Hindawi
Journal of Parasitology Research
Volume 2022, Article ID 5170550, 8 pages
https://doi.org/10.1155/2022/5170550
Research Article
A Retrospective Analysis of Malaria Trends in Maksegnit Health
Center over the Last Seven Years, Northwest Ethiopia: 2014-2020
Tegegne Eshetu ,1 Bedruzeman Muhamed,2 Merima Awol,2 Zebie Kassa,2 Mehabaw Getu,2
Adane Derso ,1 Aberham Abere,1 and Ayalew Jejaw Zeleke 1
1
Department of Medical Parasitology, School of Biomedical and Laboratory Science, College of Medicine and Health Sciences,
University of Gondar, P. O. Box: 196, Gondar, Ethiopia
2
School of Biomedical and Laboratory Science, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196,
Gondar, Ethiopia
Correspondence should be addressed to Tegegne Eshetu; tegegneeshetu5@gmail.com
Received 12 November 2021; Revised 31 March 2022; Accepted 3 May 2022; Published 24 May 2022
Academic Editor: Bernard Marchand
Copyright © 2022 Tegegne Eshetu et al. This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Background. In Ethiopia, despite various public health intervention approaches have been implemented to eliminate malaria, its
public health problem remains considerable. There are such numerous studies; however, investigating the trend of malaria
infection in various settings is paramount for area-specific evidence-based interventions, evaluating ongoing malaria control
programs. Hence, since the trend of malaria infection in Maksegnit has not yet been documented, this study is aimed at
assessing the seven-year trend of malaria in Maksegnit Health Center. Methods. An institutional-based retrospective study was
conducted to assess the trend of malaria prevalence over the last seven years (2014-2020) using recorded blood smear reports
in the laboratory logbook in Maksegnit Health Center, Northwest Ethiopia. Result. Over the last seven years, a total of 28217
clinically malaria-suspected individuals were requested for blood film examination at Maksegnit Health Center. Of whom,
microscopically confirmed malaria case was found in 4641/28217 (16.4%). A significant seasonal and interannual variation of
malaria cases was observed (P < 0:001). The highest prevalence was observed in years 2014 (25.5%) and 2020 (25.1%), while
the minimum annual prevalence was seen in 2017/18 (6.4%). The month of October (25.5%) had the highest number of
malaria cases documented, while February had the least (4.7%). Males and individuals under the age group of 15-45 were the
most affected segments of the population. A significant interannual fluctuating prevalence of malaria cases was recorded
ranging from 25.5% to 6.4% (P < 0:001). Conclusion. Malaria is still a public health threat in the study area despite significant
fluctuating patterns of malaria was observed in the last seven years. In particular, a bounced back trend of malaria from 2018
to 2020 is alarming. Thus, the implementation of ongoing intervention approaches should be reconsidered, and uninterrupted
efforts of the concerned bodies are still needed.
1. Background
Although malaria is a treatable and preventable parasitic disease, yet, it continues to be a major public health issue that
blights the lives of billions of people worldwide [1]. There
are five known Plasmodium parasites, viz., Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale, and Plasmodium knowlesi, that cause malaria
in humans through the bite of female Anopheles mosquitoes.
Two of these Plasmodium spp., P. falciparum and P. vivax,
are the most common species that pose the greatest threat
in mankind [2]. In 2020, there were an estimated 241 million
malaria cases and 627 000 malaria deaths globally. This indicates that malaria cases and deaths in 2020 were increased by
14 million and 69,000, respectively, as compared to 2019
report. Of these, Sub-Saharan Africa took the lion share of
the global burden of malaria with an estimated 95% of
malaria cases and 96% malaria associated deaths in 2020.
Children under the age of five accounted for around 80%
of all deaths in the region [3].
2
Journal of Parasitology Research
Table 1: Microscopically confirmed malaria cases among individuals who visited Maksegnit Health Center from 2014 to 2020 (n = 28217).
