Abstract
BackgroundIn Ethiopia malaria remains a leading cause of outpatient consultation despite massive control efforts. This study was aimed at analysing 5-year retrospective trend and current prevalence of malaria as well as community knowledge, attitude and practice (KAP) in Walga Health Centre (WHC) catchment area in Abeshge District, south-central Ethiopia.MethodsA cross-sectional, household survey was conducted to determine malaria prevalence and KAP in December 2013. Further, malaria cases reported from WHC in 2008–2012 were extracted. A multi-stage, random sampling technique was used to select study participants from four kebeles. Of 800 participants, 400 were interviewed to assess their KAP about malaria and the other half were recruited for malaria microscopy.ResultsOverall, 11,523 (33.8 %) slide-confirmed malaria cases were reported (no fatalities) among 34,060 outpatients diagnosed in 2008–2012. There was successively significant decline in malaria prevalence from 2009 onwards although a significant rise was noticed in 2009 compared to 2008 (p <0.0001). Male malaria suspects (17,626) were significantly higher than of females (16,434) (p = 0.0127) but malaria prevalence was not significantly variable between sexes. Individuals who were ≥15 years constituted 44.9 % of the patients. Although most participants (78.8 %) associated mosquito bites with malaria, the remaining mentioned exposure to rain or body contact with malaria patients as causes of malaria. Mosquito nets, draining stagnant water and indoor residual spraying were the most frequently mentioned malaria preventive measures. In the parasitological survey, a single individual (0.25 %) with mixed Plasmodium falciparum-Plasmodium vivax infections was found.ConclusionAlthough malaria remains a primary cause of outpatient admission in WHC, the retrospective data showed a significantly declining trend. This together with the very low prevalence in the current parasitological survey suggests the effectiveness of ongoing control interventions in the locality.
Highlights
In Ethiopia malaria remains a leading cause of outpatient consultation despite massive control efforts
Significantly higher number of febrile patients visited the health facility in 2010 than in 2009 (X2 = 6.388, p = 0.0115) the reverse was noted in terms of malaria prevalence
Despite a fluctuating trend, the health system data showed a successive and significant decline in malaria prevalence starting from 2009. This significantly declining pattern of malaria cases in the studied healthcare setting coupled with the low prevalence rate observed among the study participants in the current communitybased cross-sectional study, demonstrates the effectiveness of the control measures being implemented in the area
Summary
In Ethiopia malaria remains a leading cause of outpatient consultation despite massive control efforts. The global burden of malaria is substantially declined, but in Africa the disease remains a major public health problem [1]. In Ethiopia, great progress has been achieved in recent years due to scale-up of control interventions, malaria is still a formidable health challenge in the country. In 2012, countrywide, 1,822,581 confirmed cases and 253 deaths were attributed to Insecticide-treated bed nets (ITNs) are among major malaria control interventions globally. Reports show that ITNs, especially long-lasting insecticidal nets (LLINs), reduce the incidence of clinical malaria by 50 % [5, 6]. In Africa, countries such as South Africa have achieved a notable decline in the level of malaria transmission in some provinces through elimination of the major local malaria vectors using IRS [10]
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