scholarly journals Malaria Outbreak Facilitated by Increased Human Activities around Swamps: Kisoro District, Uganda, December 2017-March 2018

2019 ◽  
Author(s):  
Joyce Nguna ◽  
Dennis Okethwangu ◽  
Daniel Kadobera
Keyword(s):  
Malaria Elimination ◽  
Human Activities ◽  
Case Control Study ◽  
Case Control ◽  
Bed Net ◽  
Sudden Increase ◽  
Breeding Sites ◽  
Late Night ◽  
Malaria Outbreak ◽  
Control Study

Abstract Background: Malaria elimination is increasingly becoming a global priority. On 19 December 2018, a district in southwestern Uganda known to have achieved pre-elimination levels of malaria (<30 cases per month) reported a sudden increase in cases to the Ministry of Health. We investigated to determine the magnitude and scope of the outbreak and identify exposures associated with transmission. Methods:We reviewed medical records in all health facilities in the affected Kanaba and Murora sub-counties to find cases. We calculated attack rates (AR) by age, sex, and village using the projected 2016 population. In a case-control study, we compared potential exposures between case-patients, selected randomly from the line-list, and neighborhood- and age-matched asymptomatic controls. We conducted an entomological and environmental assessment of randomly-selected households and potential breeding sites of the affected sub-counties. Results: We found 3,130 malaria cases (compared with 879 cases during the same period the previous year). Persons in the age groups 10-19 (AR=14/1,000) and 20-29 (AR=12/1,000) years were the most affected. Villages closest to the swamp had the highest attack rate. In the case-control study, 89% (129/145) of case-patients and 73% (106/145) of controls reported frequent late-night mosquito bites (ORCLR=3.9; 95%CI: 1.8-8.4); 70% (102/145) of case-patients and 59% (86/145) of controls had a household size >5 (ORCLR=1.8; 95%CI: 1.04-3.1); 78% (113/145) of case-patients and 86% (125/145) of controls usually slept under a bednet (ORCLR=0.56; 95%CI: 0.29-1.1). Anopheles gambiae sensu lato was identified in breeding places around Sereri and Mpundu swamps. In total, 64% (23/36) of female adult Anopheles captured in case-patients’ households by pyrethrum spray catches were fed, suggesting low bed-net usage the previous night in the surveyed households. Conclusion: This malaria outbreak was likely propagated by favorable breeding conditions, including recent heavy rainfall, and exacerbated by new human activities around two swamps. To achieve malaria elimination, low-endemic areas should be particularly aware of activities that can lead to resurgences in malaria, such as night-time exposures, lack of bed-net usage, and human activities focused around breeding sites. We recommended increased awareness about bed-net usage and use of larvicides in the residential area and swamps to break the breeding cycle.

scholarly journals Factors Associated with a Malaria Outbreak at Tongogara Refugee Camp in Chipinge District, Zimbabwe, 2021: A Case-Control Study

2021 ◽  
Author(s):  
Kudzai Patience Takarinda ◽  
Simon Nyadundu ◽  
Emmanuel Govha ◽  
Addmore Chadambuka ◽  
Notion Tafara Gombe ◽  
...  
Keyword(s):  
Case Control Study ◽  
Refugee Camp ◽  
Case Control ◽  
Habitat Modification ◽  
Whole Body ◽  
Disease Notification ◽  
Breeding Sites ◽  
Factors Associated ◽  
Malaria Outbreak ◽  
Control Study

