Trends of malaria cases by zones and years
Within five years from July 2013-June 2018 a total of 5,735,065 populations were attended health facilities in Central, North and west Gondar zones. The average annual health facility attendance rate of these zone were a total of 1,147,013 patients (285/1000 population) each year. In five years period a total of 2,827,722 cases were receiving a diagnostic test of Microscopy 1,712,193 (60.56%) and RDT 1115529 (39.44 %). From total cases received diagnostic tests only 1,003,391 (36%) were confirmed and clinical cases treated with antimalaria. Of these treated with antimalarial cases, plasmodium falciparum and vivax malaria cases were 1,002,946 (99.96%) and clinical malaria cases were 445(0.04%) in Central, North and West Gondar zones. Among the total confirmed malaria cases 8623 (0.86%) were pregnant women positive for malaria. Average annual malaria cases were 200,589 (55 cases per 1000 population). The trends of total clinically and confirmed malaria cases were increased from 220406(22%) in July 2013-June 2014 to 249474 (25%) in July 2015- June 2016 in Central, North and West Gondar zone. In July 2017- June 2018 total patients treated as confirmed malaria cases were decreased by 139,296 (14%) as compared to July 2015- June 2016; 249474(25%). Trends of malaria cases by zones were presented in figure 2.
Trends of confirmed malaria species by years and zones
From a total of 1,002, 946 confirmed malaria cases in Central, North and West Gondar zones; Plasmodium falciparum species were 736,149 (73.4 %) and plasmodium vivax were 266,797 (26.6 %). Within five years period in West, Central and North Gondar Zones Plasmodium falciparum accounts 337,807(77.7%), 351,433(71.1%) and 46,909(63.2%), respectively. Plasmodium vivax infection were 96,836(22.3%) in West Gondar, 142,646(28.9%) in Central Gondar and 27,315(36.8%) in North Gondar zones. On average the number of malaria cases per year were 86,929(273/1000 population), 98,816 (35/1000 population) and 14,845(17/1000 population) in West, Central and North Gondar zones respectively. Total confirmed PF and PV species by years were presented in figure 3.
Trends of malaria cases by months and Epidemiological (EPI) Weeks
The trends of malaria cases in July 2014- June 2015 and July 2016-June 2017 were high on November and lowest on April in both years. In July 2017- June 2018 highest number of cases was registered on October and lowest numbers of cases were reported on April. The highest malaria cases were reported in EPI week of 45, 46 and 47 in these three zones within five years period. Trends of malaria transmission by months and EPI week were presented in figure 4 and 5 respectively.
Trends of PF and PV transmission by months
Annual average highest monthly Plasmodium falciparum transmission were observed in November with 24993(17%) cases followed by October 20873(14%) and September 16892(11%) cases respectively. Plasmodium vivax transmission were also high in November, October and September with 7365(14%), 5813(11%) and 5431(10%) cases respectively at Central, North and West Gondar zones. Average Seasonal transmissions of falciparum and vivax malaria by months were presented in figure 6.
Malaria morbidity and mortality
Morbidity due to malaria was reported in all age groups including pregnant mothers. Within five years period >15 years of age were more affected by malaria. Out of 1,003,391 total confirmed and clinical malaria cases obtaining outpatient and inpatient service, > 15 years of age accounts 721,430 (71.89 %) followed by 5-14 years of age 183,656 (18.31%), < 5 years 89,676 (8.94%) and pregnant women 8,629 (0.86%). All malaria cases treated in inpatient and OPD by age group were presented in figure 7.
Within five years period a total of 1,770 (0.18%) cases received inpatient malaria service. Average annual inpatient malaria cases in West Gondar zone were 265 (83 per 100,000 population) followed by Central Gondar 69 (three per 100,000 populations) and North Gondar 20 (two per 100,000 populations). There were a total of 20 deaths in five years period. Case Fatality Rate (CFR) in North Gondar Zone were three (4/100,000 population), West Gondar zone were 13(3/100,000 population) and Central Gondar zone were four (0.89/100,000 population). In patient of malaria case and inpatient of all disease by zone were presented in figure 8.
Plasmodium falciparum and vivax species transmission
Plasmodium falciparum cases in West Gondar Zone of; Matema were 152017 (45%), Quara were 79894(24%) and Mirab Armachio were 71137(23%) within five years period compared to other woredas in the zone. Plasmodium vivax in Metema were 35649(37%) followed by Mirab Armachio 27843(29%) from west Gondar zone and Tegede Woreda 25220 (18%) from central Gondar zone. Transmissions of PF and PV in Central, North and West Gondar zone by its woredas were presented in figure 9.
Annual Parasite Incidence (API) by Zones and Districts (woredas)
Annual parasite incidence of malaria case in West Gondar zone were 86,929 (273/1000 population), Central Gondar zone were 98,816 (40/1000 population) and North Gondar zone were 14,845 (17/1000 population). The annual parasite incidence of Mirab Armachio, Gendawuha, Metema and Quara woreda were 20,796 (481/1000 population), 7,754 (298/1000 population), 37,553 (269/1000 population) and 20,846(191/1000 population) cases respectively from West Gondar Zone. Annual parasite incidences by zones were presented in figure 10.
Annual blood examination and test positivity rates
The Annual blood examination rate (ABER) of West Gondar zone was 237,675 (75%) followed by Central Gondar 286,527 (12%) and North Gondar zone 41,342 (5%). Test positivity rate of was greater in West Gondar zone. ABER test and falciparum positivity rate of zone were presented in figure 11.