prediction values of model random effects.
Results
About 53.82 and 28.72 per cents of the sampled households in the study regions had no mosquito net and sprayed at least once within the last 12 months, respectively. The results of this study indicate that age, gender, household had mosquito nets, the dwelling has windows, source of drinking water, the two SEA-level variables, i.e. region and median altitude, were significantly related to the prevalence of malaria. After adjusting for these seven variables, about 45% of the residual variation in the prevalence of malaria in the study regions was due to systematic differences between SEAs, while the remaining 55% was due to unmeasured differences between persons or households. The estimated MOR, i.e. the unexplained SEA heterogeneity, was 4.784. This result suggests that there is high variation between SEAs in the prevalence of malaria. In addition, the 80% interval odds ratios (IORs) related to SEA-level variables contain one suggesting that the SEA variability is large in comparison with the effect of each of the variable.
Conclusions
The multilevel logistic regression with random effects model used in this paper identified five individual / household and two SEA-level risk factors of malaria infection. Therefore, the public health policy makers should pay attentions to those significant factors, such as improving the availability of pure drinking water. Further, the findings of spatial clustering provide information to health policymakers to plan geographically targeted interventions to control malaria transmission.
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Affiliation(s)
- Bereket Tessema Zewude
- Department of Statistics, University of South Africa, Johannesburg, South Africa
- * E-mail:
| | | | - Tadele Akeba Diriba
- Department of Statistics, University of South Africa, Johannesburg, South Africa
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Chiuya T, Villinger J, Falzon LC, Alumasa L, Amanya F, Bastos ADS, Fèvre EM, Masiga DK. Molecular screening reveals non-uniform malaria transmission in western Kenya and absence of Rickettsia africae and selected arboviruses in hospital patients. Malar J 2022; 21:268. [PMID: 36115978 PMCID: PMC9482282 DOI: 10.1186/s12936-022-04287-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 09/07/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
In sub-Saharan Africa, malaria is the common diagnosis for febrile illness and related clinical features, resulting in the under-diagnosis of other aetiologies, such as arboviruses and Rickettsia. While these may not be significant causes of mortality in malaria-endemic areas, they affect the daily life and performance of affected individuals. It is, therefore, important to have a clear picture of these other aetiologies to institute correct diagnoses at hospitals and improve patient outcomes.
Methods
Blood samples were collected from patients with fever and other clinical features associated with febrile illness at selected hospitals in the malaria-endemic counties of Busia, Bungoma, and Kakamega, and screened for Crimean-Congo haemorrhagic fever, Sindbis, dengue and chikungunya viruses, Rickettsia africae, and Plasmodium spp. using high-throughput real-time PCR techniques. A logistic regression was performed on the results to explore the effect of demographic and socio-economic independent variables on malaria infection.
Results
A total of 336 blood samples collected from hospital patients between January 2018 and February 2019 were screened, of which 17.6% (59/336) were positive for Plasmodium falciparum and 1.5% (5/336) for Plasmodium malariae. Two patients had dual P. falciparum/P. malariae infections. The most common clinical features reported by the patients who tested positive for malaria were fever and headache. None of the patients were positive for the arboviruses of interest or R. africae. Patients living in Busia (OR 5.2; 95% CI 2.46–11.79; p < 0.001) and Bungoma counties (OR 2.7; 95% CI 1.27–6.16; p = 0.013) had higher odds of being infected with malaria, compared to those living in Kakamega County.
Conclusions
The reported malaria prevalence is in line with previous studies. The absence of arboviral and R. africae cases in this study may have been due to the limited number of samples screened, low-level circulation of arboviruses during inter-epidemic periods, and/or the use of PCR alone as a detection method. Other sero-surveys confirming their circulation in the area indicate that further investigations are warranted.
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The Occurrence and Distribution of Plasmodium Species in Woyn Wuha Health Center, Ethiopia. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2881879. [PMID: 36105932 PMCID: PMC9467730 DOI: 10.1155/2022/2881879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/09/2022] [Accepted: 08/20/2022] [Indexed: 12/05/2022]
Abstract
Plasmodium species is an important causative agent of malaria in the world including Ethiopia, and the majority of people were at risk of infection. The study's general objective was to determine the occurrence and distribution of Plasmodium species in the study area through microscopic examination of blood films. A cross-sectional study was carried out in the study sites from September 2016 to February 2017. Out of 512 participants, 32 (6.25%) were malaria positive. Of these, 17 (53.12%, 95% CI: 0.358, 0.704) were P. vivax, 12 (37.5%, 95% CI: 0.207, 0.543) P. falciparum, and 3 (9.375%, 95% CI: -0.007, 0.195) mixed out of the total positive case. The occurrence of parasites was greater in rural villages (59.375%) than in urban villages (40.625%) but not significant (χ2 = 1.2917, df = 1, p = 0.2557). More males were infected compared to females but not significant (χ2 = 0.0005665, df = 1, p = 0.981). The monthly distribution of Plasmodium species was higher in September and October but there was no significant variation in each month (χ2 = 10.142, p = 0.4281). Due to the high occurrence of Plasmodium vivax in the study area, the result contrasts with the national figure of the Plasmodium species report. The result of the current study may be useful to those individuals who work in Plasmodium species control and prevention program.
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Goshu EM, Zerefa MD, Tola HH. Occurrence of asymptomatic malaria infection and living conditions in the lowlands of Ethiopia: a community-based cross-sectional study. Infect Dis Poverty 2022; 11:94. [PMID: 36064653 PMCID: PMC9444277 DOI: 10.1186/s40249-022-01018-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background A significant decline in malaria burden was documented in previously high burden African countries. Even though the global decline in malaria burden is significant, about 95% of it was typically found in 29 African countries and the decline was affected by COVID-19 in 2020. The considerable reduction in malaria incidence was noted due to effective prevention and treatment efforts, and rapid changes in living conditions. The relationship between the occurrence of asymptomatic malaria infection and household living conditions is well unstudied. This study aimed to determine the association between household living conditions and the occurrence of asymptomatic malaria in the lowlands of Ethiopia. Methods A community-based cross-sectional study was conducted from January to March 2021 in twelve villages of Gambella, Southern Nation Nationalities and People Region and Afar in Ethiopia. A total of 1366 households were randomly selected, interviewed, and tested for malaria by rapid diagnostic test and blood film microscopic examination. Multiple logistic regression model was used to determine the independent association between living conditions and asymptomatic malaria infection. Results The prevalence of asymptomatic malaria infection among individuals living in dwellings built with traditional floor/wall/roof ranges from 8.1% to 8.4% while it ranges from 2.0% to 4.6% among those living in modern floor/wall/roof houses. Dwellings built with traditional wall materials (P = 0.050), spending nights with cattle in the same house (P < 0.001), and availability of kitchen in the main house with no partition (P = 0.004) were significantly associated with asymptomatic malaria infection. Conclusions Asymptomatic malaria infection was 4.3 times higher among occupants residing in dwellings built with traditional wall materials; 5.6 times higher among households spending nights with cattle in the same house, and 2.3 times higher among households with kitchen in the main house with no partition. Therefore, policies and strategies on malaria elimination need to address or target improvements of the above listed living conditions for the community. A multi sectoral action is required to use these social determinants as a vector control strategic addition; and malaria elimination programs are expected to coordinate the implementation. Supplementary Information The online version contains supplementary material available at 10.1186/s40249-022-01018-3.
