Magnitude of Malaria and Associated Factors Among Febrile Patients Visiting Public Health Facilities in Olanchity Town, East Shewa, Central Ethiopia, 2022. Crosssectional Study Design.

doi:10.21203/rs.3.rs-1840155/v1

Download PDF

Research Article

Magnitude of Malaria and Associated Factors Among Febrile Patients Visiting Public Health Facilities in Olanchity Town, East Shewa, Central Ethiopia, 2022. Crosssectional Study Design.

https://doi.org/10.21203/rs.3.rs-1840155/v1

This work is licensed under a CC BY 4.0 License

Version 1

posted

You are reading this latest preprint version

Background: Mortality and Morbidity caused by malaria is a major public health problem in developing countries like Ethiopia. Despite efforts to reduce its impact on community, the disease is still a projecting health problem in Ethiopia. In the study area, there is no study done that indicated extent of malaria and predisposing factors related as far as our knowledge concerned. This study, therefore, was undertaken to assess the magnitude of malaria and associated factors among febrile patient visiting public health facilities in Olanchit Town.

Objectives: to assess the magnitude of malaria and associated factors among febrile patients visiting public health facilities in Olanchit Town, East Shewa, Central Ethiopia.

Methods: Institution based cross sectional study was conducted from April 1^st - June 30^th, 2022. Every other febrile patient from all patients visiting the health facilities during the data collection period were interviewed using structured interviewer administered questionnaire. The collected data was coded, edited and entered in to Epi-Info version 7.1 and analyzed SPSS version 24. Descriptive statistics was performed to describe the magnitudes of malaria. Multiple logistic regression analysis was conducted to identify associated factors at 95% confidence interval and P -value <0.05 was used as cut-off points to declare significance in the final model.

Result: in the study 306 respondents were involved making response rate 100%. Among febrile cases visited public health 85 (27.8%), (95% CI;17.0, 26.1) were positive for malaria cases and P. Vivax 43 (14.1%) were dominant species followed by mixed 26 (8.5%) and more cases 47 (15.4%) were observed in male. Malaria infection were associated with Sex who are male in gender (AOR = 5.7; 95% CI. 2. 74 – 16.1; P= 0.021), Age (AOR =7.7, 95% CI; 2.191 – 27. 321, P= 0.007), family members ever contracted malaria in their life (AOR = 3.7; 95% CI 1.469, 7.108; P = value 0.004).

Conclusion and Recommendation: malaria cases found in this report was high when compared with strategies being followed now by MOH. To lower the prevalence of malaria infection there should be strong community mobilizer and active case search which might contribute to elimination goal that targeted clearing new and existing cases.

Malaria

Plasmodium

Boset Woreda

Acute Febrile illness

Globally, there were an estimated 229 million malaria cases in 2019 in 87 malaria endemic countries, declining from 238 million in 2000. At the Global technical strategy for malaria 2016–2030 (GTS) baseline of 2015, there were 218 million estimated malaria cases(1). Twenty-nine countries accounted for 95% of malaria cases globally. Nigeria (27%), the Democratic Republic of the Congo (12%), Uganda (5%), Mozambique (4%) and Niger (3%) accounted for about 51% of all cases globally. Of the 92 countries that were malaria endemic globally in 2015, 31 (34%) were estimated to be on track for the GTS morbidity milestone for 2020, having achieved 40% or more reduction in case incidence or reported zero malaria cases. Malaria mortality rates remained at the same level in 2020 as 2015 in seven countries (8%), whereas there were estimated increases in another 12 countries (13%), six of which had increases of 40% or more(1, 2).

Malaria is caused by a protozoan parasite belonging to the genus Plasmodium. Plasmodium (P) falciparum, P. vivax, P. ovale, P. malariae, and P. knowlesi are known to infect humans. However, P. falciparum and P. vivax are the most prevalent species in the world. Malaria is a global public health problem; however, majority of the cases and deaths occur in the tropics and subtropics. Most of the malaria cases occur in African region (90%) followed by the Southeast Asia (7%) and Eastern Mediterranean (2%) regions. There were an estimated 241 million malaria cases and 627,000 global malaria deaths in 2020 compared to 227 million cases in 2019—an increase of about 14 million cases and 69,000 deaths over the previous year. About 95% of all malaria cases and deaths were in the World Health Organization (WHO) African Region(2–5).

