Factors Associated With Continued Transmission of Malaria in Geita District, Tanzania

Abstract

Background: Malaria is still a public health problem in Tanzania causing morbidity and mortality among the population, especially the underfives and pregnant women who are the most at risk group. Through the introduction and scale-up of key malaria interventions, significant progress has been made in the fight against malaria in Tanzania. Data from the 2011/12 THMIS showed a nationwide decline of malaria prevalence from 18% to 9%, equivalent to 50% decline. However, in some districts like Geita, the prevalence remains high at 32%. The factors associated with persistence of high prevalence have not been explored. Objective: This study examined the current prevalence of malaria among underfive children and the factors associated with persistence of high prevalence in Geita district. Methodology: A qualitative cross-sectional study of 182 household and 351 underfive children was carried out in two wards of Geita District in August 2015. Finger prick blood samples from underfives were examined using malaria rapid diagnostic tests to establish the current prevalence of malaria. Questionnaire interview were conducted with heads of households to obtain information on factors such as knowledge, attitudes and practices affecting use of insecticide treated nets and indoor residual spraying. Also, a survey for observation and identification of potential breeding sites associated with malaria transmission was carried out. Results: Overall prevalence of malaria among underfive was 18.2 %, while for the two wards of Kalangalala and Mtakuja it was 4.9% and 32.5% respectively. Knowledge about insecticide treated nets was high, at 49.5 % and low about indoor residual spraying 11%. The level of insecticide treated nets ownership was 57.1 %, while indoor residual spraying acceptance was 76.4%. Among the household interviewed, 93.4 % of respondents said children were out door at night with their mothers while preparing meals. Conclusion: The overall prevalence of malaria among underfive in Geita district has declined from 32% to 18%, although it is still high when compared to the overall nationwide malaria prevalence of 9%. Area of residence, nocturnal outdoor behaviour and presence of productive anopheline mosquito larva habitats contribute to continued malaria transmission. Effective control and intervention measures together with strong health education campaigns, as well as promotion of behaviour change will bring impact in reducing malaria transmission.