Year
Total number of blood films examined
Microscopically confirmed malaria cases, n (%)
Pf
Pv
Mixed (%)
2014
2015
2016
2017
2018
2019
2020
Total
5972
4971
4987
2890
2624
3970
2803
28217
1520 (25.4)
807 (16.2)
803 (16.1)
184 (6.4)
167 (6.4)
456 (11.5)
704 (25.1)
4641 (16.4)
982 (16.4)
422 (8.5)
433 (8.7)
110 (3.8)
111 (4.2)
244 (6.1)
473 (16.9)
2775 (9.8)
537 (9.0)
311 (6.3)
272 (5.5)
63 (2,2)
46 (1.8)
171 (4.3)
221 (7.9)
1621 (5.7)
11 (0.2)
74 (1.5)
85 (1.7)
7 (0.2)
5 (0.2)
35 (0.9)
9 (0.3)
226 (0.8)
Pf: Plasmodium falciparum; Pv: Plasmodium vivax.
Proportion of malaria cases (%)
30
25
25.5
25.1
20
16.2
15
16.1
11.5
10
6.4
5
0
2013
2014
2015
2016
2017
6.4
2018
2019
2020
2021
Year of investigation
Figure 1: Trends of malaria prevalence in Maksegnit Health Center, northwest Ethiopia (2014-2020).
In Ethiopia, where nearly three-fourths of the country’s
landmass is favorable for malaria transmission, more than
60 million people (60% the population) live in malarious
areas [4]. Indeed, over the last decade, the morbidity and
mortality of malaria has been remarkably reduced following
implementation of public health intervention measures
including insecticide-treated mosquito nets (ITNs), indoor
residual spraying (INR), accurate diagnosis and prompt
treatment with artemisinin-based combination therapies
(ACT), and intermittent preventive treatment of pregnant
women (IPTp) throughout the country. However, recent
findings indicate that the incidence of malaria is coming
increasingly globally, and Ethiopia has proven to be no
exception [5, 6]. In 2020, Ethiopia accounted for 1.8% and
1.5% of all malaria cases and deaths globally, respectively
[3]. The morbidity level and transmission status of malaria
in most parts of Ethiopia is unstable and show marked seasonal, interannual, and spatial variability [7]. The instability
of malaria transmission pattern relay on altitude, rainfall,
and variation in socio-demographic risk factors. Its incidence and transmission mainly occur in two major (September–December) following a heavy summer rainfall season
and minor (April–June) following short rainy seasons [6,
8–10]. This unstable transmission pattern along with the
recent evidence of shifting malaria transmission pattern to
the previously unexposed area may be an obstacle for the
success of the national plan of eliminating malaria in certain
low transmission settings by 2020 and eradicated by 2030.
Furthermore, the seasonal migration of adult male
laborers from the study region to the Metema–Humera lowlands, where malaria is highly common, is complicating the
malaria elimination campaign, particularly in northwest
Ethiopia. The migrant returnees with other aggravating factors in play, the study area renowned in malaria outbreaks at
various times, despite there is lack of clear evidence regarding the morbidity and mortality of malaria in Maksegnit.
As a result, the goal of this study was to indicate the prevalence and trend of malaria in the study area during the last
seven years in order to assess the impact of intervention
strategies, because we believed that such analysis of malaria
morbidity trends in endemic areas would help to understand
the dynamics of malaria transmission. Besides, such information is crucial to evaluate the effectiveness of current
intervention, approaches to control disease burden, and
mapping evidence-based interventions. Thus, herein, we
assessed a seven-year trend of malaria and distribution over
sex, age, and season in Maksegnit Health Center, northwest
Ethiopia.
Microscopically confirmed malaria cases (n)
Journal of Parasitology Research
3
800
700
600
500
400
300
200
100
0
2014
2015
2016
2017
2018
2019
2020
Year of investigation
Spring
Autumn
Winter
Summer
Figure 2: Seasonal distribution of malaria among individuals requested for malaria examination at Maksegnit Health Center from 2014 to
2020 (n = 28217).
2. Materials and Methods
Table 2: Monthly distribution of malaria among individuals
requested for malaria examination at Maksegnit Health Center
from 2014 to 2020 (n = 28217).
