Malaria Outbreak Investigation in Mecha, Dera and Fogera Districts, Amhara Region, Ethiopia

Introduction- Malaria is caused by the protozoan parasite plasmodium and transmitted by anopheles mosquitoes. It remains the major public health challenge in Amhara region. Mecha, Dera and Fogera are some of the malaria endemic districts of the region. The aim of this study was to investigate the outbreak and guide intervention measures. Methods – Descriptive cross sectional investigation of malaria outbreak was conducted. We used health facility records of malaria data and entomological survey. We discussed with health extension workers and available morbidity, mortality and diagnostic data was collected. We surveyed households for clinical malaria cases and utilization of LLINs and its status, the condition of IRS operation at household level was observed. Results-In Midre-Genet kebele/village the prevalence rate of malaria in the 4th week of April was 3 per 1000(19) population and reached to 37 per 1000(226) population in the 2nd week of May 2012.The attack rate was 82.5 per 1000(67) population in under-fives and 82.6 per 1000(429) population in >5 years old. In Wotet-Ber kebele the prevalence rate of malaria increased to 5 per 1000(35) population in the 1st week of May 2012 and became 22 per 1000 (150) population in the 2nd week of May. The attack rate was 30.4 per 1000(28) population in under-fives and 42.9 per 1000(253) population in >5 years old. In Zemene-Hiwot kebele/village the prevalence rate of malaria increased to 4.5 per 1000 (45) population in the 1st week of May 2012 and became 17 per 1000(171) population in the 3rd week of May 2012. The attack rate was 82.6 per 1000(111) population in under-fives and 36.3 per 1000(312) in >5 years old.In Hamusit cluster the number of confirmed malaria cases surpass the threshold starting from December 2011. Attack rate was 8.9 per 1000(559) population in December 2011 and became 14.7 per 1000(919) population in April 2012. In Aba Kiros kebele prevalence rate of malaria increased in the 2nd week of May 2012 1.2(8) and reached to 14.9(93) per 1000 population in the 1st week of June 2012. Vector control interventions were not done in all affected villages/kebeles. Conclusion- There were multiple breeding sites where the larvae of anopheles mosquitoes found and vector control interventions were not carried out timely. There was no weekly monitoring chart at districts and health facilities to detect increased malaria cases at an early stage.