Prevalence and associated risk factors of malaria among febrile under-five children visiting health facilities in Ziquala district, Northeast Ethiopia: A multicenter cross-sectional study

Abstract

Background Malaria is among the leading causes of mortality and morbidity among under five children in developing countries. Ethiopia has set targets for controlling and eliminating malaria through at-risk group interventions. However, the disease remains a serious public health concern in endemic areas like in Wollo, Northeast Ethiopia. Therefore, this study aimed to determine malaria prevalence, risk factors and parasite density among under five children in Ziquala district. Method A facility—based cross-sectional study was conducted in Ziquala hospital, and Tsitsika, Mishra and Hamusit health centers in Ziquala district, Northeast Ethiopia, from January 2022 to April 2022. The study enrolled a total of 633 under five children using a systematic sampling technique. A capillary blood sample was collected from each child to prepared thin and thick blood smears. Smears were then stained with 10% Giemsa and examined under light microscope. A pretested structured questionnaire was used to collect on socio-demographic data, parental/caregiver knowledge, and malaria determining factors. Bivariable and multivariable logistic regression analysis was done to identify factors associated with malaria. Result The overall prevalence of malaria among children visiting Ziquala district health institutions was 24.6% (156/633). Plasmodium falciparum, P. vivax, and mixed infection (both species) accounted for 57.1%, 38.5%, and 4.5% of the cases, respectively. Regarding to parasite load, moderate parasitemia was the most common, followed by low and high parasitemia with the proportion of 53.8%, 31.4% and 14.7% parasite density, respectively. Malaria infection was linked to irregular utilization of insecticide-treated bed nets (AOR = 5.042; 95% CI: 2.321–10.949), staying outside at night (AOR = 2.109; 95% CI: 1.066–4.173), and parents not receiving malaria health education in the past six months (AOR = 4.858; 95% CI: 2.371–9.956). Conclusion Malaria was prevalent among children under the age of five enrolled in the study. The local government should focus on regular insecticide treated net utilization, reducing the risk of mosquito bites while sleeping outdoors at night and increasing public understanding of malaria prevention and control through health education would also help to minimize the burden of malaria.

Symptomatic and asymptomatic malaria prevalence and its determinant factors in pastoral communities of Waghemira Zone, Northeast Ethiopia: A community‐based cross‐sectional study

“…This disparity could be attributed to differences in study design and setting; for example, the study in Ibadan, Nigeria, was done in health facilities, which may have overestimated the prevalence compared to a community‐based study. In contrary to this, the prevalence of symptomatic malaria in this study was higher than reported in Ziquala district, Northeast Ethiopia (24.6%), 44 Lake Tana and its surrounding areas, Northwest Ethiopia 24.7%, 45 the Mount Cameroon area (41.7%), 46 the Pakro subdistrict of Ghana 32.9%, 47 and Dzanga Sangha Region, Central African Republic (35.2%) 48 and Malawi (19.0%) 49 . This variation might be attributed to the different data collection periods, settings, laboratory method, and laboratory personnel skills.…”

“…Similarly, people who stayed outside at night were approximately five times more likely to be infected with malaria than those who did not. This finding was supported by a report from the Ziquala, Armachiho, and Dembia districts of the Amhara region of Ethiopia 44,58,59 . This could be explained by the exophagic—exophilic biting behaviors of mosquitoes 60 .…”

“…This finding was supported by a report from the Ziquala, Armachiho, and Dembia districts of the Amhara region of Ethiopia. 44,58,59 This could be explained by the exophagic-exophilic biting behaviors of mosquitoes. 60 This could also be attributed to the hot weather, as people prefer to sleep outside to get fresh air and cool off, and this could make it difficult to use ITNs while sleeping outside.…”

Potential hiddenPlasmodium vivaxmalaria reservoirs from low parasitemia Duffy-negative Ethiopians: molecular evidence

“…falciparum). Parasitemia was then classified as low (<1000 parasites per microliter of blood), intermediate (1000-4999 parasites per microliter of blood) and high (≥5000 parasites per microliter of blood) (24). Slides were declared negative after examination of at least 100 highpower microscope fields (25).…”

“…; https://doi.org/10.1101/2023.04. 24.23289013 doi: medRxiv preprint Saharan Africa (18,19). However, recent studies have shown that P. vivax can infect Duffynegative reticulocytes (20), and is no longer a barrier to such infections (21).…”