Dataset Information

Malaria serosurvey among acute febrile patients come for health care seeking at the high malaria-endemic setting of North West Ethiopia.

ABSTRACT:

Objectives

This study aimed to assess malaria seroprevalence among acute febrile illness cases who come for health care seeking in the high malaria-endemic setting of North West Ethiopia.

Methods

Institutional-based descriptive serosurvey of malaria infections was employed among 18,386 febrile patients from September 2020 to August 2021. Data were entered using Epi Data version 4.2 and exported to STATA (SE) R-14 version statistical software for further analysis. Bi-variable and multivariable regression analyses were conducted to identify malaria infection. Finally, variables with P-value less than 0.05 were considered significant predictors for malaria infection.

Results

The mean (±standard deviation) age of participants was 48.6 (±18.4) years. The overall seroprevalence of malaria infection was estimated as 27.8% (95% confidence interval = 27.2; 28.6, standard error = 0.003). Malaria infection was significantly associated with participants being female (adjusted odds ratio = 2.9; 95% confidence interval = 1.8; 3.7, P = 0.01), age 5-29 years (adjusted odds ratio = 2.2; 95% confidence interval = 1.7; 2.8, P = 0.02), rural (adjusted odds ratio = 3.9; 95% confidence interval = 1.9; 4.4, P = 0.001), and Hgb ⩽11 mg/dL (adjusted odds ratio = 3.4; 95% confidence interval = 1.9; 5.86, P = 0.01).

Conclusion

Nearly every three to ten acute febrile cases were positive for confirmed malaria infection. The risk of malaria infection was significantly associated with respondents being female, aged 5-29 years, rural, and levels of hemoglobin were significantly associated with malaria infection.

SUBMITTER: Kebede F

PROVIDER: S-EPMC9290101 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundPrompt care seeking and appropriate use of anti-malarial drugs are critical components of malaria prevention and control. This study assessed malaria related perceptions, care seeking behavior and anti-malarial drug use in malaria endemic settings of Ethiopia.MethodsData were generated from a community based cross-sectional study conducted among 798 households during January 2014 as part of a larger household behavioral study in three malaria endemic districts of Jimma Zone, Southwest Ethiopia. Both quantitative and qualitative data were collected and analyzed using SPSS 17.0 and STATA 12.0.ResultsIn this study, only 76.1% of the respondents associated malaria to mosquito bite, and incorrect beliefs and perceptions were noted. Despite moderate level of knowledge (estimated mean = 62.2, Std Err = 0.7, 95% CI: 60.6-63.8%), quite high favorable attitude (overall estimated mean = 91.5, Std Err = 0.6, 95% CI: 90.1-92.9%) were recorded towards malaria preventive measures. The mean attitude score for prompt care seeking, appropriate use of anti-malarial drugs, LLIN use and Indoor Residual Spray acceptance was 98.5 (Std Err = 0.4, 95% CI:97.5-99.4), 92.7 (Std Err = 0.6 95% CI:91.5-93.9), 88.8 (Std Err = 0.5, 95% CI:85.5-92.1) and 86.5 (Std Err = 1.2, 95% CI: 83.9-89.1), respectively. The prevalence of fever was 2.9% (116/4107) and of the study participants with fever, 71.9% (95% CI: 65.5-78.3%) sought care and all of them consulted formal health care system. However, only 17 (19.8%) sought care within 24 hours after onset of fever. The frequency of care seeking was higher (77.8%, n = 21/27) and more prompt (28.6%, 6/21) for children under five as compared to old age groups despite it was not statistically significant (p > 0.05). However, higher median time of seeking first care was observed among Muslims and people who did not attend school (p < 0.05). Of those who used anti-malarial drugs, 9.1% indicated that they used it inappropriately through saving and/or sharing. Irregular availability of anti-malarial drugs; irregular presence of frontline health workers and misconceptions were mentioned to contribute to delayed care seeking and irrational use of anti-malarial drugs.ConclusionsAlthough care seeking behavior for febrile illness was quite high in this community, the habit of prompt care seeking was very limited. Thus, malaria prevention and control programs need to take into account local misconceptions and wrong perceptions, and health system factors to achieve optimal health seeking behavior in such malaria endemic settings.