The Ethiopian Federal Ministry of Health has been making efforts to reduce malaria morbidity and mortality through utilization of insecticide-treated nets (ITNs), environmental control, chemoprophylaxis, and rapid case detection followed by prompt case management. Hence, the disease incidence shows a decline in the country. However, the parasite incidence has been increasing in certain focal areas within the last years. Therefore, periodic assessment of malaria prevalence in endemic areas helps to evaluate the existing interventions(6). Therefore, this study will be undertaken to assess the magnitude of malaria and associated factors among malaria suspected patients attending Olanchit public health facilities.

Study area

Institution based cross-sectional study design was conducted from June 1^st to July 30^th, 2022 in Olanchit District town, which is one of the town in Boset woreda, situated in East Shewa Zone, at distance of 115 km South East from Addis Ababa and 25km away from Adama town through main road of Ethio-Djibouti. The town has two public health facilities Olanchit Health Center and Olanchit Hospital. The Hospital was established since 2015 in Boset woreda with aim to give curative and Promotive health services including maternal and child health service for about 400, 000 total population including referral cases from different areas districts and from some kebeles of Amhara region (Minjar district). Whereas Olanchit health center was founded before hospital and serving most communities near to the town. In both facilities outpatients and inpatients were opened for community to give routine and emergency services by health professionals. In the district malaria cases were ranked first from group of AFI reported and known to be public health problem till today.

Study design and period

Study was conducted from April 1^st to July 30^th 2022 using institutional based cross sectional study design

Source and Study population

Source population

All patients came to public health facilities found in Olanchit town from April 1^st to June 30^th during study was considered.

Study population

Sampled patients with febrile cases those who visited public health facilities and sent for blood film to the laboratory at public health facilities found at Olanchit Town during study period were taken and interviewed.

Inclusion criteria: - patients greater than age of 5 years old, able to talk was included in the study.

Exclusion: - patients less than 5 years old, seriously sick unable to talk and visit facility for more than once during study time for malaria treatment with in one study period were excluded.

Sample size and sampling procedures

Sample size determination

Sample size was determined by using a formula for single population proportion: (

n = Zα/2²p (1-p) /d²

Where n = the sample size, Zα/2 = 1.96 at 95% confidence interval (CI), d= margin of error, p = expected malaria prevalence rate in the locality which was 25% from previous study conducted in East Shawa Zone, Ethiopia(7), margin of error (d) at 5%, and non-respondent rate = 5%.

n = Zα/2² x p (1-p) =1.96² x.0.25x0.75 = 288

d ² (0.05)²

Since source population is 7920, which is less than 10,000, correction formula was used to get the final sample. Here sample were

Here the final sample size was 278 x 10% non-response rate = 306

Sampling procedure

There were two public health facilities in Olanchit town and both were included in the study. Consecutive sampling techniques were used to access patients after proportional allocation was made based on flow of patients during study period. Hence in the last year 2021 in the same months a total of 3080 clients had visited Olanchit health center out patient’s department claiming fever and 4840 patients visited Olanchit Hospital out patient for the same reason. In general, 7920 patients were visited public health facilities at Olanchit town having a febrile case for which blood film were requested.

Sample allocation to respective facilities

Data collection procedures (instruments, personnel, measurements)

Data were collected from study participants using semi-quantitative structured questionnaire containing Socio-demographic data, and factors affecting about malaria and other relevant information’s related to the study which was developed after reviewing of the relevant literature. Data was collected by trained health workers holding BSc. Before the actual data collection, a half day training about the aim of the study and the content of the instrument were given for the two data collectors.

Data quality assurance

The questionnaire was pre-tested in Adama Comprehensive Specialized Hospital Medical College to ensure the quality of data and for improvement of data collection tool on five percent (5%) of total sample. Then some modification of the tool was done, and irrelevant questions removed, some questions were rewritten again to make them clear. After adapting the final version of the questionnaire, the questionnaire was distributed for each data collectors in the form of hard copy. Respondents were interviewed during the data collections. Supervision by principal investigators during data collection were done to understand how the data collectors would handle the questionnaire and each filled out questionnaire were checked for its completeness, accuracy, clarity, consistency on daily basis by principal investigators.

Data processing and analysis

After checking the completeness, missing values, and coding of questionnaires, data was entered to computer, processed and analyzed using SPSS version 24. The data was summarized and described using descriptive statistics. Hence associated factors were determined using logistic regressions at 95% CI and p value less than 0.05. Adjusted Odds ratio was used to determine associated factors. Then finally data was presented in tables, frequency percentage and different charts.