Months of
examination
Microscopic
examination result
Total number of suspected Positive Negative
individuals (N)
N (%)
N (%)
January
1763
February
1364
March
2187
April
2384
May
2624
June
2323
July
2110
August
2478
September
2426
October
2722
November
3403
December
2433
1643
(93.2)
1300
64 (4.7)
(95.3)
239
1948
(10.9)
(89.1)
315
2069
(13.2)
(86.8)
572
2052
(21.8)
(78.2)
374
1949
(16.1)
(83.9)
250
1860
(11.8)
(88.2)
422 (17) 2056 (83)
434
1988
(18.1)
(81.9)
695
2027
(25.5)
(74.5)
773
2630
(22.7)
(77.3)
379
2054
(15.6%) (84.4%)
120 (6.8)
2.1. Study Area and Period. The study was conducted in
Maksegnit Health Center which is located in central Gondar
zone, Amhara regional state, located 40 km from Gondar
town, Ethiopia. The area is located at latitude, longitude,
and altitude of 12.3-13.8° N, 35.3-35.7° E, and 2,220 at sea
level. Maksegnit Health Center is the only health institute
that provides healthcare services to the community in the
town. The local average temperature varies from 15°C to
31°C and is characterized by two main rainy seasons (JuneAugust) peak rainfall season and (March-May) minor rainy
season. Based on the local health bureau report, Maksegnit is
renowned for a periodic outbreak of malaria cases during the
major rainy seasons. The data was retrieved from the laboratory log book between January and February 2021.
2.2. Study Design and Population. A health facility-based retrospective study was conducted to determine the trend,
prevalence, and distribution of malaria over sex, age, and
season over the past seven years in Maksegnit Health Center.
The study populations were all malaria-suspected individuals who provided blood samples for blood film microscopy
and registered in the lab logbook of the health center.
2.2.1. Inclusion and Exclusion Criteria. Participants who had
full recorded data such as age, sex, year, and date of diagnosis were included in the study, whereas individuals who had
incomplete recorded information in the logbook were
excluded.
2.3. Data Collection Tools and Techniques. Prior to extracting participants’ data from the laboratory logbook, a data
extraction sheet that was specifically designed to address
participants’ demographic data (age, sex), month, and year
of diagnosis was prepared using Microsoft Excel. Then, the
variables of interest were transferred from the laboratory
logbook to the preprepared data extraction excel sheet. The
Journal of Parasitology Research
Microscopically confirmed malaria cases (n)
4
900
750
600
450
300
150
0
2014
2015
2016
2017
2018
2019
2020
Year of investigation
<5
5–14
15–45
46-64
≥ 65
Figure 3: Trend analysis of malaria in relation to participants’ age from 2014 to 2020 (n = 28217).
extracted study variables included clients’ sex, age, date of
diagnosis, diagnostic tools used, results of investigation,
and species of parasite detected. To assure the quality and
consistency of the data, data collectors were trained regarding the data extraction tool, variables of interest, and the
objective of the study. Besides, every activity of the data
extraction and entry process was supervised by the study
team members.
2.4. Data Processing and Analysis. Prior to any statistical
analysis, data were coded and checked for its completeness
using epi data software and transferred to SPSS software
for statistical analysis. Descriptive statistics was used to show
the distribution of malaria transmission in terms of individuals’ sex, age, season, and species of parasite detected. Pearson’s χ2 test was carried out to assess the association
between dependent variable with independent variables,
and P value < 0.05 was considered statistically significant.
The results were displayed using text, graphs, and tables.
3. Results
3.1. Annual Prevalence of Malaria in Maksegnit Health
Center (2014-2020). Over the last seven years, a total of
28217 clinically malaria-suspected individuals were
requested for blood film examination at Maksegnit Health
Center. Of whom, 16311 (57.8%) of the suspected individuals were male. The majority of the study participants
(58.4%) were in the age group of 15-45 years. Of the total
suspected participants, microscopically confirmed malaria
was found in 4641 suspected individuals with an estimated
positivity rate of 16.4% (95% CI: 16%-16.9%). On average,
663 microscopically confirmed malaria cases were recorded
annually. In all years of investigation, Plasmodium falciparum was the predominant malaria parasite identified with
an estimated prevalence of 9.8%, followed by Plasmodium
vivax (5.7%). The remaining 0.8% cases of malaria were
Plasmodium falciparum-Plasmodium vivax mixed infections
(Table 1).