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Affiliation(s)
- Endale Mengesha Goshu
- Water and Public Health Stream, Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Meseret Dessalegne Zerefa
- Water and Public Health Stream, Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia
| | - Habteyes Hailu Tola
- Tuberculosis/HIV Research Directorate, Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia
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Malaria Infection, Parasitemia, and Hemoglobin Levels in Febrile Patients Attending Sibu Sire Health Facilities, Western Ethiopia. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6161410. [PMID: 35993053 PMCID: PMC9391188 DOI: 10.1155/2022/6161410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/19/2022] [Accepted: 07/27/2022] [Indexed: 11/23/2022]
Abstract
Background Malaria is endemic in tropical and subtropical regions and causes up to one million deaths each year. It mostly affects sub-Saharan African countries including Ethiopia. In Ethiopia, it was estimated that about 75% of the land and 68% of the population are exposed to malaria. The aim of the current study was to determine malaria cases, its impact on the level of hemoglobin, and parasitemia and predisposing factors among febrile patients who visited Sibu Sire Health Care centers. Methods Institution-based cross-sectional study was undertaken from May to October, 2020. Febrile patients who visited Sibu Sire Health Care centers were purposefully selected as the target population for the present study. Blood samples were collected and thick and thin smears stained with Giemsa. Hemoglobin level was determined using HemoCue Hb 301. Structured questionnaire and SPSS statistical software were used to collect and analyze data. P value < 0.05 was stated as statistically significant. Results The overall prevalence of malaria was 168/979 (17.2%) out of which Plasmodium falciparum was 132/168 (78.5%), Plasmodium vivax was 27/168 (16.1%), and mixed infection was 9/168 (5.4%). To assess factors associated with dependent variable and determine the strength of association, binary logistic regression was used at adjusted odds ratios with 95% confidence intervals. The associations between malaria cases, hemoglobin levels, and parasitemia were estimated to evaluate the impacts of malaria on hemoglobin levels and parasitemia level. Out of 979 febrile patients (male 453 and female 526), 168 (male 99 and female 69) individuals were infected with Plasmodium species and Plasmodium falciparum were the predominant parasites. The majority of the study participants 144/168 (85.7%) were from rural residences. Highest malaria-infected patients 74/168 (44%) were aged between 15 and 30 years old. The level of hemoglobin and parasitemia was highly associated with malaria cases; hence, in this study area, intensities of hemoglobin and parasitemia are significantly associated with Plasmodium species. Conclusion There was a moderate prevalence of malaria parasitemia and hemoglobin level among patients visiting Sibu Sire Health Care center; however, it needs further intervention to prevent and control malaria transmission in this malaria hotspot area.
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Carrasco-Escobar G, Matta-Chuquisapon J, Manrique E, Ruiz-Cabrejos J, Barboza JL, Wong D, Henostroza G, Llanos-Cuentas A, Benmarhnia T. Quantifying the effect of human population mobility on malaria risk in the Peruvian Amazon. ROYAL SOCIETY OPEN SCIENCE 2022; 9:211611. [PMID: 35875474 PMCID: PMC9297009 DOI: 10.1098/rsos.211611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 06/29/2022] [Indexed: 06/15/2023]
Abstract
The impact of human population movement (HPM) on the epidemiology of vector-borne diseases, such as malaria, has been described. However, there are limited data on the use of new technologies for the study of HPM in endemic areas with difficult access such as the Amazon. In this study conducted in rural Peruvian Amazon, we used self-reported travel surveys and GPS trackers coupled with a Bayesian spatial model to quantify the role of HPM on malaria risk. By using a densely sampled population cohort, this study highlighted the elevated malaria transmission in a riverine community of the Peruvian Amazon. We also found that the high connectivity between Amazon communities for reasons such as work, trading or family plausibly sustains such transmission levels. Finally, by using multiple human mobility metrics including GPS trackers, and adapted causal inference methods we identified for the first time the effect of human mobility patterns on malaria risk in rural Peruvian Amazon. This study provides evidence of the causal effect of HPM on malaria that may help to adapt current malaria control programmes in the Amazon.
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Affiliation(s)
- Gabriel Carrasco-Escobar
- Health Innovation Lab, Institute of Tropical Medicine ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia, Lima, Peru
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Jose Matta-Chuquisapon
- Health Innovation Lab, Institute of Tropical Medicine ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Edgar Manrique
- Health Innovation Lab, Institute of Tropical Medicine ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jorge Ruiz-Cabrejos
- Health Innovation Lab, Institute of Tropical Medicine ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jose Luis Barboza
- Health Innovation Lab, Institute of Tropical Medicine ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Daniel Wong
- Health Innovation Lab, Institute of Tropical Medicine ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Alejandro Llanos-Cuentas
- Instituto de Medicinal Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
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Idris IO, Ayeni GO, Iyamu IO, Sina-Odunsi AB, Adebisi YA, Obwoya JG. Factors influencing severity of recurrent malaria in a conflict-affected state of South Sudan: an unmatched case-control study. Confl Health 2022; 16:34. [PMID: 35690836 PMCID: PMC9188688 DOI: 10.1186/s13031-022-00463-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/28/2022] [Indexed: 11/26/2022] Open
Abstract
Background The burden of malaria remains the highest in sub-Saharan Africa and South Sudan is not an exception. The country has borne the brunt of years of chronic warfare and remains endemic of malaria, with increasing mortality and morbidity. Limited data still exists on factors influencing the recurrence of severe malaria, especially in emergency contexts such as South Sudan, affected by various conflicts and humanitarian situations. This study therefore aimed to investigate factors influencing severity of occurrence malaria in selected primary healthcare centres in South Sudan. This would assist and guide in malaria prevention, treatment, and eradication efforts. Methods We conducted an unmatched case-control study using routinely collected clinic data for individuals aged 1 year and above who received a diagnosis of severe malaria at 3 primary healthcare centres (PHCC); Malual Bab PHCC, Matangai PHCC and Malek PHCC between September 15, 2019 to December 15, 2019 in South Sudan. Patient characteristics were analyzed using simple descriptive statistics. Inferential statistics were also conducted to identify the associated factors influencing recurrence of severe malaria. All analyses were conducted using R Version 3.6.2. Results A total of 289 recurrent malaria cases were included in this study. More than half of the participants were female. Overall, the prevalence of severe recurrent malaria was 66.1% (191) while 74.4% (215) did not complete malaria treatment. Among those who did not complete malaria treatment, 76.7% (165) had severe recurrent malaria, while among those who completed malaria treatment 35.1% (26) had severe recurrent malaria (p < 0.001). There is a significant association between marital status (OR 0.33, 95% CI 0.19–0.56, p < 0.001), employment status (OR 0.35, 95% CI 0.14–0.87, p = 0.024), the use of preventive measures (OR 3.82, 95% CI 1.81–8.43, p < 0.001) and nutrition status (OR 0.22, 95% CI 0.13–0.37, p < 0.001). When adjusted for employment, marital status, nutritional and prevention measures in turns using Mantel–Haenszel test of association, this effect remained statistically significant. Conclusions Our study showed that there is a high prevalence of severe recurrent malaria in South Sudan and that a significant relationship exists between severe recurrent malaria and antimalarial treatment dosage completion influenced by certain personal and social factors such as marital status, employment status, the use of preventive measures and nutrition status. Findings from our study would be useful for effective response to control and prevent malaria in endemic areas of South Sudan.
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Affiliation(s)
- Israel Oluwaseyidayo Idris
- Department of Field Operation and Project Coordination, Health Pooled Fund, Juba, South Sudan. .,Department of Social and Preventive Medicine, V.N Karazin Kharkiv National University, Kharkiv, Ukraine. .,Department of Population Health, Faculty of Epidemiology and Population Health, School of Hygiene and Tropical Medicine, London, UK.
| | - Gabriel Omoniyi Ayeni
- Department of Field Operation and Project Coordination, Health Pooled Fund, Juba, South Sudan
| | - Ihoghosa Osamuyi Iyamu
- School of Population and Public Health (SPPH), University of British Columbia, Vancouver, Canada
| | - Ayomide Busayo Sina-Odunsi
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.,Regional Office for the East and Horn of Africa, International Organization for Migration, United Nations Migration Agency, Nairobi, Kenya
| | | | - Justin Geno Obwoya
- Department of Field Operation and Project Coordination, Health Pooled Fund, Juba, South Sudan
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Chan K, Cano J, Massebo F, Messenger LA. Cattle-related risk factors for malaria in southwest Ethiopia: a cross-sectional study. Malar J 2022; 21:179. [PMID: 35689237 PMCID: PMC9188194 DOI: 10.1186/s12936-022-04202-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the low to moderate intensity of malaria transmission present in Ethiopia, malaria is still a leading public health problem. Current vector control interventions, principally long-lasting insecticidal nets and indoor residual spraying, when deployed alone or in combination, are insufficient to control the dominant vector species due to their exophagic and exophilic tendencies. Zooprophylaxis presents a potential supplementary vector control method for malaria; however, supporting evidence for its efficacy has been mixed. METHODS To identify risk factors of malaria and to estimate the association between cattle and Anopheles vector abundance as well as malaria risk, a cross-sectional study was conducted in a village near Arba Minch, Ethiopia. Epidemiological surveys (households = 95, individuals = 463), mosquito collections using CDC light traps and a census of cattle and human populations were conducted. To capture environmental conditions, land cover and water bodies were mapped using satellite imagery. Risk factor analyses were performed through logistic, Poisson, negative binomial, and spatial weighted regression models. RESULTS The only risk factor associated with self-reported malaria illness at an individual level was being a child aged 5 or under, where they had three times higher odds than adults. At the household level, variables associated with malaria vector abundance, especially those indoors, included socioeconomic status, the proportion of children in a household and cattle population density. CONCLUSIONS Study results are limited by the low abundance of malaria vectors found and use of self-reported malaria incidence. Environmental factors together with a household's socioeconomic status and host availability played important roles in the risk of malaria infection in southwest Ethiopia. Cattle abundance in the form of higher cattle to human ratios may act as a protective factor against mosquito infestation and malaria risk. Humans should remain indoors to maximize potential protection against vectors and cattle kept outside of homes.
