Community awareness about malaria, its treatment and mosquito vector in rural highlands of central Ethiopia

Background: Despite the rapid expansion of malaria into highland areas of Ethiopia and the movement of malaria inexperienced people to endemic areas, there is no enough information about how highland communities perceive malaria.Objective: To assess communities’ awareness of malaria and its mosquito vector in highland rural communities of central Ethiopia.Methods: A community-based cross–sectional survey involved 770 heads of household was conducted during September 2005 to February 2006 in nine peasant associations of five purposely selected districts in highland areas where malaria has been recently introduced, or currently free from the disease.Results: The majority of the study participants knew that malaria is a serious disease that can attack all age groups of a population (81.0%). A considerable number of individuals, 357 (47.5%) responded that they visited malarious area and about 50% of these individuals reported that they or their families had got the disease. A large proportion ofparticipants (81.6%) mentioned that mosquito transmits malaria through biting (91.6%), while 176 (42.6%) individuals are aware that mosquitoes bite during night. Participants from Sheno, Muka Turi and Sululita areas were found to better in associating the cause of malaria with mosquito bites than those participants from Ginchi and Holeta areas (

Acceptability of Provider Initiated HIV Counseling and Testing among Tuberculosis and Non-tuberculosis Patients in Shashemene Town, Ethiopia

The objective of the study was to assess the acceptability of Provider Initiated HIV Counseling and Testing (PIHCT) and factors influencing its service uptake among TB and non TB patients in Shashemene town of West Arsi Zone. Institution-based, comparative cross-sectional study was conducted from January to February 2010, on 237 TB patients attending Tuberculosis clinics and 236 non TB patients who were offered PIHCT from outpatient department of Shashemene Hospital and Health Center. Data were collected using consecutive sampling until the required sample size was attained using structured questionnaire. Majority of the participants were male 286(60.5%), in the age group 25-34 years 172(36.4%), Muslim by religion 233 (49%).Among 473 study participants 86.3% (89.9% TB versus 82.6% non TB) had accepted PIHCT. TB patients are more likely to accept PICHT than non TB patients at AOR= 2.6; 95% CI (1.3, 5.0). Those who support importance of PIHCT were more likely to accept PIHCT at AOR=11.4; 95% CI (5.1, 25.4) than those who are against PIHCT. The acceptance rate of PIHCT is relatively higher in this study; TB patients were more likely to accept PIHCT than non TB patients. The programme needs to be strengthened in all settings for both TB and non TB patients since HIV testing and counseling stands out as paramount both in treatment and in prevention of HIV/AIDS

Correlation of climate variability and malaria: A retrospective comparative study, Southwest Ethiopia

BACKGROUND: Climatic variables can determine malaria transmission dynamics. To see the correlation between malaria occurrence and climatic variables, records of malaria episodes over eight years period were analyzed incorporating climatic variables around Gilgel-Gibe Hydroelectric Dam and control sites.METHODS: Records of 99,206 confirmed malaria episodes registered between 2003 and 2011 were analyzed along with local meteorological data of the same duration. Data were analyzed with SPSS statistical software version 20 for Windows. Spearman correlation coefficient was estimated as a measure of the correlation.RESULTS: The major peaks of malaria prevalence were observed following the peaks of rainfall in the Gilgel-Gibe Hydroelectric Dam site. In the control site, the peaks of malaria in some years coincided with the peaks of rainfall, and the pattern of rainfall was relatively less fluctuating. Mean rainfall was negatively correlated with number of malaria cases at lags of 0 and 1 month, but positively correlated at lags of 2 to 4 months. Mean relative humidity showed significant positive correlations at lags of 3 to 4 months. Monthly mean maximum and minimum temperatures weakly correlated at lags of 0 to 4 months.CONCLUSIONS: Correlations of malaria and climate variables were different for the two sites; in Gilgel-Gibe, rainfall and relative humidity showed positive correlations. However, in the control site, the correlation of weather variables and malaria episodes were insignificant. Exploration of additional factors such as vegetation index and physico-chemical nature of mosquito breeding site may improve understanding of determinants of malaria dynamics in the area.KEYWORDS: climatic variables, correlations, Ethiopia, Gilgel-Gibe, malari