3.2. Trends of Malaria Cases in Maksegnit Health Center
from 2014 to 2020. Over the last seven years, the prevalence
of malaria was highly fluctuating across years ranging from
25.5% to 6.4% (P < 0:001). The highest prevalence was
observed in 2014 (25.5%), followed by 2020 (25.1%).
Although the trend of malaria prevalence was observed with
a fragile and inconsistent distribution across years, a generally steady declining trend prevalence of malaria was
recorded from 2014 to 2017 with an estimated prevalence
of 25.4% to 16.4%, respectively. However, constant malaria
case had been documented for two consecutive years from
2017 to 2018. On the other hand, a significant increment
trend of malaria prevalence was observed from 2018
(6.4%) to 2020 (16.4%) (Figure 1).
3.3. Seasonal and Monthly Distribution of Microscopically
Confirmed Malaria Cases (2014-2020). In the concern of
monthly distribution analysis of malaria cases, statistical significant variation of malaria distribution was confirmed
across months with a range of 25.5% to 4.7% (P < 0:001).
The months of October (25.5%), November (22.7%), and
May (21.8%) had the highest malaria cases documented,
while February had the least (4.7%) (Table 2). In addition,
the distribution of confirmed malaria cases showed statistical significant associations with seasons (χ2 = 387, P <
0:001). Autumn had the highest malaria cases (22.3%),
followed by spring (15.6%) and summer (15.1%). Winter
(December to February) was the season with the least
recorded malaria cases (10.1%; P < 0:001) (Figure 2).
3.4. Distribution of Confirmed Malaria Cases in relation to
Sex and Age Groups. The overall prevalence of malaria over
the last seven years in Maksegnit Health Center showed a
statistical significant variation among different age groups
Microscopically confirmed malaria cases (n)
Journal of Parasitology Research
5
1050
900
750
600
450
300
150
0
2014
2015
2016
2017
2018
2019
2020
Year of examination
Male
Female
Figure 4: Trend analysis of malaria in relation to participants gender from 2014 to 2020 (n = 28217).
(χ2 = 215, P < 0:001). Of all confirmed malaria cases, individuals within the age group of 15-45 years had the highest
malaria cases (10.8%) followed by the age group of 5-14
(2.9%), while individuals whose age ≥ 65 years were identified with the record of the least malaria cases (0.2%). The
remaining 429 (1.5%) and 300 (1.1%) confirmed malaria
cases were in the age of <5 and 46-64 years, respectively.
Moreover, regarding the trend analysis of malaria distribution among age groups, individuals whose ages lie in the
range of 15-45 years were identified as the most affected segments of the population across all years (Figure 3).
Moreover, our findings showed that males were found to
be more affected with Plasmodium infection than females
with a statistical significant level over the last seven years
with an estimated prevalence of 12% (3374/28217) and
4.5% (1267/28217), respectively. In addition, males account
the majority of malaria cases across all age groups (Figure 4).
4. Discussion
Despite significant advances in malaria control over the last
two decades, which has increased enthusiasm for the
achievement of the WHO-set goal of reducing malaria incidence and mortality by at least 90% by 2030, a worryingly
trend of malaria incidence and mortality has been observed
in recent years [3, 11, 12]. This alarming trend of malaria
is particularly pronounced in Sub-Saharan African countries, including Ethiopia. Since malaria is not a year-round
phenomenon in Ethiopia, the intensity of transmission and
distribution varies across seasons and years, depending on
the nature of the rainy season and local commitment of
implementing intervention measures [13]. As a result, we
assessed the transmission dynamics of malaria across different seasons to specifically identify malaria peak seasons and
years in order to evaluate the success of ongoing intervention strategies in the surrounding community using a
recorded data at Maksegnit Health Center for the last seven
years.
According to the review of the health center’s recorded
blood smear data from 2014 to 2020, a total of 4641 (16.4
percent) participants had microscopically confirmed malaria
cases from 28217 clinically malaria-suspected individuals.