Ethical considerations

Letter of permission was obtained from research committee of Adama General Hospital and Medical College, and submitted to Boset Woreda Health offices, Olanchit hospitals and Olanchit health center. Then support letters obtained from each facility were presented to each health facilities departments. Up on data collection the purpose of the study was explained to the participants and also their right to withdraw from the study at any time were informed then data were collected after ensuring their willingness.

3.1. Sociodemographic characteristics

In the study 306 respondents were involved making response rate to be 100%. Two third of the respondents 184 (60.1%) were male, over one quarter 82 (26.8%) of them age ranges between 21–30 years old, majority of them 272 (88.9%) were Oromo ethnicity, over half of them 159 (52%) were married, similarly their family numbers were 5–8 (51.3%), one third of the respondents were 100 (32.7%) were unable to read and write and 96 (31.4%) were farmers.

According to the finding 177 (57.8%) of respondents were living over 3000m away from surface water, and over three fourth 240 (78.4%) justified that there is no water body exists around their environments and similarly near to three fourth of them 223 (72.9%) had a travel history prior to study.

Report showed that majority of them 289 (94.4%) had not been visited by health extension workers, most of them 274 (89.5%) had no ITNs in their home, similarly not used ITNs in the previous night. Report also indicated that over one third of the respondents had contracted malaria in their life and most of them 224 (73.2%) told that their family members caught malaria prior to the study. See table 1.

Table:1. Sociodemographic characteristics of febrile patients visiting public health facilities at Olanchit Town, June 2022.

Variable	Response	Frequency	Percent
Sex	Male	184	60.1
Sex	Female	122	39.9
Age	Less than 10	16	5.2
	10–20	64	20.9
	21–30	82	26.8
	31–40	66	21.6
	Greater than 40	78	25.5
Ethnicity	Oromo	272	88.9
Ethnicity	Amhara	34	11.1
Marital	Single	115	37.6
	Married	159	52.0
	Widowed	32	10.5
Family size	Less than 5	100	32.7
	5–8	157	51.3
	Greater than 9	49	16.0
Educational status	Cannot read and write	100	32.7
	Read and write	62	20.3
	5–8	96	31.4
	9–12	32	10.5
	Diploma and Above	16	5.2
Occupation	Government employee	16	5.2
	Farmer	96	31.4
	Merchant	34	11.1
	House wife	79	25.8
	Other	81	26.5

3.2. Magnitude of malaria among febrile cases visited public health facilities at Olanchit Town

Out of respondents visited public health 85 (27.8%) at 95% CI (17.0, 26.1) were positive for malaria cases and P. Vivax 43 (14.1%) were dominant species followed by mixed 26 (8.5%) according to the laboratory report shown. In this finding 42 (13.7%) and 24 (7.8%) cases were detected in the Hospital and Health Center respectively. Report also forwarded that highest malaria prevalence were seen among 21–30 years population group followed by 10–20 age group accounting 21 (6.9%) and 3 (1.0%) respectively.

Report indicated that more cases 47 (15.4%) were observed in male, 37 (12.1%) cases were seen in married respondents of which 21 (6.9%) were farmers, 24 (7.8%) were unable to read and write and 43 (14.8%) were living at a distance of 1503 to 3000 meters away from surface water. According to the report cases were observed among respondents houses not visited by HEWs and don’t possess and use ITNs. In addition, 59 (19.3%) cases were found in respondents sleeping out side of their home, 50 (16.3%) were among respondents never developed malaria and 58 (19%) were among respondents’ family had malaria cases. See figure below.

3.3. Determinant factors among febrile cases visited public health facilities

Among determinant factors identified in the finding, Sex who are male were six times more affected by malaria than female in gender (AOR = 5.7, 95% CI, 2. 74–16.1, P = 0.021), regarding age where older individuals were eight times more positive for blood film than younger (AOR = 7.7, 95% CI, 2.191–27. 321, P = 0.007), respondents unable to read and write were more affected than other educated participants in (COR = 2.4, 95% CI 0.998–6.168, p = 0.04), distance from water surface COR = 0.513, 95% CI, 0.239–1.100, p = 0.002), family members ever contracted malaria in their life had four times more chance to acquire malaria than not as showed in this finding AOR = 3.7, 95% CI (1.469, 7.108), at P – value 0.004. See table below.