Concerns about covert HIV testing are associated with delayed presentation of suspected malaria in Ethiopian children: a cross-sectional study

BACKGROUND Early diagnosis is important in preventing mortality from malaria. The hypothesis that guardians' fear of covert human immunodeficiency virus (HIV) testing delays presentation of children with suspected malaria was tested. METHODS The study design is a cross-sectional survey. The study population consisted of guardians of children with suspected malaria who presented to health centres in Oromia Region, Ethiopia. Data were collected on attitudes to HIV testing and the duration of children's symptoms using interview administered questionnaires. RESULTS Some 830 individuals provided data representing a response rate of 99% of eligible participants. Of these, 423 (51%) guardians perceived that HIV testing was routinely done on blood donated for malaria diagnosis, and 353 (43%) were aware of community members who delayed seeking medical advice because of these concerns. Children whose guardians suspected that blood was covertly tested for HIV had longer median delay to presentation for evaluation at health centres compared to those children whose guardians did not hold this belief (three days compared to two days, p < 0.001). Children whose guardians were concerned about covert HIV testing were at a higher odds of a prolonged delay before being seen at a health centre (odds ratio 1.73, 95% confidence intervals: 1.10 to 270 for a delay of ≥ 3 days compared to those seen in ≤ 2 days). CONCLUSION Children whose guardians believed that covert testing for HIV was routine clinical practice presented later for investigation of suspected malaria. This may account for up to 14% of the delay in presentation and represents a reversible risk factor for suboptimal management of malaria

Prevalence and associated risk factors of malaria among adults in East Shewa Zone of Oromia Regional State, Ethiopia: a cross-sectional study

BACKGROUND: Malaria is one of the most important causes of morbidity and mortality in sub-Saharan Africa. The disease is prevalent in over 75% of the country's area making it the leading public health problems in the country. Information on the prevalence of malaria and its associated factors is vital to focus and improve malaria interventions. METHODS: A cross-sectional study was carried out from October to November 2012 in East Shewa zone of Oromia Regional State, Ethiopia. Adults aged 16 or more years with suspected malaria attending five health centers were eligible for the study. Logistic regression models were used to examine the effect of each independent variable on risk of subsequent diagnosis of malaria. RESULTS: Of 810 suspected adult malaria patients who participated in the study, 204 (25%) had microscopically confirmed malaria parasites. The dominant Plasmodium species were P. vivax (54%) and P. falciparum (45%), with mixed infection of both species in one patient. A positive microscopic result was significantly associated with being in the age group of 16 to 24 years [Adjusted Odds Ratio aOR 6.7; 95% CI: 2.3 to 19.5], 25 to 34 years [aOR 4.2; 95% CI: 1.4 to 12.4], and 35 to 44 years [aOR 3.7; 95% CI: 1.2-11.4] compared to 45 years or older; being treated at Meki health center [aOR 4.1; 95% CI: 2.4 to 7.1], being in Shashemene health center [aOR = 2.3; 95% CI: 1.5 to 4.5], and living in a rural area compared to an urban area [aOR 1.7; 95% CI: 1.1 to 2.6)]. CONCLUSION: Malaria is an important public health problem among adults in the study area with a predominance of P. vivax and P. falciparum infection. Thus, appropriate health interventions should be implemented to prevent and control the disease

Climate Variability and Change: Implications for Malaria Control and Elimination in Africa

In Ethiopia, malaria continues to be a major public health concern with an estimated two thirds of the national population at risk of infection. Tackling a key driver, this workshop was convened to advance the understanding of the impact of climate variability and change in relation to the malaria burden to better inform policy decisions related to current control and future elimination strategies. To achieve this, the workshop explored data, methodologies and tools that could be used by national public health researchers to improve malaria risk assessments. The motivation for the workshop came from an NIH funded project entitled “Climate Variability and Change: Implications for Malaria Control and Elimination in Africa” with the goal of supporting malaria researchers in affected countries in East Africa to identify opportunities for improving the effectiveness of prevention, control and elimination strategies by incorporating an understanding of likely short and longer term changes in the climate in their analysis. In particular, the workshop aimed to address the challenge of varied drivers of the climate, acting at multiple timescales including year to year variability, 10-20 year climate shifts and long term trends associated with climate change. Data sources explored during the workshop included the newly developed Enhanced National Climate Services (ENACTS) rainfall and temperature products disseminated by the Ethiopian National Meteorological Agency (NMA), as well as globally available climate products freely distributed online. The Climate Predictability Tool (CPT), developed by the International Research Institute for Climate and Society (IRI), to assist climatologists in making robust predictions was tested for the first time as a potential tool for the malaria research community to assess the relationship of malaria to large-scale climate processes. In addition, a multi-model malaria platform (MMMP) was presented during the workshop to explore uncertainty associated with the predictability of malaria over time using a series of process-based models