This figure indicates that malaria is still a major public
health issue in the study area. Malaria cases reported in
2020, in particular, with an estimated annual prevalence of
25.1%, are concerning and may call into question ongoing
public health intervention efforts. Studies conducted in
Dembecha, west Gojjam zone of Amhara regional state
and Jardega Jarte district, Horo guduru Wollega zone of
Oromia regional state, Ethiopia [14, 15], support the overall
finding of malaria prevalence over the last seven years in
Maksegnit Health Center. However, our finding is lower
than other retrospective studies conducted in Adi Arkay
[16], in selected zones of Amhara regional state [17], Bale
zone [18], Kersa district of Oromia region [19], Gorgora
[20], Jimma [21], Kola Diba [22], Guba [7], Tselemt [23],
and Wolaita [24], with a positivity rate ranging from 21.8
to 66.7%. On the contrary, studies conducted in Arsi Negelle
(11.45%), Ataye (8.4%), Bahrdar (5%), Bichena (9.28%),
Halaba (9.5%), Woreta (5.6%), Libokemkim (10.9%), Wolketie (8.56%), and Kombolcha (7.52%) reported lower malaria
cases [25–33] when compared with our finding.
Local community and leaders’ commitment to implementing the recommended public health intervention measures laboratory personnel skills in malaria microscopy,
geographical location of the study setting, applied diagnostic
tools, study period, and accessibility of control measures differed from one place to another which could all be the possible reasons for the discrepancies. For instance, regarding
diagnostic tool variation, a study conducted in bale Zone
[18], Ethiopia, and in selected Zone of Amhara region [17]
used a combined malaria microscopy and RDT result to estimate the overall prevalence of malaria in their respective
area, whereas our study used only malaria microscopy
report. As a result of the differences in diagnostic sensitivity
between the two techniques, the superiority of their report
6
over the current report could be due to the overestimation
effect of malaria RDT, which could be the plausible reason
for the inconsistency of the result.
In addition, a significant interannual fluctuated prevalence of malaria was observed with a maximum and minimum annual prevalence of malaria documented in 2014
(25.4%) and 2017/18 (6.4%), respectively. In this study, a
declined trend of malaria cases was seen from 2014
(25.5%) to 2018 (6.4%). This observed significant improvement may be achieved by the application of the designed
public health intervention measures in the community due
to the severity of the disease burden at that time. However,
significant reverted cases of malaria from 2018 (6.4%) to
2020 (25.1%) were observed followed by a constant case of
malaria that had been documented for two successive years
2017/18. This reverted trend of malaria is consistent with
the recent WHO reports of malaria [3]. The rise in drug
and insecticide resistance, climatic change, and asymptomatic infections as a silent transmission of malaria could all
be factors for the recent resurgence of the disease. Furthermore, the recent impact of COVID-19 on malaria control
and elimination efforts may also be a possible factor for
the rebounce back of malaria trend since 2018. This shocking trend of malaria recorded recently raises many concerns
on the ongoing prevention and control efforts in the community. This finding could be suggestive of the continued
occurrence of high malaria burden in the community which
may need collaborative efforts and careful attention from the
government and other stakeholders to minimize the public
health problems in the surrounding community.
In the concern of confirmed cases of malaria distribution
among the different age groups, greater numbers of malaria
cases were observed among individuals whose ages ranged
from 15 to 45 years. This more pronounced burden among
the productive segment of the population made the impact
of malaria more burning and concerning issues in the community, because this age group of the population are under
the time of carrying different responsibilities of their family,
society, and other else. The disproportionate share of
malaria in this segment of the population might be due to
their higher chance of mobilization to different areas and
outdoor activities. Moreover, since agriculture is the major
source of income for the majority of residents in the town
and surrounding environments, the chances of exposing to
different outdoor activities and migrating to malariaendemic farmlands are high. Due to these possible reasons,
individuals in this age group are more prone to malaria. In
addition, in our findings, males were the most affected segments of the population than females. It may be related to
increased engagement of males in many outdoor tasks, farming activities, and cattle keeping occasions when compared
with females in the community.
Our findings also assured that the occurrence of malaria
in every month of the year despite the burden of morbidity
in each month is significantly varied. The months of October, November, and May had the highest malaria cases documented, while February had the least cases of malaria in
almost all year round. Regarding the seasonal distribution
of malaria in our findings, autumn (September to Novem-
Journal of Parasitology Research
ber) had the highest malaria cases followed by spring (March
to May), which is supported by the fact that in Ethiopia,
malaria transmission hit the highest level from September
to December (following the main rainy season) and April
to May (after the minor rainy season of the country) [34].