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Affiliation(s)
- Kallista Chan
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Jorge Cano
- Expanded Special Project for Elimination of NTDs, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Fekadu Massebo
- Department of Biology, Collage of Natural Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Louisa A Messenger
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
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Gindola Y, Getahun D, Sugerman D, Tongren E, Tokarz R, Wossen M, Demissie K, Zemelak E, Okugn A, Wendimu J, Hailu G, Tegistu M, Begna D. Adherence to national malaria clinical management and testing guidelines in selected private clinics of Gambela Town, Gambela Region, Ethiopia: a mixed method study. Malar J 2022; 21:164. [PMID: 35658968 PMCID: PMC9166442 DOI: 10.1186/s12936-022-04206-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 05/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background The World Health Organization World Malaria Report of 2019 indicated an estimated 228 million cases of malaria occurred worldwide in 2018. More than 75% of the total area of Ethiopia is malarious, making malaria a leading public health problem in Ethiopia. Adherence to clinical guidelines improves the quality of care received by patients, thus improving patient outcomes. This study investigates healthcare workers’ adherence to malaria testing and treatment guidelines in selected private clinics of Gambela Town, Ethiopia. Methods A mixed study design involving a retrospective review of 425 patient files and 20 healthcare worker interviews in private clinics was implemented. Data were collected using pre-tested data collection forms. The collected data were then cleaned and entered into statistical software for analysis, with a level of significance set at < 0.05. A qualitative analysis was also conducted using healthcare worker interviews to identify the existing barriers to guideline adherence. Results Among the 430 cases of suspected malaria, only 65% were tested for malaria. Of those tested, 75% tested positive and 25% tested negative. The most common co-morbidity in patients treated for malaria was anaemia (30%), followed by gastroenteritis (10%). Patients with co-morbidities were more likely to receive appropriate treatment (p = 0.03) compared to those without co-morbidities. All healthcare workers interviewed were aware of the existence of the malaria treatment guidelines. However, many were not aware of the contents of the guidelines and only 40% had been trained to understand the guidelines. Overall, 85% of the workers claimed to adhere to guidelines, with 15% claiming non-adherence. Conclusion The gap between knowledge of the malaria treatment guidelines and their application by healthcare workers remains wide. The level of knowledge of these guidelines was also low. Continuous training, follow-up, supportive supervision, and improved adherence to the malaria guidelines are therefore recommended.
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Affiliation(s)
- Yamlak Gindola
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | | | - David Sugerman
- Centers for Disease Control and Prevention, Atlanta, USA
| | - Eric Tongren
- Centers for Disease Control and Prevention, Atlanta, USA
| | - Ryan Tokarz
- Centers for Disease Control and Prevention, Atlanta, USA
| | - Mesfin Wossen
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Akuma Okugn
- Gambela Regional Health Bureau, Gambela, Gambela Regional, Ethiopia
| | - Jimmawork Wendimu
- Department of Public Health, St'Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Girmay Hailu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mesfin Tegistu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Dumesa Begna
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Warkaw YM, Mitku AA, Zeru MA, Ayele M. Spatial pattern and predictors of malaria in Ethiopia: Application of auto logistics regression. PLoS One 2022; 17:e0268186. [PMID: 35594290 PMCID: PMC9122179 DOI: 10.1371/journal.pone.0268186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/23/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Malaria is a severe health threat in the World, mainly in Africa. It is the major cause of health problems in which the risk of morbidity and mortality associated with malaria cases are characterized by spatial variations across the county. This study aimed to investigate the spatial patterns and predictors of malaria distribution in Ethiopia. Methods A weighted sample of 15,239 individuals with rapid diagnosis test obtained from the Central Statistical Agency and Ethiopia malaria indicator survey of 2015. Global Moran’s I and Moran scatter plots were used in determining the distribution of malaria cases, whereas the local Moran’s I statistic was used in identifying exposed areas. The auto logistics spatial binary regression model was used to investigate the predictors of malaria. Results The final auto logistics regression model was reported that male clients had a positive significant effect on malaria cases as compared to female clients [AOR = 2.401, 95% CI: (2.125–2.713) ]. The distribution of malaria across the regions was different. The highest incidence of malaria was found in Gambela [AOR = 52.55, 95%CI: (40.54–68.12)] followed by Beneshangul [AOR = 34.95, 95%CI: (27.159–44.963)]. Similarly, individuals in Amhara [AOR = 0.243, 95% CI:(0.195–0.303], Oromiya [AOR = 0.197, 955 CI: (0.158–0.244)], Dire Dawa [AOR = 0.064, 95%CI(0.049–0.082)], Addis Ababa[AOR = 0.057,95%CI:(0.044–0.075)], Somali[AOR = 0.077,95%CI:(0.059–0.097)], SNNPR[OR = 0.329, 95%CI: (0.261–0.413)] and Harari [AOR = 0.256, 95%CI:(0.201–0.325)] were less likely to had low incidence of malaria as compared with Tigray. Furthermore, for one meter increase in altitude, the odds of positive rapid diagnostic test (RDT) decreases by 1.6% [AOR = 0.984, 95% CI: (0.984–0.984)]. The use of a shared toilet facility was found as a protective factor for malaria in Ethiopia [AOR = 1.671, 95% CI: (1.504–1.854)]. The spatial autocorrelation variable changes the constant from AOR = 0.471 for logistic regression to AOR = 0.164 for auto logistics regression. Conclusions This study found that the incidence of malaria in Ethiopia had a spatial pattern which is associated with socio-economic, demographic, and geographic risk factors. Spatial clustering of malaria cases had occurred in all regions, and the risk of clustering was different across the regions. The risk of malaria was found to be higher for those who live in soil floor-type houses as compared to those who lived in cement or ceramics floor type. Similarly, households with thatched, metal and thin, and other roof-type houses have a higher risk of malaria than ceramics tiles roof houses. Moreover, using a protected anti-mosquito net was reducing the risk of malaria incidence.
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Affiliation(s)
- Yamral M. Warkaw
- Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Aweke A. Mitku
- Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
- Schools of Mathematics, Statistics and Computer Science, College of Agriculture Engineering and Science, University of KwaZulu-Natal, Durban, South Africa
| | - Melkamu A. Zeru
- Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
- * E-mail:
| | - Muluwerk Ayele
- Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
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Asmare G. Willingness to accept malaria vaccine among caregivers of under-5 children in Southwest Ethiopia: a community based cross-sectional study. Malar J 2022; 21:146. [PMID: 35549710 PMCID: PMC9097094 DOI: 10.1186/s12936-022-04164-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 04/18/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Malaria is widespread in Ethiopia and has been a major cause of illness and death in that country. Therefore, Ethiopia has been exerting enormous efforts towards eliminating malaria by 2030. In the context of comprehensive malaria control, the malaria vaccine is used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate- to-high malaria transmission. METHODS A community-based cross-sectional study was conducted among caregivers of children under the age of five throughout the months of September 2021. A structured interviewer-administered questionnaire was designed for data collection, and binary logistic regression analysis was used. The final result of the association was determined based on an adjusted odds ratio (AOR) at a 95% confidence interval (CI) level, and p < 0.05 indicated statistical significance. RESULTS A total of 406 caregivers of children under the age of 5 were interviewed. Overall, 131 (32.3%) respondents were willing to vaccinate their children. Marital status (AOR = 1.243; 95% CI 1.021-3.897), knowledge (AOR = 3.120; 95% CI 1.689-5.027), and previous experience with childhood vaccination (AOR = 2.673; 95% CI 1.759-4.101) were found to be significantly associated with willingness to accept a malaria vaccine for their children, at p < 0.05. CONCLUSIONS AND RECOMMENDATIONS The willingness to accept a malaria vaccine for children among caregivers of children under the age of five was low in the study area. Thus, health education and communication are crucial for alleviating poor knowledge about malaria vaccines.
