Socio-demographic characteristics of the study participants
All 356 individuals who were included in the study gave response to the questionnaire. Among study participants two-hundred sixteen (60.7%) were males where most of them were in the age groups above fourteen years old (46.90%). Educational status for most of the study respondents (24.72%) were above grade twelve and most of them (41.57%) were private (daily laborers) (Table 1).
Table 1. Socio-demographic characteristics of study subjects (N = 356) at Batu town from April to July, 2018.
Variables
|
Frequency
|
Percentage
|
Sex
|
|
|
Male
|
216
|
60.7
|
Female
|
140
|
39.3
|
Age
|
|
|
0 – 4
|
85
|
23.87
|
5-14
|
103
|
28.93
|
>14
|
167
|
46.90
|
Education status
|
|
|
Illiterate
|
41
|
11.52
|
1- 4
|
53
|
14.89
|
5 – 8
|
71
|
19.94
|
9 – 10
|
55
|
15.45
|
11- 12
|
48
|
13.48
|
>12
|
88
|
24.72
|
Occupation*
|
|
|
Merchant
|
95
|
26.69
|
Government employer
|
62
|
17.42
|
Farmer
|
51
|
14.32
|
Private (daily laborers)
|
148
|
41.57
|
*For children less than 18 years an occupation of their parents was considered.
Malaria prevalence and its associated risk factors
Out of 356 subjects involved in the current study, 17.13% (61/356) of them were confirmed malaria positive (Table 2). Variable test positivity was recorded at different health facilities which might be due to spatial heterogeneity of mosquito breeding sites in Batu town.
Table 2. Malaria cases among selected study subjects at Batu town from April – July, 2018.
Health facilities
|
Total number of examined subjects
|
Total malaria positive cases
|
Prevalence (%)
|
Pf
|
Pv
|
Mixed (Pf + Pv) infections
|
Share Ethiopia hospital*
|
52
|
9
|
17.3
|
4
|
5
|
0
|
Tsion MC
|
43
|
10
|
23.3
|
2
|
8
|
0
|
Meskel MC
|
35
|
7
|
20
|
3
|
4
|
0
|
Kidane MC
|
20
|
5
|
25
|
3
|
1
|
1
|
Oliyad MC
|
38
|
8
|
21
|
4
|
3
|
1
|
Bari MC
|
25
|
3
|
12
|
1
|
2
|
0
|
Addisu MC
|
18
|
1
|
5.6
|
1
|
0
|
0
|
Habtemu MC
|
31
|
5
|
16
|
2
|
3
|
0
|
Rabira MC
|
11
|
2
|
18.2
|
2
|
0
|
0
|
Dembel HC***
|
14
|
3
|
21.4
|
3
|
0
|
0
|
Batu HC***
|
18
|
2
|
11.1
|
1
|
1
|
0
|
Batu hospital**
|
51
|
6
|
11.8
|
2
|
4
|
0
|
Total
|
356
|
61
|
17.13
|
28
|
31
|
2
|
MC: Medium clinic, HC: health center, Pf: Plasmodium falciparum, Pv: Plasmodium vivax
* - private hospital; ** - government hospital; *** - government health centers
Of the total malaria cases identified, higher cases (50.8%, 31/61) were occurred due to P. vivax than P.falciparum (45.9%, 28/61). Mixed infections were occurred in 3.3% (2/61) of the total malaria cases (Figure 2).
With regard to the distribution of malaria cases with sex, out of 17.13% overall prevalence of malaria, we observed 9% and 8.13% in males and females, respectively (Table 3). Sex had no statistical significance association with malaria infection (χ2 = 2.026, P = 0.155). Malaria infection occurred among all age groups. We observed higher prevalence of malaria, 11.8%, among age groups of greater than 14 years old (adolescents and adults); whereas for age groups between 0 – 4 and 5 – 14 years old, it was 2.5% and 2.8%, respectively. There was statistically significant association between age and malaria infection (Table 3).
Table 3. Prevalence of malaria in relation to sex and age groups of study participants at Batu town from April – July, 2018.
Risk factors
|
Number examined
|
Number infected
|
Percentage*
|
P-value
|
Sex
|
|
|
|
|
Male
|
216
|
32
|
9
|
0.156
|
Female
|
140
|
29
|
8.1
|
Total
|
356
|
61
|
17.1
|
|
Age groups
|
|
|
|
|
0 – 4
|
86
|
9
|
2.5
|
0.001
|
5-14
|
103
|
10
|
2.8
|
|
> 14
|
167
|
42
|
11.8
|
|
Total
|
356
|
61
|
17.1
|
|
*Percentage is out of total population (N= 356)
The average monthly prevalence of malaria was 16.9%. However, the number of patients visiting health facilities showed fluctuating during the months the study was conducted. Relatively greater number of malaria cases (36; 59.0%) were treated during June and July months (wet season) while lower number (25; 41.0%) during April and May months (Dry season) (Figure 3). However, there was no statistical significance difference in malaria prevalence between seasons (χ2 = 3.118, P = 0.077) (Table 4).
Table 4. Seasonal pattern of malaria by Plasmodium species in Batu town health facilities
Season
|
Month
|
No. examined
|
Slide positive n, (%)
|
Pf, n
|
Pv, n
|
Mixed, n
|
P- value
|
Dry season
|
April
|
93
|
14 (15.05%)
|
7
|
7
|
0
|
0.077
|
May
|
89
|
11 (12.36%)
|
6
|
4
|
1
|
Wet season
|
June
|
99
|
21 (21.21%)
|
7
|
14
|
0
|
July
|
75
|
15 (20.27%)
|
8
|
6
|
1
|
|
Total
|
356
|
61 (17.13%)
|
28
|
31
|
2
|
|
Pf: Plasmodium falciparum, Pv: Plasmodium vivax
Among patients treated for malaria at health facilities in Batu town 82% of patients were treated at private health facilities while 18% at government health facilities (Figure 4).
Logistic regression analysis showed that individuals who use ITN were less likely to get malaria infection (OR = 0.38, 95% CI (0.194, 0.743), and P = 0.005). Individuals who had been living closer to stagnant water were almost three-fold times to get malaria infection than those who were found at a distant from reservoir water (OR= 2.97, 95% CI (1.68, 5.26) and P < 0.001). Similarly, individuals whose houses were sprayed with insecticides were approximately 0.2 times less chance of getting infection with malaria as compared to those whose houses were not sprayed with insecticides (OR = 0.18, 95% CI (0.097,0.34) and P < 0.001) (Table 5).
Table 5. Logistic regression analysis for association of other risk factors with malaria infections in the study area, from April – July, 2018.
Variables
|
Category
|
Malaria cases (n = 61)
|
Malaria negatives (n = 295)
|
OR (CI at 95%)
|
P- value
|
Sex
|
Male
|
32
|
184
|
0.67 (0.384,1.17)
|
0.156
|
Female
|
29
|
111
|
ITN utilization
|
Yes
|
16
|
38
|
0.38, (0.194,0.743)
|
0.005
|
No
|
45
|
257
|
Presence of stagnant water
|
Yes
|
38
|
106
|
2.97, (1.68, 5.26)
|
<0.001
|
No
|
23
|
189
|
Insecticide spray
|
Yes
|
26
|
39
|
0.18, (0.097,0.34)
|
<0.001
|
No
|
35
|
256
|
|
|
|
|
|
|
|
OR: odds ratio, CI: confidence interval