Knowledge of Malaria and Its Association with Malaria-Related Behaviors—Results from the Malaria Indicator Survey, Ethiopia, 2007

Background: In 2005, the Ministry of Health in Ethiopia launched a major effort to distribute over 20 million long-lasting insecticidal nets, provide universal access to artemisinin-based combination therapy (ACTs), and train 30,000 village-based health extension workers.\ud \ud Methods and Findings: A cross-sectional, nationally representative Malaria Indicator Survey was conducted during the malaria transmission season in 2007. Multivariate logistic regression analyses were performed to assess the effect of women's malaria knowledge on household ITN ownership and women's ITN use. In addition, we investigated the effect of mothers' malaria knowledge on their children under 5 years of age's (U5) ITN use and their access to fever treatment on behalf of their child U5. Malaria knowledge was based on a composite index about the causes, symptoms, danger signs and prevention of malaria. Approximately 67% of women (n = 5,949) and mothers of children U5 (n = 3,447) reported some knowledge of malaria. Women's knowledge of malaria was significantly associated with household ITN ownership (adjusted Odds Ratio [aOR] = 2.1; 95% confidence interval [CI] 1.6–2.7) and with increased ITN use for themselves (aOR = 1.8; 95% CI 1.3–2.5). Knowledge of malaria amongst mothers of children U5 was associated with ITN use for their children U5 (aOR = 1.6; 95% CI 1.1–2.4), but not significantly associated with their children U5 seeking care for a fever. School attendance was a significant factor in women's ITN use (aOR = 2.0; 95% CI 1.1–3.9), their children U5′s ITN use (aOR = 4.4; 95% CI 1.6–12.1), and their children U5 having sought treatment for a fever (aOR = 6.5; 95% CI 1.9–22.9).\ud \ud Conclusions: Along with mass free distribution of ITNs and universal access to ACTs, delivery of targeted malaria educational information to women could improve ITN ownership and use. Efforts to control malaria could be influenced by progress towards broader goals of improving access to education, especially for women

Prevalence and risk factors for initiating alcohol and tobacco consumption in adolescents living in urban and rural Ethiopia

© 2019 The Authors Objectives: African countries are potential high growth markets for the alcohol and tobacco industries. This study aimed to identify exposures that are associated with initiating use of alcohol and tobacco products in young people living in Ethiopia. As televised football and Internet viewing are media through which products can be promoted to this population efficiently, these risk factors were of particular interest. Study design: This is a cross-sectional study. Methods: Data were collected using a self-administered questionnaire of 3967 children aged 13–19 years in 20 high schools in urban and rural Ethiopia on consumption and risk factors for alcohol and tobacco use in 2016, as well as exposure to potential sources of advertising. Results: Eight percent of respondents reported having ever smoked and 3% were current smokers. Twenty-nine percent reported ever having used alcohol, and 14% were current users. Risk factors for ever smoking included father smoking (odds ratio [OR] 1.95; 95% confidence interval [CI]: 1.21 to 3.15), mother smoking (OR 3.90; 95% CI: 1.63 to 9.33), best friend smoking (OR 5.86; 95% CI: 4.31 to 7.96) and home Internet access (OR 1.75; 95% CI: 1.35 to 2.27). There was a very strong positive association between ever having smoked cigarettes and ever having tried alcohol (P < 0.001). Risk factors for currently drinking alcohol included father drinking (OR 1.45; 95% CI: 1.05 to 2.01), mother drinking (OR 2.00; 95% CI: 1.44 to 2.77), home Internet access (OR 1.53; 95% CI: 1.24 to 1.90) and regular watching of televised football (OR 2.44 compared to those who do not; 95% CI: 1.58 to 3.78). Conclusions: As in rich countries, tobacco and alcohol use among Ethiopian teenagers increases among those exposed to family and peer use but are also more common among those accessing the Internet and, for alcohol, those watching televised football. The effect of watching televised football on alcohol use, at least, is likely to be due to exposure to advertising