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Affiliation(s)
- Getachew Asmare
- Department of Reproductive Health and Nutrition, School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
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Abdishu M, Gobena T, Damena M, Abdi H, Birhanu A. Determinants of Malaria Morbidity Among School-Aged Children Living in East Hararghe Zone, Oromia, Ethiopia: A Community-Based Case–Control Study. Pediatric Health Med Ther 2022; 13:183-193. [PMID: 35615100 PMCID: PMC9124698 DOI: 10.2147/phmt.s347621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Understanding the determinants of malaria morbidity offers helpful insights toward the changing malaria situation, which might lead to the adjustment of malaria program activities. Even though the determinants of malaria morbidity remain unknown, school-aged children were the highest malaria morbidity contributors in the East Hararghe Zone. Therefore, this study aimed to assess the determinants of malaria morbidity among school-aged children in the study area from February 1 to May 31, 2020. Methods A case-control study was conducted among school-aged children living in ten randomly selected low, moderate, and high malaria transmission kebeles. Cases were confirmed as positive for malaria, while controls were confirmed as negative for malaria among randomly selected school-aged children. Rapid diagnostic testing (RDT) and blood film (BF) malaria testing methods were used. Multivariable logistic regression was used to identify association between malaria and its determinants. Results The determinants of malaria infection were having no formal education (adjusted odds ratio (AOR)=4.91, 95% CI: 1.20–20.17), low family wealth index (AOR=2.50, 95% CI: 1.22–5.12), being from rural residence (AOR=2.34, 95% CI: 1.87–4.12), living near to stagnant water (AOR=2.01, 95% CI: 1.14–3.54), having a maximum of three family members (AOR=0.37, 95% CI: 0.18–0.78), using indoor residual spraying (IRS) (AOR=0.15, 95% CI: 0.08–0.29) and long-lasting insecticide-treated net (LLITN) over the last night (AOR=0.19, 95% CI: 0.10–0.35), and living in the house surrounded by cultivated land(AOR=0.24, 95%CI: 0.10-0.60) compared with their counterparts. Conclusion This study revealed that residence, family size, education, wealth index, stagnant water existence, and using LLITN and IRS had significant association with malaria morbidity. Thus, all concerned bodies, including the community should strengthen working on stagnant water elimination around their house to cut the breeding site of the malaria vector mosquito. Moreover, the findings have an important implication for improving interventions targeting the economic status and literacy of the society that may help in the reduction of the risk of malaria in the school-aged children.
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Affiliation(s)
- Mohammedawel Abdishu
- Public Health Emergency Management Officer at Gursum District Health Office, Gursum, Oromia Region, Ethiopia
| | - Tesfaye Gobena
- Haramaya University, College of Health and Medical Sciences, School of Public Health, Harar, Ethiopia
| | - Melake Damena
- Haramaya University, College of Health and Medical Sciences, School of Public Health, Harar, Ethiopia
| | - Hassen Abdi
- Haramaya University, College of Health and Medical Sciences, School of Public Health, Harar, Ethiopia
| | - Abdi Birhanu
- Haramaya University, College of Health and Medical Sciences, School of Medicine, Harar, Ethiopia
- Correspondence: Abdi Birhanu, Email
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Melese Y, Alemu M, Yimer M, Tegegne B, Tadele T. Asymptomatic Malaria in Households and Neighbors of Laboratory Confirmed Cases in Raya Kobo District, Northeast Ethiopia. Ethiop J Health Sci 2022; 32:623-630. [PMID: 35813680 PMCID: PMC9214748 DOI: 10.4314/ejhs.v32i3.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 02/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background Malaria is the leading vector-borne parasitic disease that is causing high morbidity and mortality worldwide. So far huge efforts to control and eliminate malaria are hindered by the occurrence of asymptomatic carriers that are a potential source of infection. Yet, there is a scarcity of data nationally and in the current study area as well. Therefore, this study was aimed to assess the prevalence of asymptomatic malaria in Northeast Ethiopia. Methods A community-based cross-sectional study was conducted in 2019 involving a total of 270 study participants recruited via purposive non-probability sampling technique. A structured questionnaire was used to collect data on sociodemographic characteristics, individual and household factors related to asymptomatic malaria. Data were entered in Epi Data 3.1 version and analyzed by using SPSS version 20, and p< 0.05 was considered statistically significant. Results The overall prevalence of asymptomatic malaria was 7.0%, with 3.0%, 5.2%, and 12.0%, respectively by Rapid diagnostic tests (RDT), Microscopy and Polymerase chain reaction (PCR). The majority of infections (73.7%) were identified from index households. Previous malaria history (AOR: 4.030, 95% CI: 1.021-15.903), living with index cases (AOR: 3.880, 95% CI: 1.275-11.806) and family size > 6 members (AOR: 4.820, 95% CI: 1.260-18.437) were significant predictors of asymptomatic malaria. Conclusion Reactive case detection had identified considerably higher asymptomatic malaria cases in the community. Therefore, active case investigation should be established in the community by tracking the symptomatic cases at the health facilities.
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Affiliation(s)
| | - Megbaru Alemu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia
| | - Mulat Yimer
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia
| | | | - Tigist Tadele
- Department of Biomedical Sciences, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia
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Mmbando BP, Mwaiswelo RO, Chacky F, Molteni F, Mohamed A, Lazaro S, Ngasala B. Nutritional status of children under five years old involved in a seasonal malaria chemoprevention study in the Nanyumbu and Masasi districts in Tanzania. PLoS One 2022; 17:e0267670. [PMID: 35486649 PMCID: PMC9053822 DOI: 10.1371/journal.pone.0267670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background Malnutrition and malaria are common co-morbidities in low-income countries, especially among under-fives children. But the malnutrition situation in Masasi and Nanyumbu districts, its interaction with malaria infection and the influence of socioeconomic factors are not well understood. Methods Children aged between 3–59 months in Masasi and Nanyumbu were screened for nutritional status and malaria infection in the community. Nutritional status was determined using age and anthropometric parameters. Z-scores (weight for age (WAZ), height for age (HAZ) and weight for height (WHZ)) were calculated based on the World Health Organisation (WHO) growth reference curves. Malaria infection was determined using malaria rapid diagnostic test and microscopy. Hemoglobin concentration was assessed using HemoCue spectrophotometer, and anemia was classified as hemoglobin concentration < 11.0g/dL. Structured questionnaire was used to collect socio- demographic information electronically. Results A total of 2242 children, 1539 (68.6%) from Masasi and 1169 (52.1%) females were involved in the study. The mean z-scores (WAZ = -0.60 and HAZ = -1.56) were lower than the WHO reference population. The overall prevalence of malnutrition was 49%, and it was significantly higher in Nanyumbu (52.5%) than in Masasi (47.3%), (x2 = 5.045, p = 0.025). Prevalence of malnutrition was higher in boys (53.0%) than in girls (45.0%) (x2 = 13.9, p < 0.001). Stunting was the most prevalent component of undernutrition; it was slightly prevalent in Nanyumbu (46.5%) compared to Masasi (42.0%), (x2 = 3.624, p = 0.057) and in boys (48.2%) than in girls (39.1%), x2 = 17.44, p<0.001. Only 15.8% of the undernourished children had malaria infection. Sex, age group and anaemia were significantly associated with undernourishment (p<0.05), while district and malaria infection were marginally (p≤0.06) associated with undernourishment. None of the undernutrition indices was associated with malaria infection. Conclusion Undernutrition was highly prevalent in the study population and was influenced sex, age, anaemia and malaria infection. More emphasis is needed to address the malnutrition problem especially stunting in Masasi and Nanyumbu districts.
