Department of Medical Biotechnology, Institute of Biotechnology, University of Gondar, Gondar, Ethiopia.
Gondar University Specialized Hospital, University of Gondar, Gondar, Ethiopia.
J Epidemiol Glob Health. 2022 Sep;12(3):362-371. doi: 10.1007/s44197-022-00034-8. Epub 2022 Mar 27.
Currently, the district-level malaria transmission stratification has indicated the Northern, Northwestern, Southern, and rift valley lowland and surrounding highland districts are almost entirely classified as high or moderate malaria transmission zones. Conducting malaria surveillance to track, test, and treat all malaria cases cannot be implemented in Ethiopia in the current situation.
To show malaria transmission dynamics in different health facilities located from 1800 to 2772 m altitudes during 2018-2021 in Northwest Ethiopia.
A total of 3.5 years (2018-2021) retrospective confirmed and treated malaria cases in 43 kebeles health posts and clinics in Gondar Zuria district were used for analysis.
The total malaria count was 5893 for 2019 compared to 31, 550 for 2020 and 33, 248 for 2021. Mean monthly malaria incidence/1000 people in 2019 was 2.39 ± 5.4 and increased to 10.64 ± 16.99 in 2020 and 11.19 ± 16.59 in 2021. Annual malaria incidence increased from 24 cases/1000 people in 2019 to 139.08 cases/1000 people in 2021 and is alarming danger in malaria elimination program in the district or the country as a whole. Poisson and Negative binomial regressions models indicated 5.78- and 5.26-fold malaria cases increase, respectively, in 2021 compared to 2019. The sudden increase in malaria incidences (counts) in 2020 and 2021 coincided with the interruption of residual insecticide application in Gondar Zuria district during the transition period towards the malaria pre-elimination stage implicating the role of malaria control tools in suppressing transmission. Study on climate variability also indicated that the rainfall variability in different months might have also favored high malaria transmission in 2020 and 2021 compared to 2019. Thus, in addition to re-starting the use of malaria control tools, giving attention to climate anomalies (variability) that favors malaria transmission, for prompt interventional actions, is required. The malaria elimination program in Ethiopia might have not reached a pre-elimination stage as malaria cases per 1000 people have not decreased below five in the majority of Ethiopian districts. Tracing, confirming, and treating individual cases to stop further transmission is, almost, impossible. In a situation like this, the Ethiopian malaria elimination program should work intensively towards understanding malaria epidemiology at the district level to re-design a localized malaria control strategy. The renewed malaria control program should also consider altitudes above 2000 m.
目前，地区疟疾传播分层表明，北部、西北部、南部和裂谷低地以及周围高地地区几乎全部被归类为高或中度疟疾传播区。在埃塞俄比亚目前的情况下，无法进行疟疾监测以跟踪、检测和治疗所有疟疾病例。
展示 2018-2021 年期间埃塞俄比亚西北部海拔 1800 至 2772 米的不同卫生设施中的疟疾传播动态。
总共使用了 Gondar Zuria 区 43 个 kebeles 卫生哨所和诊所 3.5 年（2018-2021 年）的回顾性确诊和治疗疟疾病例进行分析。
2019 年总疟疾病例数为 5893 例，而 2020 年为 31550 例，2021 年为 33248 例。2019 年每月每 1000 人疟疾发病率为 2.39±5.4，到 2020 年增加到 10.64±16.99，到 2021 年增加到 11.19±16.59。2019 年的疟疾年发病率为每 1000 人 24 例，到 2021 年增加到 139.08 例/1000 人，这在该地区或全国消除疟疾规划中令人担忧。泊松和负二项回归模型表明，2021 年的疟疾病例分别比 2019 年增加了 5.78 倍和 5.26 倍。2020 年和 2021 年疟疾发病率（病例数）的突然增加恰逢 Gondar Zuria 区在向疟疾消除前阶段过渡期间停止使用残留杀虫剂，这表明疟疾控制工具在抑制传播方面发挥了作用。对气候变异性的研究也表明，与 2019 年相比，不同月份的降雨变异性也可能有利于 2020 年和 2021 年的高疟疾传播。因此，除了重新开始使用疟疾控制工具外，还需要关注有利于疟疾传播的气候异常（变异性），以便及时采取干预措施。埃塞俄比亚的消除疟疾规划可能尚未达到消除前阶段，因为大多数埃塞俄比亚地区每 1000 人疟疾病例数仍未降至 5 例以下。追踪、确认和治疗个别病例以阻止进一步传播几乎是不可能的。在这种情况下，埃塞俄比亚的消除疟疾规划应努力深入了解地区一级的疟疾流行病学，重新设计本地化的疟疾控制战略。新的疟疾控制方案还应考虑海拔 2000 米以上的地区。