Abstract Background: Malaria is a leading cause of morbidity and mortality among forcibly displaced populations including refugees, approximately two-thirds of whom reside in malaria endemic regions. Data from the rapid disease notification system (RDNS) reports for Manicaland Province in Zimbabwe showed that despite implementation of malaria control initiatives, there was an increase in number of malaria cases above action thresholds at Tongogara Refugee Camp in Chipinge District during weeks 12-14. We investigated the malaria outbreak describing the outbreak by person, place and time, assessing malaria emergency preparedness and response and appropriateness of case management. We also determined the factors associated with contracting malaria to enable the formulation of appropriate interventions, establish control and prevent future malaria outbreaks among this vulnerable population.Methods: We conducted a 1:1 unmatched case control study involving 80 cases and 80 controls using interviewer-administered questionnaires at household level. Data was entered using Epi Data version 3.1 and analyzed using Epi InfoTM version 7.2.4 to generate medians, proportions, odds ratios and their 95% confidence intervals.Results: Malaria cases were distributed throughout the 10 residential sections within Tongogara Refugee Camp, the majority being from section 7, 28/80 (35%). Despite constituting 11% of the total population, Mozambican nationals accounted for 36/80 (45%) cases. Males constituted 47/80 (59%) among cases versus controls 43/80 (54%), p=0.524. Median age for cases was also lower compared to controls; 15 years [Interquartile range (IQR), 9-26] versus 17 years (IQR, 10-30). Several natural and manmade potential vector breeding sites were observed around the camp. Risk factors associated with contracting malaria were engaging in outdoor activities at night [AOR 4.26 (95% CI, 1.43-12.68)], wearing clothes that do not cover the whole body [AOR=2.74 (95% CI 1.04-7.22) while sleeping in a refugee housing unit reduced the risk of contracting malaria [AOR=0.18 (CI, 0.06-0.55)]. Conclusions: The malaria outbreak at Tongogara Refugee Camp reemphasizes the role of behavioral factors in malaria transmission. We recommend intensified health education to address human behaviors that expose residents to malaria and habitat modification with larviciding to eliminate mosquito breeding sites.

scholarly journals Factors associated with a malaria outbreak at Tongogara Refugee Camp in Chipinge District, Zimbabwe, 2021: A case-control study

2021 ◽  
Author(s):  
Kudzai Patience Takarinda ◽  
Simon Nyadundu ◽  
Emmanuel Govha ◽  
Addmore Chadambuka ◽  
Notion Tafara Gombe ◽  
...  
Keyword(s):  
Case Control Study ◽  
Refugee Camp ◽  
Case Control ◽  
Habitat Modification ◽  
Whole Body ◽  
Disease Notification ◽  
Breeding Sites ◽  
Factors Associated ◽  
Malaria Outbreak ◽  
Control Study

Abstract BackgroundMalaria is a leading cause of morbidity and mortality among forcibly displaced populations including refugees, approximately two-thirds of whom reside in malaria endemic regions. Data from the rapid disease notification system (RDNS) reports for Manicaland Province in Zimbabwe showed that despite implementation of malaria control initiatives, there was an increase in number of malaria cases above action thresholds at Tongogara Refugee Camp in Chipinge District during weeks 12-14. We investigated the malaria outbreak describing the outbreak by person, place and time, assessing malaria emergency preparedness and response and appropriateness of case management. We also determined the factors associated with contracting malaria to enable the formulation of appropriate interventions, establish control and prevent future malaria outbreaks among this vulnerable population.MethodsWe conducted a 1:1 unmatched case control study involving 80 cases and 80 controls using interviewer-administered questionnaires at household level. Data was entered using Epi Data version 3.1 and analyzed using Epi InfoTM version 7.2.4 to generate medians, proportions, odds ratios and their 95% confidence intervals.ResultsMalaria cases were distributed throughout the 10 residential sections within Tongogara Refugee Camp, the majority being from section 7, 28/80 (35%). Despite constituting 11% of the total population, Mozambican nationals accounted for 36/80 (45%) cases. Males constituted 47/80 (59%) among cases versus controls 43/80 (54%), p=0.524. Median age for cases was also lower compared to controls; 15 years [Interquartile range (IQR), 9-26] versus 17 years (IQR, 10-30). Several natural and manmade potential vector breeding sites were observed around the camp. Risk factors associated with contracting malaria were engaging in outdoor activities at night [AOR 4.26 (95% CI, 1.43-12.68)], wearing clothes that do not cover the whole body [AOR=2.74 (95% CI 1.04-7.22) while sleeping in a refugee housing unit reduced the risk of contracting malaria [AOR=0.18 (CI, 0.06-0.55)]. ConclusionsThe malaria outbreak at Tongogara Refugee Camp reemphasizes the role of behavioral factors in malaria transmission. We recommend intensified health education to address human behaviors that expose residents to malaria and habitat modification with larviciding to eliminate mosquito breeding sites.