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Affiliation(s)
- Bruno P Mmbando
- National Institute for Medical Research, Tanga Centre, Tanga, Tanzania
| | - Richard O Mwaiswelo
- Department of Microbiology, Immunology and Parasitology, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | - Frank Chacky
- National Malaria Control Programme, Ministry of Health, Dodoma, Tanzania
| | - Fabrizio Molteni
- National Malaria Control Programme, Ministry of Health, Dodoma, Tanzania
| | - Ally Mohamed
- National Malaria Control Programme, Ministry of Health, Dodoma, Tanzania
| | - Samwel Lazaro
- National Malaria Control Programme, Ministry of Health, Dodoma, Tanzania
| | - Billy Ngasala
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Hu RS, Hesham AEL, Zou Q. Machine Learning and Its Applications for Protozoal Pathogens and Protozoal Infectious Diseases. Front Cell Infect Microbiol 2022; 12:882995. [PMID: 35573796 PMCID: PMC9097758 DOI: 10.3389/fcimb.2022.882995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/28/2022] [Indexed: 12/24/2022] Open
Abstract
In recent years, massive attention has been attracted to the development and application of machine learning (ML) in the field of infectious diseases, not only serving as a catalyst for academic studies but also as a key means of detecting pathogenic microorganisms, implementing public health surveillance, exploring host-pathogen interactions, discovering drug and vaccine candidates, and so forth. These applications also include the management of infectious diseases caused by protozoal pathogens, such as Plasmodium, Trypanosoma, Toxoplasma, Cryptosporidium, and Giardia, a class of fatal or life-threatening causative agents capable of infecting humans and a wide range of animals. With the reduction of computational cost, availability of effective ML algorithms, popularization of ML tools, and accumulation of high-throughput data, it is possible to implement the integration of ML applications into increasing scientific research related to protozoal infection. Here, we will present a brief overview of important concepts in ML serving as background knowledge, with a focus on basic workflows, popular algorithms (e.g., support vector machine, random forest, and neural networks), feature extraction and selection, and model evaluation metrics. We will then review current ML applications and major advances concerning protozoal pathogens and protozoal infectious diseases through combination with correlative biology expertise and provide forward-looking insights for perspectives and opportunities in future advances in ML techniques in this field.
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Affiliation(s)
- Rui-Si Hu
- Institute of Fundamental and Frontier Sciences, University of Electronic Science and Technology of China, Chengdu, China
- Yangtze Delta Region Institute (Quzhou), University of Electronic Science and Technology of China, Quzhou, China
| | - Abd El-Latif Hesham
- Genetics Department, Faculty of Agriculture, Beni-Suef University, Beni-Suef, Egypt
| | - Quan Zou
- Institute of Fundamental and Frontier Sciences, University of Electronic Science and Technology of China, Chengdu, China
- Yangtze Delta Region Institute (Quzhou), University of Electronic Science and Technology of China, Quzhou, China
- *Correspondence: Quan Zou,
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Prevalence and Associated Factors of Malaria Infection among Outpatients Visiting Shewa Robit Health Center, Northcentral Ethiopia. J Trop Med 2022; 2022:1784012. [PMID: 35371267 PMCID: PMC8967545 DOI: 10.1155/2022/1784012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/13/2022] [Accepted: 03/09/2022] [Indexed: 01/10/2023] Open
Abstract
Introduction Malaria infection is a serious health problem killing millions in tropical developing countries including Ethiopia. The present study focused on assessing malaria prevalence and identification of determinants in Shewa Robit, northcentral Ethiopia. Methods A cross-sectional study was conducted among 422 participants who visited Shewa Robit Health Center between 01/10/2017 and 30/04/2018, using a simple random sampling. Sociodemographic characteristics were recorded using a pre-tested semi-structured questionnaire and infection was confirmed by microscopic examination. Data were analyzed using the Statistical Program for Social Sciences (SPSS) version 20 and p < 0.05 was used to indicate the level of significance. Results Eighty-one (19.0%) microscopically confirmed malaria cases were recorded, P.vivax was the most frequently detected species (n = 58; 71.6%). Interestingly, 73.2% (n = 309) of the participant did not utilize LLINs due to the fear of toxicity (37.4%, n = 158), misconception (21.6%, n = 91), and shortage (14.2%, n = 60). The data showed age, gender, marital status, family size, usage of LLINs and application of IRS, proximity to mosquito breeding sites and less robust and porous walls were the determinants of the infection in the study area. Conclusion The prevalence of malaria in the study population was high and P. vivax being the most common causative agent. Environmental and behavioral factors related to LLIN are the potential determinants of malaria. Continued public health interventions, targeting proper utilization of bed nets, drainage of stagnant water, and improved public awareness about reducing the risk of insect bites have the potential to minimize the infection.
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Adugna T, Getu E, Yewhelew D. Parous rate and longevity of anophelines mosquitoes in bure district, northwestern Ethiopia. PLoS One 2022; 17:e0263295. [PMID: 35120146 PMCID: PMC8815865 DOI: 10.1371/journal.pone.0263295] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/14/2021] [Indexed: 11/18/2022] Open
Abstract
The intensity of malaria transmission is measured by parous rate, daily survival rate, human blood meal frequency, sporozoite rate, and entomological inoculation rates. Female parous status is a key index of vector competence, adult vector longevity, recruitment rate of adult, and the length of a gonotrophic cycle. Hence, the present study was aimed to investigate the parous rate and the longevity of Anopheles mosquitoes in Bure District, Northwestern Ethiopia. Parous rate was estimated as the number of mosquitoes with parous ovaries divided by the number of females dissected multiplied by 100. Mosquito life expectancy (longevity as d) was estimated by. One way- ANOVA was applied to confirm the presence of parous rate difference in the villages (p < 0.05). A total of 952 unfed hosts-seeking Anopheles mosquitoes was dissected for parous rate determination. The overall parous rate of An. arabiensis in the district was 52.0%, and the highest parous rate was recorded in Shnebekuma than other villages (F 2, 33 = 6.974; p = 0.003). Similarly, the parous rate of An. cinereus showed significant variation among villages (F 2, 33 = 5.044, p = 0.012) and the highest rate (63.0%) was recorded in Bukta. The mean longevity of An. funestus, An. arabiensis, An. coustani, An. squamosus, An. pharoensis, and An. cinereus was 6.5 days, 4.6 days, 3.5 days, 3.7 days, 2.7 days, and 2.2 days, respectively. The longevity of each species was not sufficient to complete the life cycle of malaria parasite for malaria transmission throughout the year because P. falciparum requires from 12–14 day.
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Affiliation(s)
- Tilahun Adugna
- Department of Biology, Faculty of Natural and Computational Sciences, Debre Tabor, Amhara, Ethiopia
- * E-mail: ,
| | - Emana Getu
- Department of Zoological Science, Addis Ababa University, Addis Ababa, Addis Ababa, Ethiopia
| | - Delenasaw Yewhelew
- Department of Medical Laboratory Sciences and Pathology, College of Health Sciences, Jimma, Oromia, Ethiopia
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Shah HA, Carrasco LR, Hamlet A, Murray KA. Exploring agricultural land-use and childhood malaria associations in sub-Saharan Africa. Sci Rep 2022; 12:4124. [PMID: 35260722 PMCID: PMC8904834 DOI: 10.1038/s41598-022-07837-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 02/24/2022] [Indexed: 11/09/2022] Open
Abstract
Agriculture in Africa is rapidly expanding but with this comes potential disbenefits for the environment and human health. Here, we retrospectively assess whether childhood malaria in sub-Saharan Africa varies across differing agricultural land uses after controlling for socio-economic and environmental confounders. Using a multi-model inference hierarchical modelling framework, we found that rainfed cropland was associated with increased malaria in rural (OR 1.10, CI 1.03-1.18) but not urban areas, while irrigated or post flooding cropland was associated with malaria in urban (OR 1.09, CI 1.00-1.18) but not rural areas. In contrast, although malaria was associated with complete forest cover (OR 1.35, CI 1.24-1.47), the presence of natural vegetation in agricultural lands potentially reduces the odds of malaria depending on rural-urban context. In contrast, no associations with malaria were observed for natural vegetation interspersed with cropland (veg-dominant mosaic). Agricultural expansion through rainfed or irrigated cropland may increase childhood malaria in rural or urban contexts in sub-Saharan Africa but retaining some natural vegetation within croplands could help mitigate this risk and provide environmental co-benefits.
