Malaria Resurgence and Associated Risk Factors at Bonga town, Kaffa zone, Southwest Ethiopia

Abstract

Currently, unpredicted rapid resurgence of malaria is happening in almost all endemic areas of Ethiopia, after decline in the few past years. This study was thus aimed at investigating malaria resurgence and associated risk factors, and challenges encountered in the process of implementing the interventional activities at Bonga town, Kaffa zone, Southwest Ethiopia. Health facility-based retrospective and cross-sectional study design was employed. Data was analyzed using SPSS software version 26. Multiple linear and logistic regression models utilized. Qualitative data was thematically analyzed. The finding of the present cross-sectional study revealed that the current malaria positivity rate (from January to May, 2024) in the study area was 50.72% (315/621). The study identified a resurgence of malaria was linked to weakened control measures (p=0.006), limited awareness of the population (p<001), and socio demographic factors such as education (p=0.037), housing condition (p<0.0001), low income level (p<001), and travel history to malaria endemic areas (p=0.001)] and weakened health care system. The findings of retrospective analysis also showed an increasing malaria positivity trend between 2010 and 2023, where the overall 30.18% (19,582/64, 885) malaria positivity rate. Plasmodium falciparum was the dominant malaria parasite 12,730 (19.62%). Age >14 years (p=0.008), male patients (p=0.018), year increment from 2010 to 2023 (p=0.013), and some months: September to November was strongly and positively associated with malaria positivity in the area. On the other hand, statistically significant negative association between intervention activities and malaria positivity rate was observed. As ITNs distribution increased by 1-unit, malaria positivity rate was decreased by 0.533 (p=0.001). Similarly, as IRS activity increased by 1-unit, malaria positivity rate was decreased by 0.781 (p=0.004). Although Ethiopia was aggressively working on the malaria control activities in the past years, the recent interruption of implementing interventional activities (distribution of ITN and IRS) could contributed for the observed high malaria positivity rate. In addition, the limited knowledge and awareness of patients observed on the malaria infection calls the need for immediate community sensitization activities, besides designing integrated interventional strategies to tackle the current terrible situation.