Abstract
BackgroundThe trend analysis of malaria data from health facilities is useful for understanding dynamics of malaria epidemiology and inform for future malaria control planning. Changes in clinical malaria characteristics, like gender and age distribution are good indicators of declining malaria transmission. This study was conducted to determine the malaria trend at Arjo-Didessa sugar development site and its vicinity, southwest Ethiopia, from 2008 to 2017.MethodsMonthly malaria confirmed case data from 2008 to 2017 was extracted from 11 health facilities based on clinical registers at Arjo sugar development site and its vicinity, southwest Ethiopia. Both positivity rate and malaria incidence rate were calculated. Changes in malaria parasite species and seasonality were analysed; age structure and gender distribution were compared between different study periods. Trend in malaria incidence and climatic impact were analysed and past LLIN and IRS campaigns were used as dynamics modifier.ResultsOver a period of 10 years, 54,020 blood film were collected for malaria diagnosis in the health facilities at the area, of which 18,049 (33.4%) were confirmed malaria cases by both microscopically and RDT. Plasmodium falciparum, Plasmodium vivax, and mixed infection (P. falciparum and P. vivax) accounted for 8660 (48%), 7649 (42.4%), and 1740 (9.6%) of the malaria cases, respectively. The study also revealed that P. vivax was the predominant over P. falciparum for 4 years (2010, 2014, 2015 and 2016). There was a remarkable reduction of overall malaria infection during the 10 years. Malaria has been reported in all age groups, but age distribution showed that vast majority of cases were adults age 15 years and above 13,305 (73.7%). In all age groups, males were more significantly affected than females (χ2 = 133.0, df = 2, P < 0.0001). Moreover, malaria positivity rate showed a strong seasonality (χ2 = 777.55, df = 11, P < 0.0001). However, malaria cases were reported in all seasons across 10 years in the study area.ConclusionIn general, malaria positivity showed a declining trend over 10 years period in the area. However, current prevalence shows it is public health burden and needs attention for further intensification of interventions. In the study area, both P. falciparum and P. vivax co-exist and P. vivax is more prevalent than P. falciparum in almost half of the years. Therefore, malaria interventions should be strengthened in the study area.
Highlights
The trend analysis of malaria data from health facilities is useful for understanding dynamics of malaria epidemiology and inform for future malaria control planning
Males were increasingly dominant in malaria cases, between 2008 and 2014 males accounted for 63.8% (10,082/15,792) of all cases compare to 69.2% (1562/2257) between 2015 and 2017 (χ2 = 68.26, d.f. = 1, P < 0.0001) (Fig. 4)
Cross comparison found that P. falciparum was the predominant parasite in children below 15 years, P. vivax and mixed were more pronounced in adults (χ2 = 171.2, d.f. = 2, P < 0.0001) (Additional file 2)
Summary
The trend analysis of malaria data from health facilities is useful for understanding dynamics of malaria epidemiology and inform for future malaria control planning. This study was conducted to determine the malaria trend at Arjo-Didessa sugar development site and its vicinity, southwest Ethiopia, from 2008 to 2017. Malaria remains a major public health burden globally in general, and in sub-Saharan Africa in particular, including Ethiopia. There is a global initiative to eliminate malaria and remarkable result in malaria control has been achieved. In Ethiopia, the fight against malaria has shown a notable progress in controlling the disease over the last two decades in Ethiopia. The interventions which have been contributing to such significant decline includes; the distribution of long-lasting insecticidal nets (LLIN), indoor residual spraying (IRS); and introduction of prompt and effective treatment with artemisinin-based combination therapy (ACT) to treat uncomplicated Plasmodium falciparum malaria and environmental management [4,5,6]
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