Abstract

BackgroundInformed decision making is underlined by all tiers in the health system. Poor data record system coupled with under- (over)-reporting of malaria cases affects the country’s malaria elimination activities. Thus, malaria data at health facilities and health offices are important particularly to monitor and evaluate the elimination progresses. This study was intended to assess overall reported malaria cases, reporting quality, spatiotemporal trends and factors associated in Gedeo zone, South Ethiopia.MethodsPast 8 years retrospective data stored in 17 health centers and 5 district health offices in Gedeo Zone, South Ethiopia were extracted. Malaria cases data at each health center with sociodemographic information, between January 2012 and December 2019, were included. Meteorological data were obtained from the national meteorology agency of Ethiopia. The data were analyzed using Stata 13.ResultsA total of 485,414 suspected cases were examined for malaria during the previous 8 years at health centers. Of these suspects, 57,228 (11.79%) were confirmed malaria cases with an overall decline during the 8-year period. We noted that 3758 suspected cases and 467 confirmed malaria cases were not captured at the health offices. Based on the health centers records, the proportions of Plasmodium falciparum (49.74%) and P. vivax (47.59%) infection were nearly equivalent (p = 0.795). The former was higher at low altitudes while the latter was higher at higher altitudes. The over 15 years of age group accounted for 11.47% of confirmed malaria cases (p < 0.001). There was high spatiotemporal variation: the highest case record was during Belg (12.52%) and in Dilla town (18,150, 13.17%, p < 0.001) which is located at low altitude. Monthly rainfall and minimum temperature exhibited strong associations with confirmed malaria cases.ConclusionA notable overall decline in malaria cases was observed during the eight-year period. Both P. falciparum and P. vivax were found at equivalent endemicity level; hence control measures should continue targeting both species. The noticed under reporting, the high malaria burden in urban settings, low altitudes and Belg season need spatiotemporal consideration by the elimination program.

Highlights

  • Informed decision making is underlined by all tiers in the health system

  • Both P. falciparum and P. vivax were found at equivalent endemicity level; control measures should continue targeting both species

  • Annual suspected and confirmed malaria cases based on Health center (HC) versus Health office (HO) records Overall, a notable decline in malaria, HCs, was observed during the eight-year period except in 2016 and between 2018 and 2019

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Summary

Introduction

Informed decision making is underlined by all tiers in the health system. Poor data record system coupled with under- (over)-reporting of malaria cases affects the country’s malaria elimination activities. Large proportion of infections reported is due to P. falciparum (~ 60%) followed by P. vivax (~ 40%) [1, 2] with micro-epidemiological and seasonal variation. Such co-endemicity makes malaria control and elimination more complicated in Ethiopia than in most other areas where the later species is absent or very low [2, 3]. Malaria transmission in Ethiopia is seasonal associated with precipitation and temperature changes; peaking from September to December following the large rainy season from June to August in most parts of the country [4] This rainfall pattern doesn’t include the southern and south-eastern parts of the country, which have a bimodal rainfall periods with long rainy season from March to May and short period from September to October [5]. Construction of dams and irrigation-based agricultural activities sometimes modify malaria seasonal trend in Ethiopia [6, 7]

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