Dataset Information

Malaria outbreak investigation in a rural area south of Zimbabwe: a case-control study.

ABSTRACT:

Background

Ninety percent of the global annual malaria mortality cases emanate from the African region. About 80-90% of malaria transmissions in sub-Saharan Africa occur indoors during the night. In Zimbabwe, 79% of the population are at risk of contracting the disease. Although the country has made significant progress towards malaria elimination, isolated seasonal outbreaks persistently resurface. In 2017, Beitbridge District was experiencing a second malaria outbreak within 12 months prompting the need for investigating the outbreak.

Methods

An unmatched 1:1 case-control study was conducted to establish the risk factors associated with contracting malaria in Ward 6 of Beitbridge District from week 36 to week 44 of 2017. The sample size constituted of 75 randomly selected cases and 75 purposively selected controls. Data were collected using an interviewer-administered questionnaire and Epi Info version 7.2.1.0 was used to conduct descriptive, bivariate and multivariate analyses of the factors associated with contracting malaria.

Results

Fifty-two percent of the cases were females and the mean age of cases was 29?±?13 years. Cases were diagnosed using rapid diagnostic tests. Sleeping in a house with open eaves (OR: 2.97; 95% CI 1.44-6.16; p?ConclusionHealth promotion messages should emphasize the importance of closing the entry points of the malaria vector, and the construction of better houses in the future. Residents had to be educated in the importance of consistent use of mosquito nets. The district had to improve malaria preventive measures like distribution of mosquito nets and lobby for more human resources to assist with malaria surveillance thus, curbing the recurrence of malaria outbreaks.

SUBMITTER: Mundagowa PT

PROVIDER: S-EPMC7268448 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Publications

Malaria outbreak investigation in a rural area south of Zimbabwe: a case-control study.

Mundagowa Paddington T PT Chimberengwa Pugie T PT

Malaria journal 20200601 1

<h4>Background</h4>Ninety percent of the global annual malaria mortality cases emanate from the African region. About 80-90% of malaria transmissions in sub-Saharan Africa occur indoors during the night. In Zimbabwe, 79% of the population are at risk of contracting the disease. Although the country has made significant progress towards malaria elimination, isolated seasonal outbreaks persistently resurface. In 2017, Beitbridge District was experiencing a second malaria outbreak within 12 months ...[more]

PMID: 32487249

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Project description:In January of 2014, an outbreak of malaria was declared in the Honde Valley region of Mutasa District in Zimbabwe. The area has a hot, temperate climate and high rainfall pattern ideal for vector breeding and malaria transmission. Gravity fed irrigation channels span the valley creating a number of breeding sites for malaria vectors, mosquitoes. Malaria outbreaks have been a common occurrence in the district over the past few years despite the district meeting set targets for prevention interventions like indoor residual spraying (IRS) with pyrethroids and long lasting insecticidal nets distribution. The objectives of this study were to describe the outbreak by person, place and time, to assess the community's knowledge on malaria transmission, signs and symptoms and treatment and to tease out factors associated with malaria infection in the district.An unmatched case-control study was carried out. Interviewer guided questionnaires were administered to residents of the valley who met the inclusion criteria in order to tease out possible factors associated with malaria infection. A case was defined as a resident of Honde Valley with a history of malaria symptoms and a confirmed diagnosis from 13 January 2014 to 26 January 2014. A control was a resident of Mutasa District who was present in the district during the time of the outbreak but did not develop symptoms of malaria. A total of 87 cases and 87 controls were enrolled.Cases and controls were comparable in terms of socio-demographic characteristics and knowledge on malaria transmission, treatment and prevention. Risk factors associated with contracting malaria during the outbreak were being under the age of 5 years (OR = 9.92, CI 1, 2-80, 1), not using mosquito repellents (OR = 8, 25 CI 3, 78-18, 0), having outdoor activities before dawn and after dusk (OR = 2, 81 CI 1,04-7, 6). Having received indoor residual spraying in ones house was a risk factor for contracting malaria (OR = 1, 68 CI 0, 74-3, 83). This finding was not statistically significant. Sleeping under an insecticidal net and wearing protective clothing when outdoors after dusk were protective factors against contracting malaria (OR = 0, 27 CI 0, 12-0, 59 and OR = 0, 12 CI 0, 06-0, 25 respectively). All cases were treated according to the national malaria case management guidelines.Risk factors for contracting malaria were being under the age of 5 years, outdoor activities at night and not using mosquito repellents. Net use was a protective factor from contracting malaria in Mutasa District. Indoor residual spraying with pyrethroids in Honde Valley was not a protective factor against contracting malaria.

