High asymptomatic malaria among seasonal migrant workers departing to home from malaria endemic areas in northwest Ethiopia.

BACKGROUND: In Ethiopia, thousands of seasonal migrant workers travel from non-malaria or mild malaria transmission areas to malaria-endemic areas for seasonal farm activities. Most of these migrants stay in the farm areas for land preparation, plowing, planting, weeding, and harvesting for a specific period and return to their living areas. However, there is limited evidence of how seasonal migrant workers contribute to the transmission of malaria to new or less malaria transmission areas. METHODS: A cross-sectional study was conducted at the departure phase of seasonal migrant workers in the Metema district from September 2018 to October 2019. A total of 1208 seasonal migrant workers were interviewed during their departure from farm sites to their homes. The face-to-face interviews were performed using a pretested structured questionnaire. Moreover, blood samples were collected from each study participant for microscopic malaria parasite examination. The data were fitted with the logistic regression model to estimate the predictors of malaria transmission. RESULTS: At departure to home, the prevalence of malaria among seasonal migrant workers was 17.5% (15.6-19.45%). Approximately 71.80% (177/212) of the cases were Plasmodium falciparum, and 28.20% (35/212) were Plasmodium vivax. Most seasonal migrant workers 934 (77.4%) were from rural residences and highlanders 660 (55%). Most 661 (55.4%) of the migrants visited two and more farm sites during their stay at development corridors for harvesting activities. Approximately 116 (54.7%) asymptomatic malaria cases returned to the Dembia 46 (21.7%), Chilaga 46 (19.8%) and Metema 28 (13.2%) districts. CONCLUSION: In this study, asymptomatic malaria remains high among seasonal migrant workers departing to home from malaria endemic areas. This may fuel a resurgence of malaria transmission in the high lands and cause challenges to the country's malaria prevention and elimination efforts. Hence, tailored interventions for seasonal migrant workers could be in place to enhance malaria control and elimination in Ethiopia, such as asymptomatic malaria test and treat positive cases at departure and transit, and integration between malaria officers at their origin and departure for further follow-up to decrease any risk of spread at the origin.

Malaria Infection is High at Transit and Destination Phases Among Seasonal Migrant Workers in Development Corridors of Northwest Ethiopia: A Repeated Cross-Sectional Study.

PURPOSE: Malaria is a leading public health problem in Ethiopia. Every year, thousands of seasonal farm workers travel to farm corridors in Northwest Ethiopia and fall at risk of malaria infection. However, the magnitude of malaria infection and risk factors during harvest time were not well identified. This study aimed at estimating the prevalence and risk factors of malaria infection among seasonal migrant workers in Northwest Ethiopia. METHODS: A repeated cross-sectional study was conducted at transit and destination phases in Metema district from September 15, 2018 to October 30, 2019. Data were collected using a structured questionnaire. A capillary blood sample was collected to examine infection with malaria parasite using a microscope. A multivariate logistic regression technique was used to determine risk factors. RESULTS: The malaria prevalence at transit and destination phases among migrant workers was 13.5% (95% CI: 12.07-14.93%) and 18.7% (95% CI: 16.40-21.02%), respectively. The combined prevalence was 16.1% (95% CI: 14.67-17.63%). The odds of malaria infection among migrant workers at the destination phase was 1.5 (OR=1.5, 95% CI 1.167-1.846) times higher compared to the transit phase. Education (AOR=8.198; 95% CI: 4.318-15.564), knowledge of antimalarial drugs (AOR=2.4; 95% CI: 1.43-3.95), and use of long-lasting insecticidal nets (AOR=5.0; 95% CI: 3.34-4.43) were significantly associated with malaria infection at migration phases. CONCLUSION: This study showed that the burden of malaria among seasonal migrant workers was high at transit and destination phases. Malaria prevalence was higher at the destination phase compared to the transit phase. A tailored malaria prevention intervention is needed including awareness creation, screening, treatment, repellent, and prophylaxis at both phases to reduce malaria infections.

Assesment of household burden of orphaning and coping strategies by guardians and families with orphans and vulnerable children in Hossana Town, SNNPR.