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Affiliation(s)
- Hiral Anil Shah
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK. .,Grantham Institute - Climate Change and the Environment - Imperial College London, London, UK.
| | - Luis Roman Carrasco
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
| | - Arran Hamlet
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Kris A Murray
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.,MRC Unit The Gambia at London, School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, The Gambia.,Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
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Detection of temporal, spatial and spatiotemporal clustering of malaria incidence in northwest Ethiopia, 2012–2020. Sci Rep 2022; 12:3635. [PMID: 35256698 PMCID: PMC8901673 DOI: 10.1038/s41598-022-07713-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/21/2022] [Indexed: 11/25/2022] Open
Abstract
Malaria is one of Ethiopia's most targeted communicable diseases for elimination. Malaria transmission varies significantly across space and time; and Ethiopia had space–time disparity in its transmission intensities. Considering heterogeneity and transmission intensity at the district level could play a crucial role in malaria prevention and elimination. This study aimed to explore temporal, spatial, and spatiotemporal clusters of malaria incidence in northwest Ethiopia. The analysis is based on monthly malaria surveillance data of districts and collected from the Amhara public health institute. The Kulldorff's retrospective space–time scan statistics using a discrete Poisson model were used to detect temporal, spatial, and space–time clusters of malaria incidence with and without adjusting the altitude + LLIN arm. Monthly malaria incidence had seasonal variations, and higher seasonal indices occurred in October and November. The temporal cluster occurred in the higher transmission season between September and December annually. The higher malaria incidence risk occurred between July 2012 and December 2013 (LLR = 414,013.41, RR = 2.54, P < 0.05). The purely spatial clustering result revealed that the most likely cluster occurred in the north and northwest parts of the region while secondary clusters varied in years. The space–time clusters were detected with and without considering altitude + LLIN arm. The most likely space–time cluster was concentrated in northwestern and western parts of the region with a high-risk period between July 2012 and December 2013 (LLR = 880,088.3, RR = 5.5, P < 0.001). We found eight significant space–time clusters using the altitude + LLIN arm. The most likely space–time cluster occurred in the western and northwestern parts of the region in July 2012–December 2013 (LLR = 886,097.7, RR = 5.55, P < 0.05). However, secondary clusters were located in eastern, northwestern, western parts of regions, which had different cases and relative risks in each cluster. Malaria transmission had temporal, spatial, and space–time variation in the region at the district level. Hence, considering these variations and factors contributing to malaria stratification would play an indispensable role in preventing and controlling practices that ultimately leads to malaria eliminations.
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Ejigu S, Haile D, Solomon Y. Effect of malaria and HIV/AIDS co-infection on red blood cell indices and its relation with the CD4 level of patients on HAART in Bench Sheko Zone, Southwest Ethiopia. PLoS One 2022; 17:e0263865. [PMID: 35245289 PMCID: PMC8896715 DOI: 10.1371/journal.pone.0263865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 01/28/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Malaria and HIV/AIDS are the two most common infections in sub Saharan Africa (SSA) and worldwide. HIV infected individuals in malaria endemic areas experience severe malaria episodes. The immunological basis of this clinical observation is unclear and the hematologic abnormalities such as anemia in malaria and HIV co infected patients were inconsistent from studies in the past. Ethiopia's three-fourth of the landmass is malarious and HIV prevalence is high that significantly affect RBC indices and other hematologic profiles. OBJECTIVE This study aimed to compare RBC indices and anemia in HIV patients' co-infected with malaria and those HIV patients without malaria and correlates these with CD4 level. METHODS A comparative cross-sectional study was employed on 103 malaria-HIV/AIDS co infected (MHC) and 103 HIV patients without malaria on HAART of the same ART centers in Bench Sheko Zone. Data was collected by structured questionnaire and blood samples were collected from both groups for malaria test and RBC indices measurement. Data was entered and checked in Epi-data and exported to IBM SPSS version 21 software packages for analysis. RESULTS There were significant differences in Mean±SD of RBC indices between the two groups (P<0.001). RBC, Hgb, HCT and MCV were lower in MHC patients. In total study participants, significant positive correlation was observed between CD4 count with MCV, CD4 count with MCH and CD4 count with anemia. In the group of malaria-HIV co-infected, CD4 count with RBC and CD4 count with Hgb and in HIV without malaria CD4 count with MCV, CD4 count with MCH and CD4 count with MCHC were positively correlated. Overall anemia prevalence was 45.1%. Anemia prevalence in MHC (Malaria-HIV co-infected) was 63.4%. Anemia prevalence distribution among sex showed that 61.3% in female sex and anemia prevalence distribution among CD4 group showed 55.9% in patients with CD4 count of ≤500 cells/μl. Anemia in MHC patients was higher in those with CD4 count of ≤500 cells/μl (59.3%) while in OH (Only HIV infected) anemia prevalence was similar in those with CD4 count of ≤500 and ≥500 cells/μl (50%). There is significant difference in anemia in MHC and OH infected with different CD4 group (P<0.01). CONCLUSION There was a difference in RBC indices in both groups; RBC, Hgb, HCT and MCV were lower in MHC patients. There was positive correlation between CD4 counts with some RBC indices in combined both groups. However, there was positive correlation between CD4 counts with RBC and Hgb in malaria-HIV co-infected. The combined prevalence of anemia was higher and anemia in MHC was greater than OH infected patients.
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Affiliation(s)
- Solomon Ejigu
- Department of Biomedical Sciences, Collage of Medicine and Health science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Diresbachew Haile
- Department of Physiology, School of Medicine, Collage of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yerukneh Solomon
- Department of Biomedical Sciences, Collage of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
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Geographical distribution of falciparum malaria in the world and its relationship with the human development index (HDI): countries based on the WHO report in 2017. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01336-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Amare A, Eshetu T, Lemma W. Dry-season transmission and determinants of Plasmodium infections in Jawi district, northwest Ethiopia. Malar J 2022; 21:45. [PMID: 35164768 PMCID: PMC8842575 DOI: 10.1186/s12936-022-04068-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/30/2022] [Indexed: 11/12/2022] Open
Abstract
Background Malaria remains a serious global public health problem, and continues to have a devastating impact on people’s health worldwide. Continuous monitoring and evaluation of current malaria transmission status in different seasons is a mainstay for the success of ongoing intervention strategies for malaria. The purpose of this study was to assess the dry-season transmission and determinants of malaria in Jawi district, northwest Ethiopia. Methods A community-based cross-sectional study was conducted from January 13 to February 11, 2020; among selected Kebeles in the Jawi district. A multistage sampling technique was used in this study. Random and systematic sampling techniques were carried out to select Kebeles and each household, respectively. Light microscopy and CareStart™ Malaria HRP2/pLDH (Pf/Pv) Combo RDT were implemented to determine the prevalence of malaria. Moreover, associated risk factors in the prevalence of malaria were assessed by using a bivariate and multivariate logistic regression model. Results A total of 219 study participants were enrolled in this study. Of the total enrolled individuals, malaria cases were found among 36 individuals with a positivity rate of 16.4% (95% CI 11.4–21.5). Plasmodium falciparum was the predominant species with an estimated prevalence of 87.0% in the study areas. Interrupted utilization of ITN (AOR = 4.411, 95% CI 1.401–13.880), using over 3 years older ITNs (AOR = 9.622, 95% CI 1.881–49.214), travel history (AOR = 12.703, 95% CI 2.441–66.114), living in a house with holes on the wall (AOR = 3.811, 95% CI 1.010–14.384), and living in a house with an eave (AOR = 4.23, 95% CI 1.065–16.801) significantly increased the probability of malaria positivity rate. Conclusion Malaria is still an important public health burden among individuals in the Jawi district. Interrupted utilization of ITNs, using over 3 years older ITNs, living in a house with holes on the wall, living in a house with an eave, and travel history were identified as the risk factors of malaria. Therefore, the District health office and Health extension workers should promote daily utilization of good ITNs and improve housing conditions to reduce malaria prevalence.
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Mulugeta A, Assefa A, Eshetie A, Asmare B, Birhanie M, Gelaw Y. Six-year trend analysis of malaria prevalence at University of Gondar Specialized Referral Hospital, Northwest Ethiopia, from 2014 to 2019. Sci Rep 2022; 12:1411. [PMID: 35082339 PMCID: PMC8792057 DOI: 10.1038/s41598-022-05530-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 01/13/2022] [Indexed: 11/21/2022] Open
Abstract
Globally, malaria is the major public health disease caused by plasmodium species and transmitted by the bite of the female anopheles mosquito. Assessment of the trend of malaria prevalence is important in the control and prevention of the disease. Therefore, the objective of this study was to assess the six year trend of malaria prevalence at the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia, from 2014 to 2019. A retrospective laboratory registration logbook review study was conducted on the malaria blood film examination results at the University of Gondar Comprehensive Specialized Hospital. The data was collected by using a data extraction tool and entered into SPSS version 20 for analysis. Descriptive statistics were used to summarize the socio-demographic characteristics of study participants and presented by graphs, tables and texts. The binary logistic regression was also used to test the association the trend of malaria prevalence and different factors like sex, age, year, and season. From a total of 17,500 malaria blood film examinations, 1341 (7.7%) were confirmed for malaria parasites. Of the confirmed malaria cases, 47.2%, 45.6% and 7.2% were P. vivax, P. falciparum and mixed infection, respectively. The proportion of P. vivax was the predominant species in the first three study years (2014-2016) and P. falciparum became the predominant species in the last three study years (2017-2019). The odds of malaria prevalence was lower by 68%, 60% and 69% in the year 2017, 2018 and 2019 compared to 2014, respectively. It was also 1.41 times higher in males than in females. Moreover, the odds of malaria prevalence were 1.60, 1.64, 2.45 and 1.82 times higher in the age group of < 5, 5-14, 15-24 and 25-54 years old compared to the older age groups (> 54 years old), respectively. Even there was a significant declining in prevalence trend; malaria is still a major public health problem. The study showed that there was high seasonal fluctuation from year to year. Moreover, males and the younger age groups were more affected than females and old age groups, respectively. Therefore, malaria prevention and control activities should be strengthened and require extra efforts by considering these variability.
