Community knowledge, perceptions, and practices regarding malaria and its control in Jabi Tehnan district, Amhara Region, Northwest Ethiopia

BACKGROUND : Use of long-lasting insecticidal nets (LLINs), indoor residual spraying (IRS), community-based malaria education, prompt diagnosis and treatment are key programme components of malaria prevention and control in Ethiopia. However, the effectiveness of these interventions is often undermined by various challenges, including insecticide and drug resistance, the plasticity of malaria vectors feeding and biting behaviour, and certain household factors that lead to misuse and poor utilization of LLINs. The primary objective of this study was to document households’ perceptions towards malaria and assess the prevalence of the disease and the constraints related to the ongoing interventions in Ethiopia (LLINs, IRS, community mobilization house screening). METHODS : The study was conducted in Jabi Tehnan district, Northwestern Ethiopia, from November 2019 to March 2020. A total of 3010 households from 38 villages were randomly selected for socio-economic and demographic survey. Focus group discussions (FGDs) were conducted in 11 different health clusters considering agro-ecological differences. A total of 1256 children under 10 years of age were screened for malaria parasites using microscopy to determine malaria prevalence. Furthermore, 5-year malaria trend analysis was undertaken based on data obtained from the district health office to understand the disease dynamics. RESULTS : Malaria knowledge in the area was high as all FGD participants correctly identified mosquito bites during the night as sources of malaria transmission. Delayed health-seeking behaviour remains a key behavioural challenge in malaria control as it took patients on average 4 days before reporting the case at the nearby health facility. On average, households lost 2.53 working days per person-per malaria episode and they spent US$ 18 per person per episode. Out of the 1256 randomly selected under 10 children tested for malaria parasites, 11 (0.89%) were found to be positive. Malaria disproportionately affected the adult segment of the population more, with 50% of the total cases reported from households being from among individuals who were 15 years or older. The second most affected group was the age group between 5 and 14 years followed by children aged under 5, with 31% and 14% burden, respectively. CONCLUSION : Despite the achievement of universal coverage in terms of LLINs access, utilization of vector control interventions in the area remained low. Using bed nets for unintended purposes remained a major challenge. Therefore, continued community education and communication work should be prioritized in the study area to bring about the desired behavioural changes.Additional file 1: Plate S1. Intact bed net is being used for unintended purpose such as transporting bag for crops from field to home (Photo courtesy: Abebe Asale).Additional file 2: Plate S2. Intact bed net is being used for unintended purpose such as bag for animal feed or hay near home (Photo courtesy: Abebe Asale).Norwegian Agency for Development Cooperation (NORAD)http://www.malariajournal.comam2022School of Health Systems and Public Health (SHSPH

The combined impact of LLINs, house screening, and pull‑push technology for improved malaria control and livelihoods in rural Ethiopia : study protocol for household randomised controlled trial

ADDITIONAL FILE 1. Ethics Review approval letter.ADDITIONAL FILE 2. Ethics information sheet and consent form.BACKGROUND : The combined application of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are commonly used malaria interventions that target indoor Anopheles vectors. Recent studies on the effects of house screening (HS) and LLINs have demonstrated a reduction in indoor vector densities and malaria when the interventions are combined. In addition, complementary interventions are needed to curb co-occurring pest populations which pose menace to agricultural crop productivity and food security. However, interventions that impact malaria mainly centre on public health strategies, overlooking subtle but important component of agricultural measures. Addressing the coexisting risks of malaria and crop pests could contribute to improved livelihood of communities. METHODS : A four-armed household, cluster-randomized, controlled study will be conducted to assess the combined impact of HS, LLINs and push-pull agricultural technology (PPT) against clinical malaria in children in Ethiopia. The unit of randomization will be the household, which includes a house and its occupants. A total of 838 households will be enrolled in this study. In this trial 246 households will receive LLINs and HS, 250 will receive LLINs, HS and PPT, 175 households will receive LLINs and PPT. The remaining 167 houses which receive LLINs only will be used as control. One child aged ≤14 years will be enrolled per household in each treatment and followed for clinical malaria using active case detection to estimate malaria incidence for two malaria transmission seasons. DISCUSSION : Episodes of clinical malaria, density of indoor biting malaria vectors, sporozoite infection rate, improved crop infestation rate, crop yield gain, livestock productivity and cost effectiveness analysis will be the end points of this study. Socio-economic, social demographic, cost-effectiveness analysis will be conducted using qualitative and participatory methods to explore the acceptability of HS and PPT. Documenting the combined impact of LLINs, HS and PPT on the prevalence of clinical malaria and crop pest damage will be the first of its kind. TRIAL REGISTRATION : Pan African Clinical Trials Registry, PACTR202006878245287. 24/06/2020.Norwegian Agency for Development Cooperation (NORAD) through the project Combating Arthropod Pests for Better Health, Food and Resilience to Climate Change (CAP-Africa).http://www.biomedcentral.com/bmcpublichealtham2023School of Health Systems and Public Health (SHSPH)UP Centre for Sustainable Malaria Control (UP CSMC

Effect of the Push-Pull Cropping System on Maize Yield, Stem Borer Infestation and Farmers’ Perception

The productivity of maize in Ethiopia has remained lower than the world average because of several biotic and abiotic factors. Stemborers and poor soil fertility are among the main factors that contribute to this poor maize productivity. A novel cropping strategy, such as the use of push-pull technology, is one of the methods known to solve both challenges at once. A push-pull technology targeting the management of maize stemborers was implemented in the Hawassa district of Ethiopia with the ultimate goal of increased food security among smallholder farmers. This study evaluated farmers’ perception of push-pull technology based on their experiences and observations of the demonstration plots that were established on-farm in Dore Bafano, Jara Gelelcha and Lebu Koremo village of the Hawasa district in 2016 and 2017. This study examined farmers’ perception of the importance of push-pull technology in controlling stemborers and improving soil fertility and access to livestock feed. In both cropping seasons, except for Jara Gelelcha, the maize grain yields were significantly higher in the climate-adapted push-pull plots compared to the maize monocrop plots. The majority (89%) of push-pull technology-practising farmers rated the technology better than their maize production methods on attributes such as access to new livestock feed and the control of stemborer damage. As a result, approximately 96% of the interviewed farmers were interested in adopting the technology starting in the upcoming crop season. Awareness through training and effective dissemination strategies should be strengthened among stakeholders and policymakers for the sustainable use and scaling-up of push-pull technology