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1. Baseline malaria prevalence at the targeted pre-elimination districts in Ethiopia

Author

Desalegn Nega, Adugna Abera, Bokretsion Gidey, Sindew Mekasha, Abnet Abebe, Dereje Dillu, Degu Mehari, Gudissa Assefa, Samuel Hailu, Mebrahatom Haile, Kebede Etana, Hiwot Solomon, Gezahagn Tesfaye, Daniel Nigatu, Zelalem Destaw, Berhane Tesfaye, Belendia Serda, Asnakew Yeshiwondim, Assefaw Getachew, Hiwot Teka, Honelegn Nahusenay, Semira Abdelmenan, Hailemariam Reda, Worku Bekele, Ayele Zewdie, Getachew Tollera, Ashenafi Assefa, Geremew Tasew, Adugna Woyessa, and Ebba Abate

Subjects
Baseline survey, Malaria epidemiology, Malaria elimination, Ethiopia, Public aspects of medicine, RA1-1270
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.

Published
2021
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2. Baseline Malaria Prevalence at the Targeted Pre-elimination Districts in Ethiopia

Author

Asnakew K. Yeshiwondim, Zelalem Destaw, Hailemariam Lemma Reda, Dereje Dillu, Desalegn Nega, Abnet Abebe, Gudissa Assefa, Semira Abdelmenan, Ashenafi Assefa, Belendia Serda, Ebba Abate, Worku Bekele, Hiwot Solomon, Getachew Tollera, Bokretsion Gidey, Ayele Zewdie, Assefaw Getachew, Gezahagn Tesfaye, Degu Mehari, Berhane Tesfaye, Honelegn Nahusenay, Adugna Abera, Daniel Nigatu, Mebrahatom Haile, Geremew Tasew, Adugna Woyessa, Kebede Etana, Samuel Hailu, Sindew Mekasha, and Hiwot Teka

Subjects
medicine.medical_specialty, Malaria elimination, Asymptomatic, Baseline survey, law.invention, law, Environmental health, Epidemiology, parasitic diseases, medicine, Prevalence, Humans, Malaria, Falciparum, Baseline (configuration management), Child, business.industry, Diagnostic Tests, Routine, Public health, Research, Malaria epidemiology, Public Health, Environmental and Occupational Health, medicine.disease, Malaria, Transmission (mechanics), Cross-Sectional Studies, Ethiopia, medicine.symptom, Biostatistics, Public aspects of medicine, RA1-1270, business
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.

Published
2021

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