scholarly journals Malaria Outbreak Investigation in Argoba District, South Wello Zone, Northeast Ethiopia, 2016: A case control study

2019 ◽  
Author(s):  
Getachew Yismaw workie ◽  
Getayeneh Antehunegn Tesema ◽  
Ayenew Molla Lakew ◽  
Temesgen Yihunie Akalu
Keyword(s):  
Public Health ◽  
Case Control Study ◽  
Plasmodium Species ◽  
Breeding Site ◽  
Case Control ◽  
Health Concern ◽  
Bed Nets ◽  
Bed Net ◽  
Malaria Outbreak ◽  
Control Study

Abstract Background Malaria remains a major global public health concern and approximately half of the world’s population being at risk of infection. It is one of the common epidemic prone diseases and can result in continuous epidemics and end up with serious public health emergencies. Therefore, this study aimed at identifying determinants of malaria outbreak in Argoba district. Methods Community based case-control study was employed with a 1:1 case to control ratio at Argoba district from 21 June to 7 July, 2016. A total of 150 individuals (75 cases and 75 controls) were included in the study. Cases were taken from treatment registration book and neighborhoods to the cases were taken as control groups. Structured questionnaire was used as data collection tool. Data was entered using Epi-info version 7 statistical software and exported to STATA version 14 for analysis. A multivariable logistic regression analysis was used to identify determinants of the outbreak. The magnitude of the outbreak was described by place, person, and time. Adjusted Odds Ratios (AOR) with the corresponding 95% Confidence Interval (CI) was used to show the strength of associations and variables with P-values of <0.05 were considered statistically significant. Results The predominant Plasmodium species detected was P.falciparum, which is followed by P.vivax. The overall attack rate was 1.8%. Travel history to malarias site (AOR=14.6: 95% CI: 2.8, 77.7) and presence of mosquito breeding site around the home (less than 1000 meter) (AOR=13.3: 95% CI: 3.1, 58.0) were associated with the occurrence of malaria outbreak. However, using insecticide treated bed nets (AOR=0.004; 95% CI: 0.001, 0.06) and chemical indoor residual spray (AOR=0.02; 95% CI: 0.01, 0.09) were found to be protective factors. Conclusions malaria outbreak was affected by distance from the breeding site and traveling history of malaria endemic areas. In contrast, bed net utilization and house hold spray with DDT were preventive factors of the outbreak. It is recommended to use bed net utilization and house hold spraying in the district.

scholarly journals Malaria outbreak investigation in Tanquae Abergelle district, Tigray region of Ethiopia: a case–control study

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Kissanet Tesfay ◽  
Belete Assefa ◽  
Alefech Addisu
Keyword(s):  
Case Control Study ◽  
Case Fatality ◽  
Case Control ◽  
P Value ◽  
Breeding Sites ◽  
Tigray Region ◽  
Mosquito Breeding ◽  
Associated Risk Factors ◽  
Malaria Outbreak ◽  
Control Study

Abstract Objective We investigated this outbreak to describe the magnitude and associated risk factors due to the malaria outbreak in Tanquae Abergelle district, Tigray, Ethiopia, in 2017. Result Case fatality rate of this study was zero. Among the 62 cases and 124 controls, the presence of mosquito breeding sites [OR = 6.56 CI (2.09–20.58) P value = 0.001], sleeping outside a home [OR = 5.06 CI (1.75–14.61) P-value = 0.003] and having unscreened window [OR = 14.89 CI (1.87–118.25) P-value = 0.011] were associated with illness in multivariate analysis.