Project description:BACKGROUND:In Ethiopia malaria is one of the top ten leading causes of morbidity and mortality. Community knowledge of prevention and control methods had been proven to play an important role in the implementation of effective and sustainable interventions against malaria. This information is limited in the study area. This study aimed to assess knowledge of malaria prevention and control methods and its associated factors among households in West Belessa district, 2019. METHODS:Community-based cross-sectional mixed quantitative and qualitative study was conducted from April to June 2019 in West Belessa district, North West Ethiopia. Multistage sampling was used to select an estimated 770 sample size. A structured questionnaire was used for the quantitative component and semi-structured questionnaire for the qualitative component. Quantitative data were collected by interviewing and qualitative data using focus group discussion (FGD). Quantitative data was coded and entered using Epi info software version 7 then exported to SPSS version 20 for analysis. The binary logistic regression model was fitted to identify the associated factors. Odds Ratio (OR) with 95% Confidence Interval (CI) was used to assess the strength of association. The qualitative data was transcribed manually using the thematic approach. RESULT:A total of 770 subjects were included in this study with a 99.5% response rate. Of the total respondents, 75.6% had good knowledge of malaria prevention methods. LLINs and IRS were mentioned by 84.7 and 83.7% respectively. Poorest wealth quintiles [AOR?=?0.40, 95% CI: 0.23, 0.73], poor wealth quintiles [AOR?=?0.38, 95% CI: 0.21, 0.70], and medium wealth quintiles [AOR?=?0.41, 95% CI: 0.22, 0.76], living in Menti Kebele [AOR?=?3.07, 95% CI 1.85, 5.08], living in Abay tera kebele [AOR?=?2.00, 95% CI 1.21, 3.29] were significantly associated with good knowledge. About all of the focused group discussion (FGD) participants agreed that malaria is a preventable disease and mentioned some of the preventive methods. CONCLUSION:Overall there was relatively high knowledge of malaria prevention and control methods. LLINs and IRS were known malaria prevention methods in West Belessa. Wealth index and respondents living kebele are predictors for knowledge of malaria prevention.

Project description:BackgroundEthiopia's National Malaria Control and Elimination Program aims to diagnose all suspected malaria cases within 24 h of fever onset and provide prompt treatment for confirmed cases. This study explored psychosocial factors associated with no-, delayed- and prompt- care-seeking among female caregivers of children under five years with fever in rural Ethiopia.MethodsHousehold surveys were conducted from 2016-2019 among female caregivers (N = 479) of children under five years old with fever in Oromia; Amhara; Southern Nations, Nationalities, and Peoples Region (SNNPR); and Tigray. Prompt and delayed care-seeking were defined as seeking treatment within ≤ 24 h or > 24 h of symptom onset respectively. Contextual factors explored included sociodemographic factors, household supply of bed nets, exposure to health messages, and household vulnerability (a measure of financial access to food, shelter, schooling, and medical treatment). Ideational factors included psychosocial factors related to care-seeking (knowledge, self-efficacy, response efficacy, attitudes, involvement in decision-making, and household social support).ResultsThe prevalence of fever among children under five years was 18% (ranging from 9% in Tigray to 34% in SNNPR. Overall, 45% of caregivers of children with fever sought care promptly, while 23% delayed care-seeking and 32% sought no care. Prompt care-seeking rates were higher among caregivers with positive attitudes toward prompt care-seeking (48%), involved in decision-making (48%) or perceived equitable gender norms in the community (65%). Caregivers with a high care-seeking ideation had increased odds of prompt care-seeking (aOR: 2.65; 95% CI: 1.74-4.02). Significant contextual factors included residence in the Oromia region (aOR: 2.99; 95% CI:1.40-6.41), caregivers age 35-49 years (aOR: 0.49; 95% CI: 0.26-0.95), residence in vulnerable households (aOR: 2.01; 95% CI: 1.28-3.18).ConclusionsAmong this rural Ethiopian population, prompt care-seeking was low but positively influenced by both ideational and contextual psychosocial factors occurring at the caregiver level. Multi-sectoral interventions at the individual, community, and health facility levels are needed to improve prompt care-seeking. These include social behavior change interventions to improve ideation, complemented by health facility interventions to ensure provision of high-quality services and structural interventions to increase educational attainment in these rural settings.

Project description:ObjectivesTo examine the health-seeking behaviour and cost of fever treatment to households in Ghana.DesignCross-sectional household survey conducted between July and September 2015.SettingKassena-Nankana East and West districts in Upper East region of Ghana.ParticipantsIndividuals with an episode of fever in the 2 weeks preceding a visit during routine health and demographic surveillance system data collection were selected for the study. Sociodemographic characteristics, treatment-seeking behaviours and cost of treatment of fever were obtained from the respondents.ResultsOut of 1845 households visited, 21% (393 of 1845) reported an episode of fever. About 50% (195 of 393) of the fever cases had blood sample taken for testing by microscopy or Rapid Diagnostic Test, and 73.3% (143 of 195) were confirmed to have malaria. Of the 393 people with fever, 70% (271 of 393) reported taking an antimalarial and 24.0% (65 of 271) took antimalarial within 24 hours of the onset of illness. About 54% (145 of 271) of the antimalarials were obtained from health facilities.The average cost (direct and indirect) incurred by households per fever treatment was GH¢27.8/US$7.3 (range: GH¢0.2/US$0.1-GH¢200/US$52.6). This cost is 4.6 times the daily minimum wage of unskilled paid jobs of Ghanaians (US$1.6). The average cost incurred by those enrolled into the National Health Insurance Scheme (NHIS) was GH¢24.8/US$6.5, and GH¢50/US$11.6 for those not enrolled.ConclusionsPrompt treatment within 24 hours of onset of fever was low (24%) compared with the Roll Back Malaria Programme target of at least 80%. Cost of treatment was relatively high when compared with average earnings of households in Ghana and enrolment into the NHIS reduced the cost of fever treatment remarkably. It is important to improve access to malaria diagnosis, antimalarials and enrolment into the NHIS in order to improve the case management of fever/malaria and accelerate universal health coverage in Ghana.

