Adugna Woyessa

Despite the encroaching of endemic malaria to highland-fringe areas above 2000 meters above sea level in Ethiopia, there is limited information on ownership and use of mosquito nets for malaria prevention. Thus, this study was designed to assess long-lasting insecticidal nets (LLIN) possession and use for malaria prevention in highland-fringe of south-central Ethiopia.

The highlands of Ethiopia, situated between 1,500 and 2,500 m above sea level, experienced severe malaria epidemics. Despite the intensive control attempts, underway since 2005 and followed by an initial decline, the disease remained a major public health concern. The aim of this study was to identify malaria risk factors in highland-fringe south-central Ethiopia.

Malaria is a major public health problem in Ethiopia. Plasmodium falciparum and Plasmodium vivax co-exist and malaria rapid diagnostic test (RDTs) is vital in rendering parasite-confirmed treatment especially in areas where microscopy from 2008 to 2010 is not available. CareStartTM Malaria Pf/Pv combo test was evaluated compared to microscopy in Butajira area, south-central Ethiopia. This RDT detects histidine-rich protein-2 (HRP2) found in P. falciparum, and Plasmodium enzyme lactate dehydrogenase (pLDH) for diagnosis of P. vivax. The standard for the reporting of diagnostic accuracy studies was complied. Among 2,394 participants enrolled, 10.9% (n=87) were Plasmodium infected (household survey) and 24.5% (n=392) health facility-based using microscopy. In the household surveys, the highest positivity was caused by P. vivax (83.9%, n=73), P. falciparum (15.0%, n=13), and the rest due to mixed infections of both (1.1%, n=1). In health facility, P. vivax caused 78.6% (n=308), P. falciparum caused 20.4% (n=80), and the rest caused by mixed infections 1.0% (n=4). RDT missed 9.1% (n=8) in household and 4.3% (n=17) in health facility-based surveys among Plasmodium positive confirmed by microscopy while 3.3% (n=24) in household and 17.2% (n=208) in health facility-based surveys were detected false positive. RDT showed agreement with microscopy in detecting 79 positives in household surveys (n=796) and 375 positives in health centre survey (n=1,598).

In 2005, the Ethiopian government launched a massive expansion of the malaria prevention and control programme. The programme was aimed mainly at the reduction of malaria in populations living below 2,000 m above sea level. Global warming has been implicated in the increase in the prevalence of malaria in the highlands. However, there is still a paucity of information on the occurrence of malaria at higher altitudes. The objective of this study was to estimate malaria prevalence in highland areas of south-central Ethiopia, designated as the Butajira area.

Malaria is a major public health problem and of considerable socio-economic burden in most parts of Ethiopia. The country has witnessed recurrent epidemics of the disease, resulting in grave consequences including in areas designated as highland fringe. A study was undertaken to grossly assess the magnitude of the problems, the effectiveness of the control options and to explore the challenges encountered and the experiences gained during the 1998 malaria epidemic in Akaki Town and its environs. Health facility clinical records of individual patients and weekly surveillance and epidemic control reports were utilized as principal sources of data. The information revealed that the epidemic was very alarming affecting a sizable part of Akaki and the surrounding areas, with the total number of cases amounting to 622. The epidemic was controlled by case detection and treatment as well as by intensive vector control activities. The control endeavor, however, posed great difficulties due to the absence of systematic malaria control program, owing to underestimation of the threat from highland malaria. The contribution from the adjacent Oromia Malaria Control Program and The Federal Ministry of Health to control the epidemic (mainly vector control) was reckoned to be substantial. Thus, capacity building targeted to early detection, prevention and control of malaria epidemics, and preparedness is deemed to be of paramount importance. A viable Integrated Disease Surveillance and Response at health facilities could ensure early containment of the otherwise devastating epidemics.