Analysis of malaria surveillance data in Ethiopia: what can be learned from the Integrated Disease Surveillance and Response System?

Abstract

BackgroundRoutine malaria surveillance data is useful for assessing incidence and trends over time, and in stratification for targeting of malaria control. The reporting completeness and potential bias of such data needs assessment.MethodsData on 17 malaria indicators were extracted from the Integrated Disease Surveillance and Response System database for July 2004 to June 2009 (Ethiopian calendar reporting years 1997 to 2001). Reporting units were standardized over time with 2007 census populations. The data were analysed to show reporting completeness, variation in risk by reporting unit, and incidence trends for malaria indicators.ResultsReporting completeness, estimated as product of unit-month and health facility reporting, was over 80% until 2009, when it fell to 56% during a period of reorganization in the Ministry of Health. Nationally the average estimated annual incidence of reported total malaria for the calendar years 2005 to 2008 was 23.4 per 1000 persons, and of confirmed malaria was 7.6 per 1,000, with no clear decline in out-patient cases over the time period. Reported malaria in-patient admissions and deaths (averaging 6.4 per 10,000 and 2.3 per 100,000 per year respectively) declined threefold between 2005 and 2009, as did admissions and deaths reported as malaria with severe anaemia. Only 8 of 86 reporting units had average annual estimated incidence of confirmed malaria above 20 per 1,000 persons, while 26 units were consistently below five reported cases per 1,000 persons per year.ConclusionThe Integrated Disease Surveillance and Response System functioned well over the time period mid 2004 to the end of 2008. The data suggest that the scale up of interventions has had considerable impact on malaria in-patient cases and mortality, as reported from health centres and hospitals. These trends must be regarded as relative (over space and time) rather than absolute. The data can be used to stratify areas for improved targeting of control efforts to steadily reduce incidence. They also provide a baseline of incidence estimates against which to gauge future progress towards elimination. Inclusion of climate information over this time period and extension of the dataset to more years is needed to clarify the impact of control measures compared to natural cycles on malaria.

High Prevalence of Gametocyte Carriage among Individuals with Asymptomatic Malaria: Implications for Sustaining Malaria Control and Elimination Efforts in Ethiopia

“…7 In the last decade, massive scale-up of control interventions, including the distribution of long-lasting insecticidal nets and indoor residual spraying, together with the introduction of artemisinin-combination therapy, has led to substantial reductions in malaria prevalence and incidence in Ethiopia. [8][9][10] However, asymptomatic gametocytemia could sustain malaria transmission. Therefore, the aims of this study were to determine Plasmodium gametocyte carriage rate and parasitemia among asymptomatic individuals and to assess the risk factors associated with asymptomatic malaria in the suburbs of Jimma town, southwestern Ethiopia.…”

Effect of Crude Leaf Extract of Bauhinia strychnifolia in BALB/c Mice Infected with Plasmodium berghei

“…Antimalarial drug development can follow several strategies, which range from minor modifications of existing agents to the design of novel agents that act against new targets [3]. Natural products and plant extracts have been important sources of different drugs currently available to treat severe malaria [4,5]. Quinine and derivatives of artemisinin are the two most important products of plants useful in clinical practice.…”

A Five-Year Trend Analysis of Malaria Surveillance Data in Selected Zones of Amhara Region, Northwest Ethiopia

“…Gondar zones. This result shows a different report in Burundi 4,000(4/10,000 population) cases killed due to malaria and similar to five (0.23/100,000 Population) deaths in Botswana 2017 WHO report [3,5,8]. This significant difference may be due to outbreak conditions of the country and not timely treatment or arrival of cases to treatment centers and it requires further investigations.…”

“…However, malaria remains a major killer of children under five years old, taking the life of a child every two minutes [2]. 3 There have been over 9 million cases of malaria in the East African nation since January 2016, according to the report by the United Nation humanitarian office. In Zambia 119 593 (7.7/1000 population) cases were recorded in the first 11 weeks of 2017 compared to 73 019 and 82 328 cases for the same periods in 2016 and 2015.…”