Author:
Nega Desalegn,Abera Adugna,Gidey Bokretsion,Mekasha Sindew,Abebe Abnet,Dillu Dereje,Mehari Degu,Assefa Gudissa,Hailu Samuel,Haile Mebrahatom,Etana Kebede,Solomon Hiwot,Tesfaye Gezahagn,Nigatu Daniel,Destaw Zelalem,Tesfaye Berhane,Serda Belendia,Yeshiwondim Asnakew,Getachew Assefaw,Teka Hiwot,Nahusenay Honelegn,Abdelmenan Semira,Reda Hailemariam,Bekele Worku,Zewdie Ayele,Tollera Getachew,Assefa Ashenafi,Tasew Geremew,Woyessa Adugna,Abate Ebba
Abstract
Abstract
Background
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 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.
Methods
A 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.
Result
Overall 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.
Conclusion
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. 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.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference43 articles.
1. Asih PB, Rozi IE, Herdiana PNR, Hidayati AP, Marantina SS, et al. The baseline distribution of malaria in the initial phase of elimination in Sabang municipality, Aceh Province, Indonesia. Malar J. 2012;11(1):291. https://doi.org/10.1186/1475-2875-11-291.
2. Wang RB, Zhang J, Zhang QF. Malaria baseline survey in four special regions of northern Myanmar near China: a cross-sectional study. Malar J. 2014;13(1):302. https://doi.org/10.1186/1475-2875-13-302.
3. Zhou Ti-Caol, Zhang Yi, Deng Yong ZS. Baseline survey of malaria elimination in Shaanxi Province. Exp Study. 2014;14: 1197–1199.
4. Reid H, Vallely A, Taleo G, Tatem AJ, Kelly G, Riley I, et al. Baseline spatial distribution of malaria prior to an elimination programme in Vanuatu. Malar J. 2010;9(1):150. https://doi.org/10.1186/1475-2875-9-150.
5. President’s Malaria Initiative. Malaria Operational Plan FY 2014. Pres Malar Initiat Rwanda. 2013; 1–69. Available: http://www.pmi.gov/docs/default-source/default-document-library/malaria-operational-plans/fy14/zambia_mop_fy14.pdf?sfvrsn=8