Trends of Malaria Cases, Admissions and Deaths in Amhara Region of Ethiopia (2000-2008) and the Impact of Scale up Interventions
Creators: name: Gebru, Daniel
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2009

description: Background: Health centre and hospital records are important sources of data on malaria cases, admissions and deaths, because they are readily available and can provide use full indications on the patterns of malaria at a low cost. However, there is only limited information on the health impact of expanded coverage of malaria control and preventative strategies in Ethiopia. Objective: The core objectives of this study is to asses and document the trend of malaria cases, admission and deaths over the past 9 years (2000 -2008) period and describe the impact of anti malaria interventions performed during the period. It also aims to assess the relationship between meteorological factors and malaria. Methodology: The study was conducted in Amhara region, north western Ethiopia. The present study utilized a retrospective record review on available medical records related to malaria from health facilities for nine years between 2000 and 2008 (except for Bahirdar health centre for 10.5 years: July, 1998-December, 2008) and metrological information for 9 years (July, 1998-December, 2007) from National Metrology Agency for Ethiopia. With the limited resource available, total of 14 health facilities (9 health centres and 5 hospitals) was purposively selected. Data was entered and cleaned using SPSS version 11.0 and analysed using excel 2007 and EPI INFO windows version and SPSS version 11.0 statistical software packages. To assess the trend of malaria and the impact of scale up interventions, the observed 2008 value for each indicator was compared with its corresponding, expected value for that year based on the linear trend over 2000 through 2005 (using SPSS Inc., version 11.0 for linear regression, excel 2007and 2-tailed Student's T-tests for assessing statistical significance of the difference between observation and expectation). The Chi squared test for trend was used to test whether the malaria cause outpatient cases, admission and death statistically significant decreasing over time (in years). Correlation statistical test was also applied to test for any association between malaria specific morbidity variables and meteorological factors. Result: Malaria was responsible for 25.8 % of the total outpatient consultations, 13.9% of the total inpatient cases and 15.0 % of the total death between 2000 and 2008. Comparing 2008 against the average 2000-2005, observed declines were 30.2% for total malaria cause outpatient cases and 75.8% for microscopically confirmed malaria cause outpatient cases. After adjusting the pre-intervention trends over 2000-2005, the estimated decline in total malaria cause (62.2%; P&lt;0.05) and microscopically confirmed malaria cause (85.1%; P&lt;0.05) outpatient cases were significant. Significant positive correlations were found between microscopically confirmed malaria cause outpatient cases and 2-months lag average rainfall (Pearson correlation= 0.284, P-value=0.007) and 3- months lag average rainfall (Pearson correlation= 0.420, P-value=0.000). Conclusion: malaria is one of the major public health challenges in the Amhara region. Plasmodium falcipurum and Plasmodium falcipurum are responsible for almost all malaria outpatient cases Malaria cause outpatient cases decreased in Amhara region after Long Lasting Insecticidal Nets (LLIN) and Artemisinin Based Combination Therapy (ACT) interventions are largely distributed (after the end of 2005). Malaria control offices/Bureaus, with partners of RBM, should keep on their effort to access LLINs to all at risk persons and ACT treatment in Amhara region as well in Ethiopia