Assessment of Current Malaria Status in Light of the Ongoing Control Interventions, Socio-Demographic and Environmental Variables in Jiga Area, Northwest Ethiopia

RESEARCH ARTICLE Assessment of Current Malaria Status in Light of the Ongoing Control Interventions, SocioDemographic and Environmental Variables in Jiga Area, Northwest Ethiopia Seble Ayalew1, Hassen Mamo1*, Abebe Animut2, Berhanu Erko2 a11111 1 Department of Microbial, Cellular and Molecular Biology, College of Natural Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia, 2 Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia * Abstract OPEN ACCESS Citation: Ayalew S, Mamo H, Animut A, Erko B (2016) Assessment of Current Malaria Status in Light of the Ongoing Control Interventions, SocioDemographic and Environmental Variables in Jiga Area, Northwest Ethiopia. PLoS ONE 11(1): e0146214. doi:10.1371/journal.pone.0146214 Editor: Michelle Louise Gatton, Quensland University of Technology, AUSTRALIA Received: November 22, 2014 Accepted: December 15, 2015 Published: January 11, 2016 Copyright: © 2016 Ayalew et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Following substantial decline in malaria burden in Ethiopia, the country is planning to eliminate malaria in certain low transmission settings by 2020. To evaluate the attainability of this goal in-depth examination of malaria parasite carriage at community level is necessary. This study was, therefore, aimed at assessing the current situation of malaria in relation to ongoing control interventions in Jiga area, Jabi Tehnan District in northwest Ethiopia. A cross-sectional household (HH) survey was conducted in November-December 2013. Out of 2,574 HHs (11,815 people) in the entire Jabi Tehnan District, 392 (accommodating 1911 people) were randomly selected from three purposely selected villages. One randomly selected member from each selected HH was tested for malaria using rapid diagnostic test (mRDT). All participants tested for malaria (n = 392) were afebrile (axillary temperature <37.5°C). Eleven individuals (2.8%, 95% confidence interval (CI):1.2–4.4%) were found to be mRDT positive. Most HHs (95.9%, 95% CI: 93.5–97.5%) had at least 1 long-lasting insecticidal net (LLIN). Insecticide residual spraying (IRS) coverage the last six months was 85.5% (95% CI: 82.0–88.9%). Malaria prevalence remains unexpectedly high despite high HH coverage of control interventions. Data Availability Statement: All relevant data are within the paper. Funding: The Office of Academic Vice President at Addis Ababa University supported this study. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist. Abbreviations: CI, confidence interval; FMoH, federal ministry of health; HH, household; IRS, indoor Introduction Prompt case detection and treatment with artemisinin-based combination therapies, use of insecticide treated nets (ITNs) and indoor residual spraying (IRS) resulted in reduction of malaria related cases and deaths globally [1, 2]. In Ethiopia, prior to 2004 malaria was known to cause 5–10 million clinical cases and 70,000 deaths each year [3]. Currently, however, the figures are much lower [4] because of the country’s scale-up of its control interventions in line with the global malaria control initiative. Between 2004 and 2012, nearly 46 million long-lasting insecticidal nets (LLINs) were distributed, over 70% of targeted households (HHs) covered PLOS ONE | DOI:10.1371/journal.pone.0146214 January 11, 2016 1 / 10 Current Malaria Status in Jiga Area, Northwest Ethiopia residual spraying; ITNs, insecticide treated mosquito nets; LLIN, long-lasting insecticidal net; MIS, malaria indicator survey; mRDT, malaria rapid diagnostic test; OR, odds ratio. with IRS and 9 million doses of malaria treatment provided to public health facilities all free of charge [5]. Encouraged by its achievement the Federal Ministry of Health (FMoH) aims to achieve malaria elimination within specific geographical areas with historically low malaria transmission and zero deaths due to malaria in areas with malaria transmission by 2020 [4]. Nevertheless, in the Amhara Region, where the initial malaria elimination project is planned in selected Districts, 73.7% of the HHs had at least one net in 2011 which was slightly lower compared to the level in 2007 (75.2%) and malaria slide positivity has increased from 0.6% (in 2007) to 2.0% in 2011 [6]. A total of 1,127,241 cases of malaria were reported in this Region in 2012, out of a population of 19,867,817 habitants [5]. West Amhara which consists of five administrative zones (the Amhara Region is subdivided into 11 administrative zones including Bahir Dar special zone) has accounted for 93.1% of the Region’s malaria burden of which West Gojjam had the greatest number of cases (404,926) followed by North Gondar (225,818). Jiga area which is located in Jabi Tehnan District, West Gojjam Zone, northwest Ethiopia, is among the top malaria affected areas in the Region deserving particular attention. Out of 194,818 patients examined for malaria between September 2009 and August 2013 at Jiga Health Center, 24,103 (25.4%) had slide-confirmed malaria [7]. A study conducted five years back also revealed high malaria prevalence (65.4%) among febrile patients in Jiga [8]. Thus, it is necessary to assess the current prevalence of malaria and coverage of control interventions in Jiga area. This study, therefore, assessed malaria prevalence and coverage of control interventions in this area. Ownership/utilization of LLINs and coverage of IRS; and socio-economic, environmental and demographic factors were captured and analyzed in relation to malaria status. The baseline information produced can be utilized by concerned health professionals and policy makers for malaria control and possible elimination in the area. Materials and Methods Study area description The study was conducted in Jiga area, northwest Ethiopia, which is located at 372 km from Addis Ababa (Fig 1). The area is situated at 9°20' and 14°20' north latitude and 36°20' and 40° 20' east longitude, and 1812 meters above sea level with an area of 1169.54 km2 [9,10]. It was selected purposely as it is one of malaria hotspots in the Zone. The mean annual temperature is about 23°C (ranging from 14°C to a slightly above 32°C) and the mean annual rainfall is 1250 millimeter. Agriculture is the principal source of livelihood for the population. Cereal crops such as teff (Eragrostis tef), maize, wheat and barley are the most commonly cultivated crops in the District. Pepper, sugarcane and coffee are cash crops in some sites of the District including the study villages (kebeles). In the study area, malaria transmission peaks bi-annually from September to Decembe (...truncated)