BACKGROUND: Globally the number of orphans is increasing due to HIV/AIDS, internal corflicts and others. Orphanage and vulnerability causes much of its burden on poor households and children. OBJECTIVE: This study was initiated to assess household challenges of orphaning and coping strategies by families and guardians living with Orphan and Vulnerable Children (OVC). It has also tried to look at the types and level of challenge facing OVC. METHODOLOGY: Community based descriptive cross-sectional quantitative survey was conducted from October to November 2008 using a pre-tested Amharic questionnaire among guardians of OVC in Hossana town. Hadiya zone, SNNPR. A total of 334 samples were selected using a simple random sampling technique. RESULT: Sixty nine percent (69%) of guardians were women. Almost all of the OVC had participated in one domestic activity and 26.9% of OVC were involved in domestic work in other houses. A little more than twenty two percent (22.2%) have history of involvement in productive child labor; of whom 79.7% were found working at the time of data collection Above thirty five percent (35.6%) of respondents believe that the OVC are discriminated and 23.5% of the discriminators were step parents. As household coping mechanism 24.9% reported selling domestic animals, 15.6% selling household equipments and 12.9% sell plots of land which all occurs due to lack of resources in households. CONCLUSION AND RECOMMENDATION: The study concluded that caregivers lack sufficient resources to provide basic needs to OVC. Hence, community based training on micro finance assistance, discrimination and psychological support should be given to guardians and the community in general.

Prevalence of urban malaria and assocated factors in Gondar Town, Northwest Ethiopia.

BACKGROUND: Malaria has become one of the major health problems currently facing the urban communities. The rapid increase in urbanization, rural-urban migration and climatic changes are among the main factors contributing for the rise of malaria in urban areas. To our knowledge, there has been no malaria prevalence study so far conducted in Gondar Town. OBJECTIVE: The aim of this study was to determine the prevalence of malaria infection and its associated risk factors in Gondar Town. METHODS: A community-based survey was conducted in three randomly selected malarious Kebeles of Gondar Town during November-December 2004. Blood films were collected from a finger-prick of 734 members of the selected households for microscopic examination of malaria parasites. RESULTS: Among 734 examined blood films, 39 (5.3%) were positive for malaria infection, of which 29 (74.4%) were due to Plasmodium falciparum and 10 (25.6%) due to P. vivax. Seven (18%) malaria infections were reported from children under the age of five years, indicating the endemicity of malaria to the study area. Age-specific rates show that higher malaria prevalence rate was found among under-five children (7.2%) and 15-19 year-old age group (7.3%). Proximity to mosquito breeding sites was found to be the main risk factor for malaria infection (OR = 2.4, 95% CI. 1.2-5.1). CONCLUSIONS: The prevalence of malaria in Gondar Town was found to be high. The prevalence was strongly associated with proximity of residence to potential mosquito breeding sites. The occurrence of the disease among under-five children would indicate that malaria is indigenous to the area. Use of personal protection methods such as insecticide treated mosquito nets should be scaled up, and malaria control interventions should target residents who are at a closer proximity to mosquito breeding sites.

Community perceptions and practices about urban malaria prevention and control in Gondar Town, northwest Ethiopia.

BACKGROUND: Malaria is becoming a major health problem in urban areas. Community perceptions, knowledge and practices have a major role in the implementation of effective malaria control interventions. Yet little is known about the perceptions and practices of urban community about urban malaria prevention and control. OBJECTIVE: The aim of this study was to assess the knowledge, attitudes and practices of an urban community about malaria prevention and control. METHODS: A community-based cross-sectional study was carried out in three randomly selected malarious Kebeles of Gondar Town during November-December 2004. Knowledge, attitudes and practices were assessed for 489 household members > or =18 years old. RESULTS: Almost all respondents knew about malaria and recognized it as one of the major health problems of the community. About 58% knew that malaria could be transmitted from one person to another, and most (97.2%) associated malaria with the bite of mosquito. The most frequently reported symptoms of malaria included fever (96.3%), chills and shivering (96.3%), headache (96.1%), loss of appetite (92.2%) and joini pain (90.2%). Knowledge about the names of the currently used antimalarials, sulfadoxine-pyrimethamine (90.4%) and chloroquine (81.6%), was high. About 39% of the total 163 surveyed households possessed at least one mosquito net; of these, 55 (83.7%) possessed one, 7 (11%) had two and 2 (2.3%) possessed three. Most respondents practiced draining stagnant water (46.3%) and clearing vegetation (43.3%) for malaria prevention. CONCLUSIONS: Although considerable gaps were observed between knowledge and practices of malaria prevention and control methods, community knowledge, attitudes and practices on the cause, treatment and prevention of the disease were encouraging. Since malaria is identified as a major health problem, the use of personal protection methods such as insecticide treated mosquito nets should be encouraged through increasing access to it.