Project description:BackgroundIn Ethiopia Plasmodium falciparum and Plasmodium vivax are the dominant species accounting for roughly 60 and 40% of malaria cases, respectively. Recently a major shift from P. falciparum to P. vivax has been observed in various parts of the country but the epidemiology of the other human malaria species, Plasmodium ovale spp. and Plasmodium malariae remains poorly understood. The aim of this study was to assess P. ovale curtisi and wallikeri infection in north-west Ethiopia by using microscopy and nested PCR.MethodsA health institution-based survey using non-probability sampling techniques was conducted at Maksegnet, Enfranze and Kola Diba health centres and Metema hospital in North Gondar. Three-hundred patients with signs and symptoms consistent with malaria were included in this study and capillary blood was collected for microscopic examination and molecular analysis of Plasmodium species. Samples were collected on Whatman 903 filter papers, stored in small plastic bags with desiccant and transported to Vienna (Austria) for molecular analysis. Data from study participants were entered and analysed by SPSS 20 software.ResultsOut of 300 study participants (167 males and 133 females), 184 samples were classified positive for malaria (133 P. falciparum and 51 P. vivax) by microscopy. By species-specific PCR 233 Plasmodium spp (95% CI: 72.6-82) were detected and the majority 155 (66.5%, 95% CI: 60.2-72.3) were P. falciparum followed by P. vivax 69 (29.6%, 95% CI; 24.1-35.8) and 9 (3.9%, 95% CI: 2-7.2) samples were positive for P. ovale. Seven of P. ovale parasites were confirmed as P. ovale wallikeri and two were confirmed as P. ovale curtisi. None of the samples tested positive for P. malariae. During microscopic examination there were high (16.3%) false negative reports and all mixed infections and P. ovale cases were missed or misclassified.ConclusionThis study indicates that P. ovale malaria is under-reported in Ethiopia and provides the first known evidence of the sympatric distribution of indigenous P. ovale wallikeri and P. ovale curtisi in Ethiopia. Therefore, further studies assessing the prevalence of the rare species P. ovale and P. malariae are urgently needed to better understand the species distribution and to adapt malaria control strategies.

Project description:BackgroundPlasmodium falciparum causes the majority of malaria cases worldwide and children in sub-Saharan Africa are the most vulnerable group affected. Non-sterile clinical immunity that protects from symptoms develops slowly and is relatively short-lived. Moreover, current malaria vaccine candidates fail to induce durable high-level protection in endemic settings, possibly due to the immunomodulatory effects of the malaria parasite itself. Because dendritic cells play a crucial role in initiating immune responses, the aim of this study was to better understand the impact of cumulative malaria exposure as well as concurrent P. falciparum infection on dendritic cell phenotype and function.MethodsIn this cross-sectional study, the phenotype and function of dendritic cells freshly isolated from peripheral blood samples of Malian adults with a lifelong history of malaria exposure who were either uninfected (n = 27) or asymptomatically infected with P. falciparum (n = 8) was assessed. Additionally, plasma cytokine and chemokine levels were measured in these adults and in Malian children (n = 19) with acute symptomatic malaria.ResultsWith the exception of lower plasmacytoid dendritic cell frequencies in asymptomatically infected Malian adults, peripheral blood dendritic cell subset frequencies and HLA-DR surface expression did not differ by infection status. Peripheral blood myeloid dendritic cells of uninfected Malian adults responded to in vitro stimulation with P. falciparum blood-stage parasites by up-regulating the costimulatory molecules HLA-DR, CD80, CD86 and CD40 and secreting IL-10, CXCL9 and CXCL10. In contrast, myeloid dendritic cells of asymptomatically infected Malian adults exhibited no significant responses above the uninfected red blood cell control. IL-10 and CXCL9 plasma levels were elevated in both asymptomatic adults and children with acute malaria.ConclusionsThe findings of this study indicate that myeloid dendritic cells of uninfected adults with a lifelong history of malaria exposure are able to up-regulate co-stimulatory molecules and produce cytokines. Whether mDCs of malaria-exposed individuals are efficient antigen-presenting cells capable of mounting an appropriate immune response remains to be determined. The data also highlights IL-10 and CXCL9 as important factors in both asymptomatic and acute malaria and add to the understanding of asymptomatic P. falciparum infections in malaria-endemic areas.