Baseline malaria prevalence at the targeted pre-elimination districts in Ethiopia

Desalegn Nega,Honelegn Nahusenay,Adugna Woyessa,Degu Mehari,Samuel Hailu,Assefaw Getachew,Asnakew K Yeshiwondim ,Mebrahatom Haile,Geremew Tasew,Semira Abdelmenan,Gudissa Assefa,Sindew Mekasha,Adugna Abera,Belendia Serda,Bokretsion Gidey,Daniel Nigatu,Ayele Zewdie,Ashenafi Assefa,Gezahagn Tesfaye,Zelalem Destaw,Hailemariam Lemma Reda ,Worku Bekele,Berhane Tesfaye,Dereje Dillu,Hiwot Solomon,Getachew Tollera,Abnet Abebe,Kebede Etana,Hiwot Teka,Ebba Abate

doi:10.1186/s12889-021-12036-5

Abstract

BackgroundEncouraged by the previous success in malaria control and prevention strategies, the Ethiopian ministry of health launched malaria elimination with a stepwise approach by primarily targeting the low-transmission Districts and their adjacent areas/zones in order to shrink the country’s malaria map progressively. Hence, this community survey was conducted to establish baseline malaria information at the preliminary phase of elimination at targeted settings.MethodsA community-based cross-sectional survey was conducted at 20 malaria-elimination targeted Districts selected from five Regional states and one city administration in Ethiopia. The GPS-enabled smartphones programmed with Open Data Kit were used to enumerate 9326 study households and collect data from 29,993 residents. CareStart™ Malaria PAN (pLDH) Rapid Diagnostic Tests (RDTs) were used for blood testing at the field level. Armpit digital thermometers were used to measure axillary temperature.ResultOverall malaria prevalence by RDTs was 1.17% (339/28973). The prevalence at District levels ranged from 0.0 to 4.7%. The proportion of symptomatic cases (axillary temperature > 37.5oc) in the survey was 9.2% (2760/29993). Among the 2510 symptomatic individuals tested with RDTs, only 3.35% (84/2510) were malaria positive. The 75.2% (255/339) of all malaria positives were asymptomatic. Of the total asymptomatic malaria cases, 10.2% (26/255) were under-five children and 89.8% (229/255) were above 5 years of age.ConclusionThe study shows a decrease in malaria prevalence compared to the reports of previous malaria indicator surveys in the country. The finding can be used as a baseline for measuring the achievement of ongoing malaria elimination efforts. Particularly, the high prevalence of asymptomatic individuals (0.88%) in these transmission settings indicates there may be sustaining hidden transmission. Therefore, active case detection with more sensitive diagnostic techniques is suggested to know more real magnitude of residual malaria in the elimination-targeted areas.

Highlights

During the last decade, substantial worldwide progress has been made in controlling malaria worldwide
The study shows a decrease in malaria prevalence compared to the reports of previous malaria indicator surveys in the country
The finding can be used as a baseline for measuring the achievement of ongoing malaria elimination efforts

Summary

Introduction

Background During the last decade, substantial worldwide progress has been made in controlling malaria worldwide. The country aims to eliminate malaria with a stepwise approach by targeting first the lowtransmission Districts (Districts below five cases per 1000 people per year) and their adjacent areas/zones to shrink the country’s malaria map progressively [11]. Encouraged by the previous success in malaria control and prevention strategies, the Ethiopian ministry of health launched malaria elimination with a stepwise approach by primarily targeting the lowtransmission Districts and their adjacent areas/zones in order to shrink the country’s malaria map progressively. This community survey was conducted to establish baseline malaria information at the preliminary phase of elimination at targeted settings

Methods

Results

Discussion

Conclusion