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. 2021 Nov 3;21(1):1996.
doi: 10.1186/s12889-021-12036-5.

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

Desalegn Nega #  1 , Adugna Abera #  2 , Bokretsion Gidey  2 , Sindew Mekasha  2 , Abnet Abebe  2 , Dereje Dillu  3 , Degu Mehari  3 , Gudissa Assefa  3 , Samuel Hailu  3 , Mebrahatom Haile  3 , Kebede Etana  3 , Hiwot Solomon  3 , Gezahagn Tesfaye  3 , Daniel Nigatu  4 , Zelalem Destaw  2 , Berhane Tesfaye  5 , Belendia Serda  5 , Asnakew Yeshiwondim  5 , Assefaw Getachew  5 , Hiwot Teka  6 , Honelegn Nahusenay  7 , Semira Abdelmenan  7 , Hailemariam Reda  8 , Worku Bekele  9 , Ayele Zewdie  7 , Getachew Tollera  2 , Ashenafi Assefa  2 , Geremew Tasew  2 , Adugna Woyessa  2 , Ebba Abate  2
Affiliations

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

Desalegn Nega et al. BMC Public Health. .

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.

Keywords: Baseline survey; Ethiopia; Malaria elimination; Malaria epidemiology.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Risk map of Districts by annual parasite incidence, Ethiopia, 2017 (Source FMOH malaria NSP: 2017–2020)
Fig. 2
Fig. 2
Trends in malaria prevalence by RDTs: Ethiopia MIS 2011, MIS 2015, and the current Malaria elimination baseline survey 2018. Where EMIS: Ethiopian malaria indicator survey; EMEBS: Ethiopian malaria elimination baseline survey
Fig. 3
Fig. 3
Malaria prevalence among all ages by RDTs in EMIS 2015 and EMEBA 2018. Where, EMEBS: Ethiopian malaria elimination baseline survey, SNNP: Southern nations, nationalities and peoples’ Region
See this image and copyright information in PMC

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