Treatment-seeking behaviour for febrile illness in an area of seasonal malaria transmission in rural Ethiopia

BACKGROUND: Very little is known about the management of malaria and treatment-seeking patterns among children and adults in areas of seasonal malaria transmission particularly in east Africa. OBJECTIVES: The aim of this study was to assess treatment-seeking behaviour for reported malaria among all age groups in an area of seasonal transmission. METHODS: A community-based cross-sectional study was carried out among 2,253 households in 12 randomly selected rural kebeles in Adami Tulu district in south-central Ethiopia, during October-November 2003, using a pre-tested interviewer-administered structured questionnaire. RESULTS: Reported malaria was 14% among 12,225 people assessed during the last 14 days. Family/self-diagnosis was most common and the main first responses included visiting village-based community health workers (CHWs) (33%), public health facility (23%) and private clinic (17%). Home treatment was the least reported first response (3%). Only 13% had sought treatment within the first 24 hours of symptom onset. Early treatment-seeking pattern was reported among those who visited CHWs and practiced home treatment, with more delays among public facility users. Treatment-seeking behaviour was similar in all age groups. CONCLUSION: A considerable proportion of visits were made to CHWs and private providers, necessitating the importance of strengthening both community-based interventions and peripheral public and private facilities. Finally, the community should be informed and educated about the importance of early diagnosis and prompt treatment with effective antimalarials

Factors influencing the ownership and utilization of long-lasting insecticidal nets for malaria prevention in Ethiopia

Background Utilization of long-lasting insecticidal nets (LLINs) is regarded as key malaria prevention and control strategy. However, studies have reported a large gap in terms of both ownership and utilization particularly in the sub-Saharan Africa (SSA). With continual efforts to improve the use of LLIN and to progress malaria elimination, examining the factors influencing the ownership and usage of LLIN is of high importance. Therefore, the current study was conducted to examine the level of ownership and use of LLIN along with identification of associated factors at household level. Methods A cross-sectional study was conducted in Mirab Abaya District, Southern Ethiopia in June and July 2014. A total of 540 households, with an estimated 2690 members, were selected in four kebeles of the district known to have high incidence of malaria. Trained data collectors interviewed household heads to collect information on the knowledge, ownership and utilization of LLINs, which was complemented by direct observation on the conditions and use of the nets through house-to-house visit. Bivariate and multivariable logistic regression analyses were used to determine factors associated to LLIN use. Results Of 540 households intended to be included in the survey, 507 responded to the study (94.24% response rate), covering the homes of 2759 people. More than 58% of the households had family size >5 (the regional average), and 60.2% of them had at least one child below the age of 5 years. The ownership of at least one LLIN among households surveyed was 89.9%, and using at least one LLIN during the night prior to the survey among net owners was 85.1% (n = 456). Only 36.7% (186) mentioned at least as the mean of correct scores of all participants for 14 possible malaria symptoms and 32.7% (166) knew at least as the mean of correct scores of all participants for possible preventive methods. Over 30% of nets owned by the households were out of use. After controlling for confounding factors, having two or more sleeping places (adjusted odds ratio [aOR] = 2.58, 95% CI 1.17, 5.73), knowledge that LLIN prevents malaria (aOR = 2.51, 95% CI 1.17, 5.37), the presence of hanging bed nets (aOR = 19.24, 95% CI 9.24, 40.07) and walls of the house plastered or painted >12 months ago (aOR = 0.09, 95% CI 0.01, 0.71) were important predictors of LLIN utilization. Conclusions This study found a higher proportion of LLIN ownership and utilization by households than had previously been found in similar studies in Ethiopia, and in many studies in SSA. However, poor knowledge of the transmission mechanisms and the symptoms of malaria, and vector control measures to prevent malaria were evident. Moderate proportions of nets were found to be out of use or in poor repair. Efforts should be in place to maintain the current rate of utilization of LLIN in the district and improve on the identified gaps in order to support the elimination of malaria