Project description:BACKGROUND:Kondo Rural Health Centre recorded 27 malaria patients between the 27th of January 2019 and the 2nd of February 2019 against an epidemic threshold of 19 with the malaria outbreak being confirmed on the 5th of February 2019. Indoor residual spraying as part of integrated vector management control activities had been done in the district before the onset of the rainy season as well as social behaviour change communication but residents were contracting malaria. We, therefore, investigated the risk factors associated with this outbreak to recommend scientifically effective prevention and control measures. METHODS:We conducted a 1:1 unmatched case-control study. A case was a resident of Mudzi from the 4th of February 2019 who had a positive rapid diagnostic test for malaria randomly selected from the clinic's line list whilst controls were randomly selected from the neighbourhood of cases. Pretested interviewer-administered questionnaires were used to collect information on demographic characteristics, knowledge and practices of residents in malaria prevention. Data were analysed using Epi info 7. RESULTS:A total of 567 confirmed malaria cases was recorded with an overall attack rate of 71.7 per 1000 population. Sixty-three case-control pairs were interviewed. The majority of cases 78% (49/63) were from Makaza, Chanetsa and Nyarongo villages which are within 3?km from Vhombodzi dam. A stagnant water body near a house [aOR?=?8.0, 95%CI?=?(2.3-28.6)], engaging in outdoor activities before dawn or after dusk [aOR?=?8.3, 95%CI?=?(1.1-62.7)] and having a house with open eaves [aOR?=?5.4, 95%CI?=?(1.2-23.3)] were independent risk factors associated with contracting malaria. Wearing long-sleeved clothes when outdoors at night [aOR?=?0.2, 95%CI?=?(0.1-0.4)] was protective. CONCLUSION:A stagnant water pool close to the homestead and engaging in outdoor activities before dawn and after dusk were modifiable risk factors associated with the malaria outbreak despite the community being knowledgeable on the transmission and prevention of malaria. Community sensitisation and mobilisation in the destruction of stagnant water bodies and cutting of tall grass around homesteads were recommended measures to contain the outbreak.

Project description:BackgroundAnthrax continues to be a disease of public health importance in Zimbabwe, with sporadic outbreaks reported annually in many parts of the country. A human anthrax outbreak occurred in wards 22 and 23 of Makoni District from mid-June 2013 to end of January 2014, following cattle deaths in the wards. Laboratory tests confirmed anthrax as the cause for the cattle deaths. This study investigated the clinical characteristics, distribution of cases (places, person and time) and risk factors for contracting the anthrax disease. We also assessed the environment, district preparedness and response, and outbreak prevention and control measures.MethodsWe conducted an outbreak investigation using a mixed-methods design. A 1:1 case-control study was used to assess risk factors for contracting anthrax. The controls were frequency matched to cases by sex. Data were collected using a structured interviewer-administered questionnaire. Environmental assessment, district preparedness and response, and outbreak prevention and control measures were assessed using a checklist, observations, and key informant interviews. Multivariable unconditional logic regression analysis was performed to identify independent risk factors associated with contracting anthrax.ResultsWe interviewed 37 of the 64 cases, along with 37 controls. All the cases had cutaneous anthrax, with the hand being the most common site of the eschar (43%). Most of the cases (89%) were managed according to the national guidelines. Multivariable analysis demonstrated that meat sourced from other villages [vs butchery, OR = 15.21, 95% CI (2.32-99.81)], skinning [OR = 4.32, 95% CI (1.25-14.94)], and belonging to religions that permit eating meat from cattle killed due to unknown causes or butchered after unobserved death [OR = 6.12, 95% CI (1.28-29.37)] were associated with contracting anthrax. The poor availability of resources in the district caused a delayed response to the outbreak.ConclusionThe described anthrax outbreak was caused due to contact with infected cattle meat. Although the outbreak was eventually controlled through cattle vaccination and health education and awareness campaigns, the response of the district office was initially delayed and insufficient. The district should strengthen its emergency preparedness and response capacity, revive zoonotic committees, conduct awareness campaigns and improve surveillance, especially during outbreak seasons.