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Affiliation(s)
- Amanuel Mulugeta
- School Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, The University of Gondar, Gondar, Ethiopia
| | - Atsede Assefa
- School Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, The University of Gondar, Gondar, Ethiopia
| | - Atsede Eshetie
- School Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, The University of Gondar, Gondar, Ethiopia
| | - Birhanie Asmare
- School Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, The University of Gondar, Gondar, Ethiopia
| | - Meseret Birhanie
- School Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, The University of Gondar, Gondar, Ethiopia
| | - Yemataw Gelaw
- School Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, The University of Gondar, Gondar, Ethiopia.
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Yalew AW. Achievements, Gaps, and Emerging Challenges in Controlling Malaria in Ethiopia. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2021.771030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Controlling malaria is one of the top health sector priorities in Ethiopia. The concrete prevention, control, and treatment interventions undertaken in the past two decades have substantially reduced the morbidity and mortality attributable to malaria. Emboldened by these past achievements, Ethiopia envisages to eliminate malaria by 2030. Realizing this ambition, however, needs to further strengthen the financial, technical, and institutional capacities to address the current as well as emerging challenges. It particularly needs to step up measures pertaining to diagnosis, domestic resource mobilization, vector surveillance, and seasonal weather forecasting.
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Workineh L, Lakew M, Dires S, Kiros T, Damtie S, Hailemichael W, Muleta D, Eyayu T. Prevalence of Malaria and Associated Factors Among Children Attending Health Institutions at South Gondar Zone, Northwest Ethiopia: A Cross-Sectional Study. Glob Pediatr Health 2022; 8:2333794X211059107. [PMID: 34993279 PMCID: PMC8724997 DOI: 10.1177/2333794x211059107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/13/2021] [Accepted: 10/21/2021] [Indexed: 12/02/2022] Open
Abstract
Malaria is a fatal disease among children in malaria-prone locations such as Addis Zemen and Woreta because of their weak immune systems. Despite the severity of the disease in children, the majority of research conducted in Ethiopia has focused on adult populations rather than children. Furthermore, there is no data on malaria prevalence, risk factors, or parasite density among children in the Addis Zemen and Woreta catchment areas. Therefore, this study was aimed at filling the above gap in the study area. About 422 children were enrolled in the study by systematic sampling technique. A capillary blood sample was collected from each child to do blood film. The overall prevalence of malaria among children attending South Gonder health institutions was 14.7%. The majority of parasite density was moderate parasitemia followed by low parasitemia, giving 71.0% and 16.0%, respectively. Malaria parasite infection was linked to a history of malaria and the presence of stagnant water near a home, but utilization of insecticide-treated bed nets was found to be protective against the infection. Therefore, health education should be strengthened on proper utilization of bed nets, indoor residual spraying, removing stagnant water by discarding old tires that may collect rainwater, and removing debris from streams so streams flow more freely.
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Affiliation(s)
| | | | - Shega Dires
- Debre Tabor University, Debre Tabor, Amhara, Ethiopia
| | | | | | | | | | - Tahir Eyayu
- Debre Tabor University, Debre Tabor, Amhara, Ethiopia
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Mwaiswelo RO, Mmbando BP, Chacky F, Molteni F, Mohamed A, Lazaro S, Mkalla SF, Samuel B, Ngasala B. Malaria infection and anemia status in under-five children from Southern Tanzania where seasonal malaria chemoprevention is being implemented. PLoS One 2021; 16:e0260785. [PMID: 34855878 PMCID: PMC8638878 DOI: 10.1371/journal.pone.0260785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/16/2021] [Indexed: 11/26/2022] Open
Abstract
Background Malaria and anemia remain major public health challenges in Tanzania. Household socioeconomic factors are known to influence these conditions. However, it is not clear how these factors influence malaria transmission and anemia in Masasi and Nanyumbu Districts. This study presents findings on malaria and anemia situation in under-five children and its influencing socioeconomic factors in Masasi and Nanyumbu Districts, surveyed as part of an ongoing seasonal malaria chemoprevention operational study. Methods A community-based cross-sectional survey was conducted between August and September 2020. Finger-prick blood samples collected from children aged 3–59 months were used to test for malaria infection using malaria rapid diagnostic test (mRDT), thick smears for determination of asexual and sexual parasitemia, and thin smear for parasite speciation. Hemoglobin concentration was measured using a HemoCue spectrophotometer. A structured questionnaire was used to collect household socioeconomic information from parents/caregivers of screened children. The prevalence of malaria was the primary outcome. Chi-square tests, t-tests, and logistic regression models were used appropriately. Results Overall mRDT-based malaria prevalence was 15.9% (373/2340), and was significantly higher in Nanyumbu (23.7% (167/705) than Masasi District (12.6% (206/1635), p<0.001. Location (Nanyumbu), no formal education, household number of people, household number of under-fives, not having a bed net, thatched roof, open/partially open eave, sand/soil floor, and low socioeconomic status were major risks for malaria infection. Some 53.9% (1196/2218) children had anemia, and the majority were in Nanyumbu (63.5% (458/705), p<0.001. Location (Nanyumbu), mRDT positive, not owning a bed net, not sleeping under bed net, open/partially open eave, thatched window, sex of the child, and age of the child were major risk factors for anemia. Conclusion Prevalence of malaria and anemia was high and was strongly associated with household socioeconomic factors. Improving household socioeconomic status is expected to reduce the prevalence of the conditions in the area.
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Affiliation(s)
- Richard O. Mwaiswelo
- Department of Microbiology, Immunology and Parasitology, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
- * E-mail:
| | - Bruno P. Mmbando
- Tanga Research Centre, National Institute for Medical Research, Tanga, Tanzania
| | - Frank Chacky
- National Malaria Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Fabrizio Molteni
- National Malaria Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Ally Mohamed
- National Malaria Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Samwel Lazaro
- National Malaria Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Sylvia F. Mkalla
- Directorate of Research, Coordination, and Promotion, Tanzania Commission for Science and Technology, Dar es Salaam, Tanzania
| | - Bushukatale Samuel
- Department of Medical Parasitology and Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Billy Ngasala
- Department of Medical Parasitology and Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Toma SA, Eneyew BW, Taye GA. Spatial Modelling of Risk Factors for Malaria Prevalence in SNNP Regional State, Ethiopia. Ethiop J Health Sci 2021; 31:731-742. [PMID: 34703172 PMCID: PMC8512951 DOI: 10.4314/ejhs.v31i4.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 11/24/2022] Open
Abstract
Background Malaria is one of the most severe public health problems worldwide with 300 to 500 million cases and about one million deaths reported to date of which 90% were from world health organization (WHO) Sub Saharan Africa (SSA) countries. The purpose of this study was to explore the spatial distribution of malaria parasite prevalence (MPP) among districts of Southern Nations Nationalities and Peoples Regional State (SNNRS) in Ethiopia by using 2011 malaria indicator survey (MIS) data collected for 76 districts and to model its relationship with different covariates. Method Exploratory spatial data analysis (ESDA) was conducted followed by implementation of spatial lag model (SLM) and spatial error model (SEM) in GeoDa software. Queen contiguity second order type of spatial weight matrix was applied in order to formalize spatial interaction among districts. Results From ESDA, we found positive spatial autocorrelation in malaria prevalence rate. Hot spot areas for MPP were found in the eastern and southeast parts of the region. Relying on specification diagnostics and measures of fit, SLM was found to be the best model for explaining the geographical variation of MPP. SLM analysis demonstrated that proportion of households living in earth/local dung plastered floor house, proportion of households living under thatched roof house, average number of rooms/person in a given district, proportion of households who used anti-malaria spray in the last 12 months before the survey, percentage household using mosquito nets and average number of mosquito nets/person in a given district have positive and statistically significant effect on spatial distribution of MPP across districts of SNNPRS. Percentage of households living without access to radio and television has negative and statistically significant effect on spatial distribution of MPP across districts of MPP. Conclusion Malaria is spatially clustered in space. The implication of the spatial clustering is that, in cases where the decisions on how to allocate funds for interventions needs to have spatial dimension.