These peaks of malaria transmission seasons coincide with
the major harvesting time throughout the country, as a
result of the overlapping period of the major harvesting time
and peak malaria transmission seasons suitable for the
aggravation of malaria transmission in the study area. During harvesting time, outdoor activities and frequency of contact with cattle are higher than other times. As a result, such
outdoor activities increase the risk of malaria due to the incidence of outdoor mosquito biting is increased following the
vector’s host-seeking behavior being changed as recent evidence indicated [35]. Moreover, having frequent contact
and proximity with cattle increases the probability of biting
with mosquitoes malaria vector and has a behavior of
attracted by cattle [36]. In this study, showing the burden
of malaria cases over the last seven years with a large sample
size considered as a positive side unable to address the bottlenecked factors which trigger and reaggravating the severity of malaria in recent times is the main limitation of the
study.
5. Conclusion
In this study, although the burden of malaria cases declined
from 2014 to 2018, a reverted and sharply increment trend
of malaria cases was observed from 2018 to 2020. This indicates that still malaria remains the major public health problem in the community particularly in the age group of 15-45
years which is the productive segment of the population.
This implies there is something that bottlenecks the effectiveness of the ongoing control efforts. Thus, the ongoing
malaria prevention and control strategies should be reconsidered, and the respective stakeholders/bodies should take
a strict commitment to the implementation of the
designed control and prevention efforts. The main causes
which returned the burden of malaria burden back to its
alarming status should be investigated by the local health
bureau or health extension workers or by any other concerned body.
Abbreviations
WHO:
SPSS:
Pf:
PV:
World Health Organization
Statistical Software for Social Science
Plasmodium falciparum
Plasmodium vivax.
Data Availability
The data generated or analyzed during this study is included
in this manuscript. Other data will be available from the corresponding author upon request.
Journal of Parasitology Research
7
Ethical Approval
Ethical clearance was obtained from the Ethical and Review
Committee of School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences University
of Gondar, Ethiopia. Permission and support letters were
also obtained from the Zonal Health Bureau and District
Health Office. The confidentiality of all information collected from the logbook was assured by giving a specific
identification number, and all collected information was
used for the study.
Conflicts of Interest
[7]
[8]
[9]
[10]
The authors declare that they have no competing interests.
Authors’ Contributions
BM, MA, ZK, and MG conceptualized the study, contributing to the data collection tool preparation, data collection,
analysis, and interpretation. TE, AD, AB, and AYJ were
involved in conceptualizing the study, designing the methodology, and approving the data collection tools, data analysis, and interpretation. TE took part in drafting the initial
manuscript. AD, AB, and AJZ reviewed the drafted manuscript and incorporated important comments. All authors
critically reviewed and approved the last version of the
manuscript.
Acknowledgments
We would like to express our gratitude to the University of
Gondar for all necessary supports for the initiation of this
study. Our deep gratefulness was also extended to all staff
members of Maksegnit Health Center, particularly for the
laboratory head for their cooperation for the accomplishment of the study.
References
[1] Q. Liu, W. Jing, L. Kang, J. Liu, and M. Liu, “Trends of the
global, regional and national incidence of malaria in 204 countries from 1990 to 2019 and implications for malaria prevention,” Journal of Travel Medicine, vol. 28, no. 5, 2021.
[2] M. A. Phillips, J. N. Burrows, C. Manyando, R. H. van Huijsduijnen, W. C. Van Voorhis, and T. N. C. Wells, “Malaria,”
Nature Reviews Disease Primers, vol. 3, no. 1, p. 17050, 2017.
[3] WHO, World malaria report 2021, Geneva World Health
Organ, 2021, https://reliefweb.int/report/world/worldmalaria-report-2021.
[4] T. Girum, T. Shumbej, and M. Shewangizaw, “Burden of
malaria in Ethiopia, 2000-2016: findings from the global health
estimates 2016,” Trop Dis Travel Med Vaccines, vol. 5, no. 1,
p. 11, 2019.
[5] Ethiopian Public Health Institute, Ethiopia National Malaria
Indicator Survey 2015, 2016, https://www.ephi.gov.et/images/
pictures/download2009/MIS-2015-Final-Report-December-_
2016.pdf.
