Malaria Severity in the Elimination Continuum: A Retrospective Cohort Study between Beitbridge and Lupane Districts in Zimbabwe, 2021–2023

Author:

Betera Same12ORCID,Wispriyono Bambang1,Nunu Wilfred34ORCID,Susanna Dewi1ORCID,Midzi Nicholas5,Dhliwayo Patience6,Yelda Fitra7ORCID,Nyamukondiwa Melisa15

Affiliation:

1. Department of Environmental Health, Faculty of Public Health, Kampus Baru Depok, Universitas Indonesia, Kota Depok 16424, Jawa Barat, Indonesia

2. Environmental Health Department, Ministry of Health and Child Care, Kaguvi Building, 4th Floor, Causeway, Harare P.O. Box CY 1122, Zimbabwe

3. Department of Environmental Health, Faculty of Health Sciences, School of Public Health, University of Botswana, Gaborone UB 0022, Botswana

4. Department of Public Health, Faculty of Health Sciences, University of the Free State, Bloemfontein P.O. Box 339, South Africa

5. National Institute of Health Research (NIHR), Ministry of Health and Child Care, 65 Josiah Tongogara, Harare Street, Harare P.O. Box CY 1122, Zimbabwe

6. National Malaria and Control Program, Ministry of Health and Child Care, Kaguvi Building, 4th Floor, Causeway, Harare P.O. Box CY 1122, Zimbabwe

7. Research Center of Health Science, Faculty of Public Health, Kampus Baru Depok, Universitas Indonesia, Kota Depok 16424, Jawa Barat, Indonesia

Abstract

Malaria has created a resurgence crisis in Zimbabwe’s elimination continuum, diverging from global commitment to malaria elimination by 2030. This retrospective cohort study aimed to determine the risk factors associated with severe malaria in the Beitbridge and Lupane districts. Multistage sampling was used to recruit 2414 individuals recorded in the District Health Information Software2 Tracker database. The study used IBM SPSS 29.0.2.0(20) for data analysis, and odds ratios (ORs) to estimate the relative risk (RR; 95% C.I; p < 0.05). The study revealed significant relative risks (p-value < 0.05) for individuals who had no Long-Lasting Insecticidal Nets (Beitbridge 47.4; Lupane 12.3), those who owned but used the LLINs (Beitbridge 24.9; Lupane 7.83), those who slept outdoors during the night (Beitbridge 84.4; Lupane 1.93), and adults (Beitbridge 0.18; Lupane 0.22) compared to the corresponding reference groups. Other factors showed varying RR: sex (Beitbridge 126.1), prompt treatment (Beitbridge 6.78), hosting visitor(s) (Lupane 6.19), and residence (Lupane 1.94) compared to the corresponding reference groups. Risk factor management needs to focus on increasing local awareness of malaria, universal LLINs coverage of indoor and outdoor sleeping spaces, community-based programs on proper and consistent LLIN usage, screening of visitors from malaria-endemic areas, comprehensive entomological activities, mixed malaria interventions in rural hotspots, and future research on local malaria transmission dynamics. While Zimbabwe has the potential to meet the global goal of malaria elimination, success depends on overcoming the risk factors to sustain the gains already made among malaria elimination districts.

Publisher

MDPI AG

Reference38 articles.

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2. WHO (2020). World Health Organization Report Part Title: Malaria Elimination and Prevention of Re-Establishment Report Title: WHO Technical Brief for Countries Preparing Malaria Funding Requests for the Global Fund (2020–2022), World Health Organization. Available online: https://about.jstor.org/terms.

3. Modelling the impact of interventions on imported, introduced and indigenous malaria infections in Zanzibar, Tanzania;Das;Nat. Commun.,2023

4. Transition of Malaria Control to Malaria Elimination in India;Kumari;J. Commun. Dis.,2022

5. Gao, L., Shi, Q., Liu, Z., Li, Z., and Dong, X. (2023). Impact of the COVID-19 Pandemic on Malaria Control in Africa: A Preliminary Analysis. Trop. Med. Infect. Dis., 8.

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