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Affiliation(s)
- Shammena Aklilu Toma
- Department of Statistics, College of Natural and Computational Sciences, Hawassa University, Hawassa, Ethiopia
| | - Baleh Wubejig Eneyew
- Department of Statistics, College of Natural and Computational Sciences, Hawassa University, Hawassa, Ethiopia
| | - Goshu Ayele Taye
- Department of Statistics, College of Natural and Computational Sciences, Kotebe Metropolitan University, Addis Ababa, Ethiopia
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Zerdo Z, Bastiaens H, Anthierens S, Massebo F, Masne M, Biresaw G, Shewangizaw M, Tunje A, Chisha Y, Yohannes T, Van Geertruyden JP. Prevalence and associated risk factors of asymptomatic malaria and anaemia among school-aged children in Dara Mallo and Uba Debretsehay districts: results from baseline cluster randomized trial. Malar J 2021; 20:400. [PMID: 34645464 PMCID: PMC8513194 DOI: 10.1186/s12936-021-03937-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/30/2021] [Indexed: 12/31/2022] Open
Abstract
Background Despite the growing evidence that malaria and anaemia are two interlinked health problems of school-aged children (SAC) in developing countries, there is scarce information about malaria among SAC in Ethiopia. Moreover, anaemia-related studies were more concentrated in easily accessible areas. This study aimed to assess the prevalence of malaria and anaemia and corresponding risk factors among SAC in Dara Mallo and Uba Debretshay districts, in hard to reach areas, so as to inform appropriate integrated interventions for both diseases. Methods This study was part of baseline data collected for a cluster-randomized trial registered in Pan African Clinical Trials Registry (PACTR202001837195738). Data were collected from 2167 SAC and their households through face-to-face interview; malaria was diagnosed by using rapid diagnostic test (RDT); haemoglobin concentration was determined using hemoCue hb 301 and adjusted for altitude to determine anaemic status; helminth infections were determined by using kato-katz, and anthropometric measurements were made to determine nutritional status of children. Generalized mixed effects logistic regression model was used to assess the association between predictor variables and malaria and anaemia using school as a random variable. Results The overall prevalence of malaria was 1.62% (95% CI 1.15–2.27%) (35/2167). Of the 35 children positive for malaria, 20 (57.14%), 3 (8.57%) and 12 (34.29%) were due to Plasmodium falciparum, Plasmodium vivax and mixed infections of P. falciparum and P. vivax, respectively. Malaria was significantly lower among children from literate household head (Adjusted OR = 0.38; 95% CI 0.15–0.95) and residence house located at an altitude range above 1100 masl (AOR = 0.40; 95% CI 0.17–0.94). The prevalence of anaemia was 22.00% (95% CI 20.3–23.8%) (477/2167) and was significantly reduced by eating legumes, nuts or seed group of food in their 24-h dietary diversity recall (AOR = 0.64; 95% CI 0.41–0.99). Conclusions The prevalence of malaria was low and unevenly distributed per school while the overall prevalence of anaemia was moderate. It is important to implement integrated interventions targeting both malaria and anaemia, with special emphasis given to children from illiterate households and living at an altitude below 1100 masl. The micronutrient content of locally grown legumes should be further investigated to recommend specific interventions to overcome anaemia.
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Affiliation(s)
- Zerihun Zerdo
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia. .,Global Health Institute, Antwerp University, Antwerp, Belgium.
| | - Hilde Bastiaens
- Department of Family Medicine and Population Health, Antwerp University, Antwerp, Belgium
| | - Sibyl Anthierens
- Department of Family Medicine and Population Health, Antwerp University, Antwerp, Belgium
| | - Fekadu Massebo
- Department of Biology, College of Natural Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Matewos Masne
- Department of Biology, College of Natural Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gelila Biresaw
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Misgun Shewangizaw
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Abayneh Tunje
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Yilma Chisha
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tsegaye Yohannes
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Workineh L, Mekuria S, Kiros T, Hailemichael W, Eyayu T. A Retrospective Study of Malaria Trend in Libokemkem District Over the Last Five Years: North West Ethiopia. Infect Drug Resist 2021; 14:3683-3691. [PMID: 34526788 PMCID: PMC8437413 DOI: 10.2147/idr.s329708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/02/2021] [Indexed: 11/23/2022] Open
Abstract
Background Malaria is a vector-borne disease caused by public health important Plasmodium species. Despite the fact that Ethiopia has implemented several malaria prevention and control techniques aimed at reducing its morbidity and death, it continues as major cause of morbidity and mortality in Ethiopia. Transmission dynamics are really critical for guiding the selection of the appropriate intervention in a given area. As a result, the goal of this study was to analyze the trend of malaria prevalence over the last five years in the Addis Zemen health center. Methods An institutional-based retrospective analysis on malaria data from 2015/16 to 2019/20 was undertaken in Addis Zemen health center of Libokemkem district. The data collectors thoroughly and systematically collected the results of 15,452 blood films performed over a five-year period from the malaria registration book in the health center. Any data missing species and stage of the parasite, as well as sociodemographic characteristics, date, month, and year of blood film performed, were omitted from the study. Finally, data were entered and analyzed using SPSS version 25, with P-values of less than or equal to 0.05 deemed statistically significant variables. Results The overall malaria slide positivity rate over the last five years in the study area was 10.9%. From 2015/16 to 2018/19, the positive rate fell, then it spiked in 2019/20. Plasmodium falciparum was the most common parasite found, accounting for 72.6% of the total. The months of October, November, May, June, August, and September showed the largest number of malaria cases. Males, rural residents, and adult population groups were more affected by malaria, according to multivariate logistic regression (P ≤0.05). Conclusion There was high malaria morbidity case in 2019/20 as compared to the remaining years. Therefore, malaria control, prevention, and intervention programs in the district should be strengthened.
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Affiliation(s)
- Lemma Workineh
- Department of Medical Laboratory, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Setegn Mekuria
- Department of Medical Laboratory, Addis Zemen Health Center, Addis Zemen Town, Ethiopia
| | - Teklehaimanot Kiros
- Department of Medical Laboratory, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Wasihun Hailemichael
- Department of Medical Laboratory, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Tahir Eyayu
- Department of Medical Laboratory, Debre Tabor University, Debre Tabor Town, Ethiopia
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Ayeni GO, Olagbegi OM, Nadasan T, Abanobi OC, Daniel EO. Factors Influencing Compliance with The Utilization of Effective Malaria Treatment and Preventive Measures in Wulu, South Sudan. Ethiop J Health Sci 2021; 30:501-512. [PMID: 33897210 PMCID: PMC8054463 DOI: 10.4314/ejhs.v30i4.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background High incidence of malaria disease in South Sudan may be largely due to poor/non-compliance with effective treatment and preventive measures. This study examined factors limiting/enhancing compliance with the utilization of known and effective malaria treatment and preventive measures in Wulu, South Sudan. Methods A case-control study involving 396 respondents was conducted. Participants were interviewed using a semi-structured questionnaire to elicit information regarding socio-demographics and factors influencing compliance with using available treatment and preventive measures for malaria. Result Respondents diagnosed with malaria reported lack of insecticide treated nets (51.5%) and forgetfulness (16.6%) as reasons for not using insecticide treated nets. About 26% of them lacked the knowledge of insecticide treated net's usefulness, while 57.5% of them did not consider it necessary to have door/window barriers. About 44% of all respondents forgot to take prescribed drugs at the right time while 14.5% of them did not complete drug prescriptions because they felt relief of symptoms. There were significant associations between identified factors of compliance to treatment/preventive measures and occurrence of malaria (all at p = 0.001). Having insecticide treated nets (OR: 5.78; CI: 3.46–9.00), awareness of its benefits (OR: 8.76; CI: 3.02–25.37), being taught on its use (OR: 3.35; CI: 2.17–5.18) and understanding of its use (OR: 3.80; CI: 2.01–7.20) were significantly associated with year-round utilization of insecticide treated nets. Conclusion Poor access to and knowledge of malaria treatment, control and preventive measures are leading barriers to their effective utilization in Wulu.
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Affiliation(s)
| | - Oladapo M Olagbegi
- Department of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Thayananthee Nadasan
- Department of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Okwuoma C Abanobi
- Department of Public Health Technology, Federal University of Technology, Owerri, Imo State, Nigeria
| | - Ebenezer O Daniel
- Department of Public Health School of Public Health, Texila American University Georgetown, Guyana, South America
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