[6] President’s Malaria Initiative, Ethiopia-Malaria Operational
Plan FY, 2018, https://reliefweb.int/report/ethiopia/
[11]
[12]
[13]
[14]
[15]
[16]
[17]
[18]
[19]
[20]
[21]
president-s-malaria-initiative-ethiopia-malaria-operationalplan-fy-2018.
S. Alkadir, T. Gelana, and A. Gebresilassie, “A five year trend
analysis of malaria prevalence in Guba district, BenishangulGumuz regional state, western Ethiopia: a retrospective study,”
Tropical Diseases, Travel Medicine and Vaccines, vol. 6, no. 1,
p. 18, 2020.
Federal Ministry of Health, National Malaria Guidelines,
Addis Ababa Fed Minist Health, 2012.
President’s malaria initiative, Ethiopia-Malaria Operational
Plan FY, 2017, https://reliefweb.int/report/ethiopia/
president-s-malaria-initiative-ethiopia-malaria-operationalplan-fy-2017.
W. Deressa, A. Ali, and F. Enqusellassie, “Self-treatment of
malaria in rural communities, Butajira, southern Ethiopia,”
Bulletin of the World Health Organization, vol. 81, no. 4,
pp. 261–268, 2003.
S. Kim, V. N. Luande, J. Rocklöv, J. M. Carlton, and Y. Tozan,
“A systematic review of the evidence on the effectiveness and
cost-effectiveness of mass screen-and-treat interventions for
malaria control,” The American Journal of Tropical Medicine
and Hygiene, vol. 105, no. 6, pp. 1722–1731, 2021.
S. Dhiman, “Are malaria elimination efforts on right track? An
analysis of gains achieved and challenges ahead,” Infectious
Diseases of Poverty, vol. 8, no. 1, p. 14, 2019.
Climate and Development Knowledge Network, FEATURE:
Climate Information to Help Combat Malaria in Ethiopia
[Internet], 2019, https://cdkn.org/2019/04/feature-climateinformation-to-help-combat-malaria-in-ethiopia/?loclang=
en_gb.
D. Haile, A. Ferede, B. Kassie, A. Abebaw, and Y. Million,
“Five-year trend analysis of malaria prevalence in Dembecha
Health Center, West Gojjam Zone, Northwest Ethiopia: a retrospective study,” Journal of Parasitology Research, vol. 2020,
Article ID 8828670, 7 pages, 2020.
B. Beyene, T. Gelana, and A. Gebresilassie, “Five years trend
analysis of malaria prevalence in Jardga Jarte district, western
Ethiopia,” SINET: Ethiopian Journal of Science, vol. 41, no. 2,
pp. 61–69, 2020.
H. Tesfa, A. G. Bayih, and A. J. Zeleke, “A 17-year trend analysis of malaria at Adi Arkay, north Gondar zone, Northwest
Ethiopia,” Malaria Journal, vol. 17, no. 1, p. 155, 2018.
D. Lankir, S. Solomon, and A. Gize, “A five-year trend analysis
of malaria surveillance data in selected zones of Amhara
region, Northwest Ethiopia,” BMC Public Health, vol. 20,
no. 1, p. 1175, 2020.
F. Sani Kalil, M. Hasen Bedaso, and W. S. Kabeta, “Trends of
malaria morbidity and mortality from 2010 to 2017 in bale
zone, Ethiopia: analysis of surveillance data,” Infection and
Drug Resistance, vol. Volume 13, pp. 4379–4387, 2020.
K. Karunamoorthi and M. Bekele, “Changes in malaria indices in an Ethiopian health centre: a five year retrospective
analysis,” Health Scope Journal, vol. 1, no. 3, pp. 118–126,
2012.
A. Addisu, Y. Tegegne, Y. Mihiret, A. Setegn, and A. J. Zeleke,
“A 7-year trend of malaria at primary health facilities in
Northwest Ethiopia,” Journal of Parasitology Research,
vol. 2020, Article ID 4204987, 5 pages, 2020.
A. Jemal and T. Ketema, “A declining pattern of malaria prevalence in Asendabo Health Center Jimma zone, Southwest
Ethiopia,” BMC Research Notes, vol. 12, no. 1, p. 290, 2019.
