Description of malaria epidemics and normal transmissions using rainfall variability in Gondar Zuria highland District, Ethiopia

Lemma, Wossenseged

doi:10.1016/j.heliyon.2021.e07653

Cited by 5 publications

(2 citation statements)

References 27 publications

(55 reference statements)

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“…This difference can be attributed to more significant socioeconomic inequalities such as poverty, poorer access to health care, and a higher proportion of inadequate infrastructure, contributing to increased malaria vulnerability in Esmeraldas [ 27 ]. In addition, environmental conditions such as proximity to stagnant water and deforestation create favourable breeding grounds for disease vectors [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of inpatient data on dengue fever, malaria and leishmaniasis in Ecuador: A cross-sectional national study, 2015–2022

Acosta-España,

Dueñas-Espín,

Grijalva Narvaez

et al. 2024

New Microbes and New Infections

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Section: Discussionmentioning

confidence: 99%

Analysis of inpatient data on dengue fever, malaria and leishmaniasis in Ecuador: A cross-sectional national study, 2015–2022

Acosta-España,

Dueñas-Espín,

Grijalva Narvaez

et al. 2024

New Microbes and New Infections

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“…In both study sites, malaria is routinely diagnosed by microscopy in health centres and hospitals, but RDTs are used by health extension workers. The annual malaria incidence per 1000 persons in the Gondar region was estimated to range from 24 to 139 cases from 2019 to 2021 (Lemma, 2021). Among the population of the current study, malaria slide positivity in Gondar was 10.1% in the wet season and 9.3% in the dry season.…”

Section: Methodsmentioning

confidence: 99%

Plasmodium falciparum transmission in the highlands of Ethiopia is driven by closely related and clonal parasites

Holzschuh,

Ewnetu,

Carlier

et al. 2024

Molecular Ecology

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Malaria cases are frequently recorded in the Ethiopian highlands even at altitudes above 2000 m. The epidemiology of malaria in the Ethiopian highlands, and, in particular, the role of importation by human migration from the highly endemic lowlands is not well understood. We sequenced 187 Plasmodium falciparum samples from two sites in the Ethiopian highlands, Gondar (n = 159) and Ziway (n = 28), using a multiplexed droplet digital PCR (ddPCR)‐based amplicon sequencing method targeting 35 microhaplotypes and drug resistance loci. Here, we characterize the parasite population structure and genetic relatedness. We identify moderate parasite diversity (mean HE: 0.54) and low infection complexity (74.9% monoclonal). A significant percentage of infections share microhaplotypes, even across transmission seasons and sites, indicating persistent local transmission. We identify multiple clusters of clonal or near‐clonal infections, highlighting high genetic relatedness. Only 6.3% of individuals diagnosed with P. falciparum reported recent travel. Yet, in clonal or near‐clonal clusters, infections of travellers were frequently observed first in time, suggesting that parasites may have been imported and then transmitted locally. 31.1% of infections are pfhrp2‐deleted and 84.4% pfhrp3‐deleted, and 28.7% have pfhrp2/3 double deletions. Parasites with pfhrp2/3 deletions and wild‐type parasites are genetically distinct. Mutations associated with resistance to sulphadoxine–pyrimethamine or suggested to reduce sensitivity to lumefantrine are observed at near‐fixation. In conclusion, genomic data corroborate local transmission and the importance of intensified control in the Ethiopian highlands.

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Highland Malaria Transmission Dynamics in Space and Time Before Pre-elimination Era, Northwest Ethiopia

Ewnetu

Lemma

2022

J Epidemiol Glob Health

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Background Currently, the district-level malaria transmission stratification has indicated the Northern, Northwestern, Southern, and rift valley lowland and surrounding highland districts are almost entirely classified as high or moderate malaria transmission zones. Conducting malaria surveillance to track, test, and treat all malaria cases cannot be implemented in Ethiopia in the current situation. Objective To show malaria transmission dynamics in different health facilities located from 1800 to 2772 m altitudes during 2018–2021 in Northwest Ethiopia. Methods A total of 3.5 years (2018–2021) retrospective confirmed and treated malaria cases in 43 kebeles health posts and clinics in Gondar Zuria district were used for analysis. Result The total malaria count was 5893 for 2019 compared to 31, 550 for 2020 and 33, 248 for 2021. Mean monthly malaria incidence/1000 people in 2019 was 2.39 ± 5.4 and increased to 10.64 ± 16.99 in 2020 and 11.19 ± 16.59 in 2021. Annual malaria incidence increased from 24 cases/1000 people in 2019 to 139.08 cases/1000 people in 2021 and is alarming danger in malaria elimination program in the district or the country as a whole. Poisson and Negative binomial regressions models indicated 5.78- and 5.26-fold malaria cases increase, respectively, in 2021 compared to 2019. The sudden increase in malaria incidences (counts) in 2020 and 2021 coincided with the interruption of residual insecticide application in Gondar Zuria district during the transition period towards the malaria pre-elimination stage implicating the role of malaria control tools in suppressing transmission. Study on climate variability also indicated that the rainfall variability in different months might have also favored high malaria transmission in 2020 and 2021 compared to 2019. Thus, in addition to re-starting the use of malaria control tools, giving attention to climate anomalies (variability) that favors malaria transmission, for prompt interventional actions, is required. The malaria elimination program in Ethiopia might have not reached a pre-elimination stage as malaria cases per 1000 people have not decreased below five in the majority of Ethiopian districts. Tracing, confirming, and treating individual cases to stop further transmission is, almost, impossible. In a situation like this, the Ethiopian malaria elimination program should work intensively towards understanding malaria epidemiology at the district level to re-design a localized malaria control strategy. The renewed malaria control program should also consider altitudes above 2000 m.

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Description of malaria epidemics and normal transmissions using rainfall variability in Gondar Zuria highland District, Ethiopia

Cited by 5 publications

References 27 publications

Analysis of inpatient data on dengue fever, malaria and leishmaniasis in Ecuador: A cross-sectional national study, 2015–2022

Analysis of inpatient data on dengue fever, malaria and leishmaniasis in Ecuador: A cross-sectional national study, 2015–2022

Plasmodium falciparum transmission in the highlands of Ethiopia is driven by closely related and clonal parasites

Highland Malaria Transmission Dynamics in Space and Time Before Pre-elimination Era, Northwest Ethiopia

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