Table:2. Factors associated with malaria morbidity among febrile cases visited public health facilities at Olanchit Town, 2022.

Variable	Response	COR (95% CI)	AOR (95% CI)	P value
Sex	Male	1.877(1.097, 3.212)*	5.7 (2. 74–16.1) **	.0021
Sex	Female	1	1	.0021
Age	Less than 10	1	1
	10–20	2.7 (0.878, 8.789)*	0.474 (0.157, 1.433)	0.007
	21–30	2.2 (0.748, 6.823)	1.36 (0.606, 2.858)
	31–40	16 (3.564, 74.544)*	1.07 (0.529, 2.165)
	Greater than 40	2.1 (0.698, 6.388)*	7.7 (2.191, 27.321) **
Education	Cannot read and write	1	1	0.8
	Read and write	2.8 (0.998, 6.168)*	0.631 (0.019, 1.49)
	5-8th	1.138 (0579, 2.197)	0.92 (0.019,0.447)
	9-12th	1.12 (0.636, 1.945)	0.78 (0.171, 3.565)
	Diploma and above	0.406 (0.761, 0.936)	0.631 (0.268, 1.486)
Distance	1500 m	1	1	0.148
	500-1500m	0.513(0.239, 1.100) *	0.7(0.748, 6.82)
	1501–3000	2.4 (0.852, 6.690) *	2.2 (0.601, 6.258)
	> 3000 m	0.09 (0.176, 0.936)	0.665 (0.303, 1.456)
	Yes	0.48(0.258, 0.892) *	0.553 (0.246, 1.127) **
Family members ever contracted malaria	No	1		0.004
Family members ever contracted malaria	Yes	1.631 (0.268,4.486)*	3.7 (1.469, 7.108)**	0.004
** p value less than 0.05 and AOR, * P value less than and COR

Globally, malaria mortality rate cases were reported showing reduction typically in WHO Africa regions, where assumed to be high load seen. In our study among respondents involved, over quarter of them 85 (27.8%) were positive for malaria cases and P. Vivax 43 (14.1%) were dominant species followed by mixed 26 (8.5%) as shown in the investigations. This finding was less than Report from , North Western and Akura Nigeria were overall prevalence was found to be 35.7% and 78.7% respectively. The highest prevalence was recorded in the age group of 5 – 15 years, 19.3%, followed by the under 5 group with 11.7% as of a report from North Western Nigeria and highest were recorded in age less than 10 years which is followed by age group 21 – 30 according to study done in Akura Nigeria. Whereas, in our report high malaria cases were seen among population age group 21 – 30 holding 21 (6.9%) and list were among 31 – 40 years old accounting 3 (1.0%). Discrepancy in this report were resulted from type of study design used and time of data collection which might had prominent contribution in addition to geography of both countries(8,9).

Our report was inline with finding from Ghimbie West Wollega, East Shawa, North Western Ethiopia, Hadiya Zone, Arbamich, to be 108(28.1%), 204(25%), 22.4% and 106 (25.8%) respectively. Similarity in all finding were emerged from socio-culture characteristics of community being having resemblances and methodology followed while conducting study in hence, participants were among clients looking for treatments at public health facilities(10–14).

According to our finding depicted, it is greater than report from Nonth Ethiopia, Batu Town and Chagini accounting 19%, 17.13% and 7.3 % respectively. Difference in the study was observed due to sampling procedures and study period utilized while conducting the research. In our context study was done at a time were malaria peaks being raised relating to season.

Our study reflected that P. Vivax 43 (14.1%) were dominant species followed by mixed 26 (8.5%) and list species were P. falciparum accounting for 16 (5.2%) according to the laboratory report shown. This finding was similar with study conducted at Shawa Robit, Batu town, Hadiya Zone, Central Ethiopia, and Chagini, in which P.Vivax were more dominant rating 71.6%, 50.8%, 71.7%, 54% and 55% respectively and all finding proved report released by federal ministry of health in which plasmodium vivax were a common and dominant species of malaria(7,11,13,15,16).

Our report also indicated that more malaria cases 47 (15.4%) were observed in male when compared with female. This finding justified report from Arbamich Zuriya, Btu Town, Ghimbie and Chagini that showed male counterpart were got infected which accounting 32 (53.4%), 9%, 199 (51.8%) and 164 (55.4%) respectively. Contradicted report from Nigeria Akura that showed female being infected than male illustrating that out of gender become positive female accounted for 79.6%(10,14–16).

