Highland fringe malaria and challenges in its control: the lesson from Akaki town.

Malaria is a major public health problem and of considerable socio-economic burden in most parts of Ethiopia. The country has witnessed recurrent epidemics of the disease, resulting in grave consequences including in areas designated as highland fringe. A study was undertaken to grossly assess the magnitude of the problems, the effectiveness of the control options and to explore the challenges encountered and the experiences gained during the 1998 malaria epidemic in Akaki Town and its environs. Health facility clinical records of individual patients and weekly surveillance and epidemic control reports were utilized as principal sources of data. The information revealed that the epidemic was very alarming affecting a sizable part of Akaki and the surrounding areas, with the total number of cases amounting to 622. The epidemic was controlled by case detection and treatment as well as by intensive vector control activities. The control endeavor, however, posed great difficulties due to the absence of systematic malaria control program, owing to underestimation of the threat from highland malaria. The contribution from the adjacent Oromia Malaria Control Program and The Federal Ministry of Health to control the epidemic (mainly vector control) was reckoned to be substantial. Thus, capacity building targeted to early detection, prevention and control of malaria epidemics, and preparedness is deemed to be of paramount importance. A viable Integrated Disease Surveillance and Response at health facilities could ensure early containment of the otherwise devastating epidemics.