According to the open-source statistical program R output, the average completeness of the weekly report collected from 2015–2019 was 97.9% (95% CI: 96.2%, 98.9%). The average report timeliness was 96 % (95% CI: 95.5%, 97.7%) (Fig. 1).
Figure 1: The open-source statistical program R graphical outputs of the timelines & completeness of the reports of different woreda of Awi Zone, Amhara Regional State, Ethiopia, 2020.
The overall report completeness and timeliness rate was above the World Health Organization minimum goals (80%) in the last five years (Fig. 1). The difference might be due to increasing awareness of the community and acceptance of the community, health extension workers, and other health providers of the PHS.
In this analysis, we were done a malaria incidence rate of the zone and woreda according to the previous 5-year data to identify the hotspot zone and woreda. The surveillance data from the year 2015–2019 provided that North Gondar (59.7), Awi (54.3), South Gondar (27.5), and West Gojam (26.3) per 1000 populations had the highest Annual average incidence rate (Fig. 2).
Figure 2: The open-source statistical program R Graphical output of malaria average annual parasitic incidence rate per 1000 population by zones in Amhara Region, Ethiopia, 2015–2019.
In the current study, the Awi zone is our study area because the second hotspot area and all woreda were Ivermectin mass drug administration targeted woreda from the Year 2015–2019 and malaria incidence rate (Table 1 and Fig. 3).
Table 1
The open-source statistical program R tabular outputs of the malaria incidence rate of the study area from 2015–2019, Awi zone, Amhara Region, Ethiopia.
s.no | Name of Woreda | 2015 | 2016 | 2017 | 2018 | 2019 |
1 | Ankesha | 35.70 | 22.70 | 11.33 | 7.30 | 7.26 |
2 | Banja | 56.85 | 24.80 | 15.75 | 10.21 | 12.46 |
3 | Chagni | 160.20 | 88.56 | 53.22 | 59.57 | 80.91 |
4 | Dangila Ketama | 21.97 | 10.52 | 9.37 | 7.66 | 9.71 |
5 | Dangila zuria | 28.06 | 16.42 | 12.41 | 8.18 | 13.85 |
6 | Fagita lokoma | 30.01 | 14.88 | 9.67 | 8.81 | 4.82 |
7 | Guagusa shekudade | 47.74 | 18.30 | 13.37 | 7.96 | 6.23 |
8 | Guanga | 44.51 | 31.48 | 13.74 | 8.57 | 22.82 |
9 | Injebra | 45.76 | 15.06 | 12.88 | 8.18 | 8.98 |
10 | Jawi | 333.24 | 237.06 | 154.71 | 310.84 | 175.48 |
11 | Zigem | 50.82 | 28.34 | 26.03 | 41.40 | 28.20 |
No effect of Ivermectin on malaria elimination because the current API rate was still high. API reported from 2015–2019 was 0.52 (Fig. 4)
Population under PHS
PHEM targets all the population to be under surveillance for all the 21 diseases nationally and 22 diseases (include Lehimaniasis) in the Amhara region. All residents who selected Woreda of Awi Zone and Visited Woredas by 2020 covered in the study.
The national PHEM targets all the population in the country to be under PHS for all the 22 priority diseases. The Awi zone cascade the same structure, with a total population of 1,253,909 in 2020 with a population conversion factor from this 474012 population under PHS.
Current malaria test results
PHEM reports of 2019/2020 showed that 143,131 total malaria fever cases were examined by RDT or Microscopy regionally. Of which 43,131 confirmed malaria cases reported in the Awi zone. Of this 33,666 (78%) and 9,465 (22%) were Plasmodium falciparum and Plasmodium Vivax respectively. Malaria accounts for 16.6% of the total outpatient cases and 0.07% of the inpatient cases. Of the total malaria cases, 6,255 (14.5%) were under-five children, 21% were people aged from 5–14. 64.5% were above 15 years old. However, there were 1(0.02%) deaths due to malaria. The death of pregnant mothers was 596 (1.5%). During the same year, Awi Zone also reported 259,009(35.6% of the region) total malaria cases examined by RDT or Microscopy, of which 18,726 (58%) from the zone confirmed (Fig. 5).
Figure 5: The open-source statistical program R graphical outputs of trends of confirmed malaria cases by woreda and WHO Epidemiologic week of Awi Zone, woreda, Amhara region Ethiopia, 2020.
A Zone reported 43,131 confirmed malaria cases reported from July 2019 to August 2020. A total of 41,959 and 8,793 confirmed malaria cases were reported from the woredas Ankesha, Banja, Changi, Guasgusa, and Zigem respectively to Awi Zone from July 2019 to January 2020. Of these, 6,430 (73%) cases were positive for Plasmodium falciparum. The 2020 PHEM report also showed 8793 confirmed malaria cases reported from 27 weeks up to WHO week 52. 6430 (73%) and 2363 (27%) were plasmodium falciparum and plasmodium Vivax substantially.