scholarly journals Malaria Outbreak Facilitated by Appearance of Vector-Breeding Sites after Heavy Rainfall and Inadequate Preventive Measures: Nwoya District, Northern Uganda, February–May 2018

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Godfrey Nsereko ◽  
Daniel Kadobera ◽  
Denis Okethwangu ◽  
Joyce Nguna ◽  
Damian Rutazaana ◽  
...  
Keyword(s):  
Heavy Rainfall ◽  
Case Control Study ◽  
Preventive Measures ◽  
Case Fatality ◽  
Case Control ◽  
Control Measures ◽  
Northern Uganda ◽  
Entire Study ◽  
Breeding Sites ◽  
Control Study

Background. Malaria is a leading cause of morbidity and mortality in Uganda. In April 2018, malaria cases surged in Nwoya District, Northern Uganda, exceeding expected limits and thereby requiring epidemic response. We investigated this outbreak to estimate its magnitude, identify exposure factors for transmission, and recommend evidence-based control measures. Methods. We defined a malaria case as onset of fever in a resident of Anaka subcounty, Koch Goma subcounty, and Nwoya Town Council, Nwoya District, with a positive rapid diagnostic test or microscopy for malaria from 1 February to 25 May 2018. We reviewed medical records in all health facilities of affected subcounties to find cases. In a case-control study, we compared exposure factors between case-persons and asymptomatic controls matched by age and village. We also conducted entomological assessments on vector density and behavior. Results. We identified 3,879 case-persons (attack rate [AR] = 6.5%) and two deaths (case-fatality rate = 5.2/10,000). Females (AR = 8.1%) were more affected than males (AR = 4.7%) (p<0.0001). Of all age groups, 5–18 years (AR = 8.4%) were most affected. Heavy rain started in early March 2018, and a propagated outbreak followed in the first week of April 2018. In the case-control study, 55% (59/107) of case-persons and 18% (19/107) of controls had stagnant water around households for several days following rainfall (ORM-H = 5.6, 95% CI = 3.0–11); 25% (27/107) of case-persons and 51% (55/107) of controls wore full extremity covering clothes during evening hours (ORM-H = 0.30, 95% CI = 0.20–0.60); 71% (76/107) of case-persons and 85% (91/107) of controls slept under a long-lasting insecticide-treated net (LLIN) 14 days before symptom onset (ORM-H = 0.43, 95% CI = 0.22–0.85); 37% (40/107) of case-persons and 52% (56/107) of controls had access to at least one LLIN per 2 household members (ORM-H = 0.54, 95% CI = 0.30–0.97). Entomological assessment indicated active breeding sites in the entire study area; Anopheles gambiae sensu lato species were the predominant vector. Conclusion. Increased vector-breeding sites after heavy rainfall and inadequate malaria preventive measures were found to have contributed to this outbreak. We recommended increasing coverage for LLINs and larviciding breeding sites in the area.

scholarly journals Neglected cause of retinal detachment: a hospital-based case-control study on occupational heavy lifting as a risk factor

2021 ◽  
Vol 96 (1) ◽  
Author(s):  
Nayera S. Mostafa ◽  
Radwa Nabil El Shereif ◽  
Ayat F. Manzour
Keyword(s):  
Risk Factor ◽  
Family History ◽  
Retinal Detachment ◽  
Head Trauma ◽  
Case Control Study ◽  
Case Control ◽  
Work And Family ◽  
Sudden Increase ◽  
History Of ◽  
Control Study