Project description:BackgroundAnthrax continues to be a disease of public health concern in Zimbabwe. Between December 2021 and February 2022, Tengwe reported 36 cases of human anthrax. Gastrointestinal anthrax has the potential to cause serious outbreaks leading to loss of human life. We investigated the outbreak, identified the risk factors using one health approach to inform outbreak control.Materials and methodsWe conducted descriptive analysis of the outbreak and a 1:2 unmatched case control study to identify risk factors for anthrax. A case was any Tengwe resident who developed an ulcer and/or abdominal symptoms and epidemiologically linked to a confirmed environmental exposure. Validated, structured interviewer-administered questionnaires were used to collect data from the cases and neighbourhood controls. Soil and dried meat samples were collected for laboratory investigations. District preparedness and response was assessed using a checklist. Data was analysed using Epi Info version 7.2.5. The odds of exposure were calculated for each risk factor examined. Multivariable logistic regression analysis was performed to identify the independent factors associated with contracting anthrax.ResultsThrough active case finding we identified 36 cases, 31 were interviewed. Twenty-one (67.7%) were males. The median age was 33 years (Inter quartile range: 22-54). Nineteen (61.2%) cases presented with abdominal symptoms with zero deaths reported. The independent risk factor for contracting anthrax was eating under-cooked meat (aOR = 12.2, 95% CI: 1.41-105.74, p = 0.023). All samples collected tested positive for anthrax. No livestock vaccinations or zoonotic meetings were being conducted prior to the outbreak. Notification of the outbreak was done 11 days after index case presentation however one health response was instituted within 24 hours.ConclusionThe anthrax was confirmed in Tengwe. Consumption of under-cooked meat was associated with gastrointestinal anthrax. The timely one health response resulted in excellent outcomes. Using one health approach in managing zoonotic threats is encouraged.

Project description:BackgroundGlobally in 2015 about 214 million malaria cases and 438,000 deaths were reported with 75% were from Sub-Saharan Africa. Malaria transmission in Ethiopia is unstable, and outbreaks are considered public health emergencies. Understanding the trigger for outbreaks in low-transmission areas can help facilitate malaria elimination. On July 8th malaria outbreak was reported from Laelay Adyabo district. The objective was to investigate the magnitude and associated factors with malaria outbreak.MethodsWe defined a case as confirmed malaria using microscopy or a rapid diagnostic test for Plasmodium parasites in a resident of Laelay-Adyabo District from July 9-28, 2017. We identified cases by reviewing health facility records and conducted a case-control study using randomly-selected cases from a line list, and two neighborhood controls per case. A pretested semi-structured questionnaire adapted from WHO malaria guidelines was used to collect data from case-patients and controls. We calculated crude (COR) and adjusted (AOR) odds ratios to identify factors associated with malaria.ResultA total of 145 confirmed malaria cases (57.9% males) were identified with village attack rate (AR) of 12.1/1000. The AR was higher among males than females (14.1 verses 10.1/1000), children aged 5-14 years (12.9/1000), and in Zelazle Kebelle (13.6/1000 population). Wearing protective clothing (AOR = 0.27, 95% CI 0.11-0.66), having good knowledge of malaria transmission (AOR = 0.25, 95% CI 0.08-0.75), having waste collection material at home (AOR = 0.25 95% CI 0.11-0.61), availability of mosquito breeding sites around home (AOR = 9.08, 95% CI 3.6-22.93), and staying outdoor overnight (AOR = 3.7, 95% CI 1.44-9.56) were independently associated with malaria.ConclusionThe overall attack rate for malaria during this outbreak was high affecting > 1% of the population. Wearing protective clothing at night, knowing about malaria transmission, having mosquito breeding sites around the home, staying outdoors overnight, and having waste collection material in their house were predictors of the infection. Laelay Adyabo district health office should provide health education on malaria transmission and prevention measures and how to clear mosquito breeding sites.

Dataset Information

Malaria outbreak investigation in a rural area south of Zimbabwe: a case-control study.

Background

Methods

Results

Publications

Malaria outbreak investigation in a rural area south of Zimbabwe: a case-control study.

Similar Datasets

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