The finding of our reported indicated that older individuals had 8 times more affected by malaria than other population age group and this finding supported report from Arbamich Zuriya, Shawa Robit town, East Shaw Zone and Dambia district, North Western Ethiopia in which malaria cases were associated with age and respondents who are older had high risk of acquiring plasmodium parasite than other age groups of populations. This justified that most of the time ITNs were provided to family putting to consideration on presence of children under five years and pregnant women. This implies that older individuals had high possibility to sleep out side of ITNs during out door activities(7,11,12,14).

Our study also reflected those male respondents were high chances to develop malaria as compared with female in gender. It was also reported in other studies Dambia district and Shaw Robit town that concluded male respondents had high odds to develop malaria than females. However, it is contradicted with finding from Hamusit Health Center that showed female partners were more affected than male. This finding was verified with national malaria cases distributions that stated male were more affected than other gender groups. In our context female activities were confined to indoor which limited them from being exposed for encountering mosquitoes and considered during ITNs supplementations(12,17).

The study also showed that respondents whose family members had contracted malaria had 4 times more prone to malaria than family members not affected prior. This report were inline with finding from Hamusit Health Center and Chagini that that mentioned malaria positivity were associated with respondents having history of family with malaria cases(16,17).

LIMITATION

Data were collected in the health institutions which could not be easy to generalize to all respondents in the woreda.
The study was conducted using cross-sectional study design which could not tell us whether effect or cause comes first.

Overall, the study showed that 85 (27.8%) of respondents were found to be infected with plasmodium species. P. Vivax 43 (14.1%) were dominant species followed by mixed 26 (8.5%) and more cases 47 (15.4%) were observed in male. Malaria infection were associated with Sex who are male in gender, Age, family members ever contracted malaria in their life.

AVAILABILITY OF DATA AND MATERIALS

All data for the report were found in the main document including all additional supporting files. If additional information is required it can be obtained from the corresponding author based on a reasonable request.

ACKNOWLEDGEMENT

We would like to extend our deep pleasure and sincere thanks to Boset Woreda Health Office for great cooperation while conducting this research.

Finally, we forward our appreciation to our families without their assistance hard to bring real our dream. Lastly not least we would like to show our love for our friends for their patience during preparation and data collection.

Funding

Ther is no any fund sourced for this research

Authors Information

Authors and Affiliations

Oromia Regional Health Office, East Shawa Zonal Department, Adama Woreda Health Office, Disease Prevention Control Team

Yosef Gudeta Etefa

Department of Public Health, College of Health Sciences, Adama General Hospital and Medical College

Rediet Daniel, Duret Aman

Contributions

RD, and DA collected the data, Printed questionnaires, Supervised data collection, Oriented data collectors.

YGE performed a proposal and research, and drafted the manuscript, performed data analysis, reviewed and drafted the manuscript. RD Critically drafted and reviewed the manuscript. All authors read and approved the final manuscript.

Ethics approval and consent to participate

Ethically approved by Research Ethical Review committee. Privacy and confidentiality were maintained throughout the study.