8
[22] A. Alemu, D. Muluye, M. Mihret, M. Adugna, and
M. Gebeyaw, “Ten year trend analysis of malaria prevalence
in Kola Diba, North Gondar, Northwest Ethiopia,” Parasites
& Vectors, vol. 5, no. 1, p. 173, 2012.
[23] M. Shiferaw, M. Alemu, K. Tedla, D. Tadesse, S. Bayissa, and
G. Bugssa, “The prevalence of malaria in Tselemti Wereda,
North Ethiopia: a retrospective study,” Ethiopian Journal of
Health Sciences, vol. 28, no. 5, pp. 539–546, 2018.
[24] D. Legesse, Y. Haji, and S. Abreha, “Trend analysis of malaria
occurrence in Wolaita zone, southern Ethiopia: retrospective
cross-sectional study,” Malaria Research and Treatment,
vol. 2015, Article ID 123682, 8 pages, 2015.
[25] H. Mengistu and G. Solomon, “Trend analysis of malaria prevalence in Arsi Negelle health center, Southern Ethiopia,” Journal of Infectious Diseases and Immunity, vol. 7, no. 1, pp. 1–6,
2015.
[26] D. G. Feleke, D. Gebretsadik, and A. Gebreweld, “Analysis of
the trend of malaria prevalence in Ataye, North Shoa, Ethiopia
between 2013 and 2017,” Malaria Journal, vol. 17, no. 1, p. 323,
2018.
[27] M. Yimer, T. Hailu, W. Mulu, B. Abera, and W. Ayalew, “A 5
year trend analysis of malaria prevalence with in the catchment areas of Felegehiwot referral hospital, Bahir Dar city,
Northwest-Ethiopia: a retrospective study,” BMC Research
Notes, vol. 10, no. 1, p. 239, 2017.
[28] A. Minwuyelet and Y. Aschale, “Analysis of five-year trend of
malaria at Bichena Primary Hospital, Amhara Region, Ethiopia,” Journal of Parasitology Research, vol. 2021, 6 pages, 2021.
[29] T. Shamebo and B. Petros, “Trend analysis of malaria prevalence in Halaba special district, southern Ethiopia,” BMC
Research Notes, vol. 12, no. 1, p. 190, 2019.
[30] A. Derbie and M. Alemu, “Five years malaria trend analysis in
Woreta Health Center, Northwest Ethiopia,” Ethiopian Journal of Health Sciences, vol. 27, no. 5, pp. 465–472, 2017.
[31] L. Workineh, S. Mekuria, T. Kiros, W. Hailemichael, and
T. Eyayu, “A retrospective study of malaria trend in Libokemkem district over the last five years: northwest Ethiopia,” Infection and Drug Resistance, vol. Volume 14, pp. 3683–3691,
2021.
[32] A. Solomon, D. Kahase, and M. Alemayehu, “Trend of malaria
prevalence in Wolkite health center: an implication towards
the elimination of malaria in Ethiopia by 2030,” Malaria Journal, vol. 19, no. 1, p. 112, 2020.
[33] D. Gebretsadik, D. G. Feleke, and M. Fiseha, “Eight-year trend
analysis of malaria prevalence in Kombolcha, South Wollo,
north-central Ethiopia: a retrospective study,” Parasites & Vectors, vol. 11, no. 1, p. 55, 2018.
[34] S. Ergete, S. Sorsa, E. Loha, and S. Asnake, “Trend of malaria
cases in Hana and Keyafer health centers, south Omo zone,
southern Ethiopia,” Ethiopian Journal of Health Sciences,
vol. 28, no. 3, pp. 277–286, 2018.
[35] I. R. Moshi, H. Ngowo, A. Dillip et al., “Community perceptions on outdoor malaria transmission in Kilombero Valley,
Southern Tanzania,” Malaria Journal, vol. 16, no. 1, p. 274,
2017.
[36] M. A. Zeru, S. Shibru, and F. Massebo, “Exploring the impact
of cattle on human exposure to malaria mosquitoes in the
Arba Minch area district of southwest Ethiopia,” Parasites &
Vectors, vol. 13, no. 1, p. 322, 2020.
Journal of Parasitology Research