Post-outbreak malaria morbidity and uptake of interventions in muleba compared to kigoma district, Tanzania

Abstract

Introduction Malaria is widespread in tropical and subtropical parts of America, Asia and Africa. Approximately 350- 500 million malaria cases and, 1-3 million deaths are reported annually, majority are children under 5 years in Sub-Saharan Africa. In 2008, about 247million malaria cases and 1 million malaria deaths were reported, mostly among children living in Africa. About 90% of the burden of malaria occurs in Sub-Saharan Africa where it is mostly endemic with epidemics necessitating concerted community based control intervention strategies, which with sustained use would avert future malaria epidemics. Thus, the aim of this study was to assess current use of triple malaria interventions following control of malaria epidemic in Muleba district five years ago, compared to Kigoma district implementing regular malaria control intervention. Methodology This was a cross-sectional analytic study, conducted between November 2010 and March 2011 in Muleba and Kigoma rural districts. Multistage sampling was used to get required study subjects who were heads of households or their delegates. A total of 400 participants (203 from Muleba and 197 from Kigoma rural districts) were involved in the study. Data was collected using structured questionnaires, data entry and analysis was done using Epi Info version 3.5.1. vii Results Among the study households 207 (51.7%) were headed by females and 314 (78.5%) household head age was more than 30years. The ownership and use of LLIN was higher in Muleba 91.6% and 66.5% respectively compared to Kigoma where 78.3% and 59.9% of the study population reported to own and use LLIN respectively. Among the factors found to be statistically significant were; level of education of LLINs user and size of family (P<0.05) in Kigoma. Reported malaria in the past two weeks was very low (12.3%) in Muleba compared to Kigoma, which was much higher (54.7%). Use of ACT among individuals with history of malaria was higher (76.8%) in Kigoma compared to Muleba (68.0%), the difference was not statistically significant (P>0.05). Although ACT use was higher in individuals with age >30yrs, level of education ≥ primary school, and households with under-fives ≥ 2, but these factors were not significant (P > 0.05). Conclusion and Recommendation The study revealed that people in Muleba continued and sustained the use of LLIN and IRS compared to Kigoma which was not exposed to the malaria control interventions. There was also very low reported malaria morbidity in Muleba compared to Kigoma suggesting a likelihood of averting malaria epidemic in the near future. The combination of three interventions (LLINs, ACT and IRS) in Muleba to control the epidemic was sustained and it might have contributed to the low malaria prevalence five years after the epidemic has been controlled. Control strategies used in Muleba can be applied to other places to increase uptake and utilization of malaria interventions. More studies should be done to explore factors associated with uptake of these interventions in order to maximize their coverage and use such lessons elsewhere thus maximize their benefits.