GTS ……………………………………. Global Technical Strategy

ITNS …………………………………….. Insecticides Treated Nets

LLITN …………………………………….. Long Lasting Impregnated Treated Nets

MDG …………………………………….. Millennium Development Goal

RDT …………………………………….. Rapid Diagnostic Test

WHO ……………………………………? World Health Organization

WHO. World malaria report 2020: 20 years of global progress and challenges. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.
WHO. “World malaria report,” 2017, December 2019, https://www.who.int/malaria/publications/world-malaria-report2017.
WHO. “World malaria report 2011,” World Health Organization, Geneva, Switzerland, 2012, June 2020, https://www.mmv.org/newsroom/publications/world-malaria-report2011?gclid.
WHO. “Guidelines for the treatment of malaria,” 2015, ISBN: 978 92 4 1549127. 2019, https://apps.who.int/iris/handle/10665/162441. [4] WHO, “World malaria report 2017,” 2017, December 2019,.
WHO. World Malaria Report, World Health Organization, Geneva, Switzerland, 2021, https://www.who.int/news-room/ fact-sheets/detail/malaria.
Federal Ministry of Health (FMOH). National five-year strategic plan for malaria prevention and control in Ethiopia 2006–2010, FMOH, Addis Ababa, Ethiopia, 2006.
Tadesse et al. Prevalence and associated risk factors of malaria among adults in East Shewa Zone of Oromia Regional State, Ethiopia: a cross-sectional study. BMC Public Health (2018) 18:25 DOI 10.1186/s12889-017-4577-0.
Millicent Ladi Umaru, and Gabriel Noblefather Uyaiabasi,. “Prevalence of Malaria in Patients Attending the General Hospital Makarfi, Makarfi Kaduna – State, North-Western Nigeria.” American Journal of Infectious Diseases and Microbiology, vol. 3, no. 1 (2015): 1–5. doi: 10.12691/ajidm-3-1-1.
Obimakinde and Simon-Oke. The Prevalence of Malaria Infection among Patients Attending the Health Centre of the Federal University of Technology, Akure, Nigeria: International Journal of TROPICAL DISEASE & Health. DOI: 10.9734/IJTDH/2017/35340.
Adamu Mengistu, Beyene Dobo and Solomon Sorsa. Prevalence of Malaria Infections Among Patients in Gimbie Adventist Hospital Western Wollega, Oromia Regional State, Ethiopia. International Journal of Healthcare and Medical Sciences. DOI: https://doi.org/10.32861/ijhms.73.31.40.
Azene Tesfaye and Tadegew Teshome. Prevalence and Associated Factors of Malaria Infection among Outpatients Visiting Shewa Robit Health Center, Northcentral Ethiopia. Hindawi Journal of Tropical Medicine Volume 2022, Article ID 1784012, 8 pages https://doi.org/10.1155/2022/1784012.
Tarekegn et al. Malaria prevalence and associated risk factors in Dembiya district, North-western Ethiopia. Malar J (2021) 20:372 https://doi.org/10.1186/s12936-021-03906-9.
Delil RK, Dileba TK, Habtu YA, Gone TF, Leta TJ (2016). Magnitude of Malaria and Factors among Febrile Cases in Low Transmission Areas of Hadiya Zone, Ethiopia: A Facility Based Cross Sectional Study. PLoS ONE 11(5): e0154277. doi:10.1371/journal.pone.0154277.
Ashenafi Abossie, Tsegaye Yohanes, Adisu Nedu, Weynshet Tafesse, Mengistu Damitie. Prevalence of Malaria and Associated Risk Factors Among Febrile Children Under Five Years: A Cross-Sectional Study in Arba Minch Zuria District, South Ethiopia. Infection and Drug Resistance 2020:13 363–372.
Jifar Hassen and Hunduma Dinka. Magnitude of urban malaria and its associated risk factors: the case of Batu town, Oromia Regional State, Ethiopia. Journal of International Medical Research 50(3) 1–11.
Belay et al. Malaria prevalence, knowledge, attitude, and practice among febrile patients attending Chagni health center, Northwest Ethiopia: a cross-sectional study. Tropical Diseases, Travel Medicine and Vaccines (2021) 7:20 https://doi.org/10.1186/s40794-021-00146-2.
Getu Abeje Negatu, Getaneh Alemu Abebe, and Woynshet Gelaye Yalew. Prevalence of Malaria and Associated Factors among Malaria Suspected Patients Attending Hamusit Health Center, Northwest Ethiopia: A Cross-Sectional Study: Hindawi Journal of Parasitology Research Volume 2022, Article ID 1306049, 7 pages https://doi.org/10.1155/2022/1306049.

No competing interests reported.

Download PDF

Version 1

posted

You are reading this latest preprint version

Magnitude of Malaria and Associated Factors Among Febrile Patients Visiting Public Health Facilities in Olanchity Town, East Shewa, Central Ethiopia, 2022. Crosssectional Study Design.

Status:

Version 1

Abstract

Figures

Background

Methods

Study area

Study design and period

Source and Study population

Source population

Study population

Sample size and sampling procedures

Sample size determination

Sampling procedure

Data collection procedures (instruments, personnel, measurements)

Data quality assurance

Data processing and analysis

Ethical considerations

Result

3.1. Sociodemographic characteristics

3.2. Magnitude of malaria among febrile cases visited public health facilities at Olanchit Town

3.3. Determinant factors among febrile cases visited public health facilities

Discussion

LIMITATION

Conclusion

Declarations

Abbreviations

References

Additional Declarations

Status:

Version 1