Malaria epidemiology and interventions in Ethiopia from 2001 to 2016

Abstract

BackgroundEthiopia is one of the African countries where Plasmodium falciparum and P. vivax co-exist. Monitoring and evaluation of current malaria transmission status is an important component of malaria control as it is a measure of the success of ongoing interventions and guides the planning of future control and elimination efforts.Main textWe evaluated changes in malaria control policy in Ethiopia, and reviewed dynamics of country-wide confirmed and clinical malaria cases by Plasmodium species and reported deaths for all ages and less than five years from 2001 to 2016. Districts level annual parasite incidence was analysed to characterize the malaria transmission stratification as implemented by the Ministry of Health. We found that Ethiopia has experienced major changes from 2003 to 2005 and subsequent adjustment in malaria diagnosis, treatment and vector control policy. Malaria interventions have been intensified represented by the increased insecticide treated net (ITN) and indoor residual spraying (IRS) coverage, improved health services and improved malaria diagnosis. However, countrywide ITN and IRS coverages were low, with 64% ITN coverage in 2016 and IRS coverage of 92.5% in 2016 and only implemented in epidemic-prone areas of > 2500 m elevation. Clinical malaria incidence rate dropped from an average of 43.1 cases per 1000 population annually between 2001 and 2010 to 29.0 cases per 1000 population annually between 2011 and 2016. Malaria deaths decreased from 2.1 deaths per 100 000 people annually between 2001 and 2010 to 1.1 deaths per 100 000 people annually between 2011 to 2016. There was shrinkage in the malaria transmission map and high transmission is limited mainly to the western international border area. Proportion of P. falciparum malaria remained nearly unchanged from 2000 to 2016 indicating further efforts are needed to suppress transmission.ConclusionsMalaria morbidity and mortality have been significantly reduced in Ethiopia since 2001, however, malaria case incidence is still high, and there were major gaps between ITN ownership and compliance in malarious areas. Additional efforts are needed to target the high transmission area of western Ethiopia to sustain the achievements made to date.Electronic supplementary materialThe online version of this article (10.1186/s40249-018-0487-3) contains supplementary material, which is available to authorized users.

A 7-Year Trend of Malaria at Primary Health Facilities in Northwest Ethiopia

“…In this study area, long-lasting insecticidal nets (LLIN) and IRS were used, though the coverage of IRS was low. This result was similar to the result of a study conducted by the Malaria Epidemiology and Interventions in Ethiopia, and it was reported that IRS coverage was low nationwide with an average coverage of 23% between 2014 and 2016 [7].…”

“…These results were similar to the results of a study on malaria epidemiology and interventions in Ethiopia which reported a decrease in malaria incidence and death rate in Ethiopia from 2001 to 2016. But malaria case number and incidence reported in 2016 exceeded the WHO standard for "pre-elimination strategy" [7]. This might be due to the use of propoxur instead of bendiocarb as indoor residual spray insecticide or relatively decreased number of subcities covered by chemical spray (Table 1).…”

“…In Ethiopia, the overall trends of malaria cases and deaths among under-five children decreased by 59.3% and 72.1%, respectively. On the other hand, malaria incidence rate decreased from an average of 43.1 to 29 cases and 2.1 to 1.1 deaths per 1000 people annually between 2001 and 2016 [7]. According to the 2016 Ethiopian malaria intervention report, there were 64% and 92.5% coverage of indoor residual spray (IRS) and insecticide-treated net (ITN), respectively [7].…”

A five year trend analysis of malaria prevalence in Guba district, Benishangul-Gumuz Regional State, western Ethiopia: A retrospective study

“…In the present retrospective data analysis, malaria prevalence trend appeared to be non-uctuating, in which the malaria positivity rate continued to show consistent decline in the past ve years. This nding is congruent with similar studies from several malaria endemic areas of Ethiopia which reported a decrease in malaria prevalence from 2001 to 2016 [2,17,[21][22]. Ethiopia has been implementing key malaria interventions, including use of insecticide treated net (ITN) and indoor residual spraying (IRS), prompt diagnosis and treatment with artemisinin-based combination therapy, intermittent preventive treatment in pregnancy and environmental management in integrated manner throughout the country since 2005 [1].…”

Linking insecticide-treated mosquito nets to malaria: The roles of malaria Knowledge and household-income

“…Additionally, most of these studies relied on the assessment of knowledge about malaria with speci c study populations. Studies indicate that Ethiopian communities are not well aware of the multi-dimensional challenges of the disease despite the acrimonious facts, misuse of ITN, and unsatisfactory malaria control methods reported [22][23][24][25][26]. Therefore, it is pertinent to consider the impact of knowledge on strategic interventions to prevent the spread of the disease.…”