Abstract Background Heavy lifting may lead to sudden increase in venous, intra-abdominal, and intraocular pressure which in turn may cause retinal detachment (RD). The epidemiological evidence for this association is still inconclusive. This study was carried out to investigate the relationship between occupational heavy lifting and RD. Methods A case-control study was carried out on 151 RD cases and 113 controls free of RD attending the ophthalmology outpatient clinic at Ain Shams University. Personal, medical, and occupational data were collected using interview questionnaires in addition to conducting full ophthalmologic examination. Results The mean age of study participants was 45.8 ± 9.1 years (46.8 ± 8.9, 44.4 ± 9.2 for RD cases and controls respectively). Statistically significant differences were found between cases and controls regarding years of working, occupational categories, frequency of occupational heavy lifting, non-work heavy lifting, history of head trauma, history of eye surgeries, and family history of RD. Multivariate logistic regression analysis showed that lifting (Odds ratio (OR) = 4.8, p < 0.0001), history of head trauma (OR = 3.3, p = 0.013), diabetes mellitus (DM) (OR = 4.96, p < 0.0001), and previous eye surgeries (OR = 3.5, p = 0.003) increased the risk of RD. Conclusion Occupational heavy lifting is associated with RD. Occupational categories, duration of lifting heavy objects during work and family history of RD had a significant effect on RD. An ergonomic approach should be adopted and practiced as it has a significant impact on reducing the risks of lifting and carrying heavy objects. The workplace’s design (including having appropriate mechanical aids available) is also of significant importance to reducing the risks. During the patient’s visit, ophthalmologists should consider and look for the occupational heavy lifting history as a potential risk factor of the patient’s symptoms.

scholarly journals Malaria outbreak investigation in a rural area south of Zimbabwe: a case-control study

2020 ◽  
Author(s):  
Paddington Tinashe Mundagowa ◽  
Pugie T. Chimberengwa
Keyword(s):  
Human Resources ◽  
Case Control Study ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Stepwise Logistic Regression ◽  
Factors Associated ◽  
Mosquito Nets ◽  
Entry Points ◽  
Malaria Outbreak ◽  
Control Study

Abstract Background Ninety percent of the global annual malaria mortality cases emanate from the African region. About 80-90% of malaria transmissions in sub-Saharan Africa occur indoors during the night. In Zimbabwe, 79% of the population are at risk of contracting the disease. Although the country has made significant progress towards malaria elimination, isolated seasonal outbreaks persistently resurface. In 2017, Beitbridge District was experiencing a second malaria outbreak within twelve months prompting the need for investigating the outbreak.Methods An unmatched 1:1 case-control study was conducted to establish the risk factors associated with contracting malaria in Ward 6 of Beitbridge District from week 36 to week 44 of 2017. The sample size constituted of 75 randomly selected cases and 75 purposively selected controls. Data were collected using an interviewer-administered questionnaire and Epi Info version 7.2.1.0 was used to conduct descriptive, bivariate and multivariate analyses of the factors associated with contracting malaria.Results Fifty-two percent of the cases were females and the mean age of cases was 29±13 years. Cases were diagnosed using rapid diagnosed tests. Sleeping in a house with open eaves (OR: 2.97; 95%CI: 1.44-6.16; p<0.01), spending the evenings outdoors (OR: 2.24; 95%CI: 1.04-4.85; p=0.037) and sleeping in a poorly constructed house (OR: 4.33; 95%CI: 1.97-9.51; p<0.01) were significantly associated with contracting malaria while closing eaves was protective (OR:0.45; 95%CI: 0.20-1.02; p=0.055). After using backward stepwise logistic regression, sleeping in a poorly constructed house was associated with five-fold odds of getting sick from malaria (AOR: 8.40 ; 95%CI: 1.69-41.66; p=0.009). Those who had mosquito nets did not use them consistently. The district health team and the rural health center were well prepared to response despite having limited human resources.Conclusion Health promotion messages should emphasize the importance of closing the entry points of the malaria vector, and the construction of better houses in the future. Residents had to be educated in the importance of consistent use of mosquito nets. The district had to improve malaria preventive measures like distribution of mosquito nets and lobby for more human resources to assist with malaria surveillance thus, curbing the recurrence of malaria outbreaks.

Association between the use of insecticide-treated bed net and malaria infection in Ende District, East Nusa Tenggara

2017 ◽  
pp. 62
Author(s):  
M. S. Sekunda ◽  
A. A. Sagung Sawitri ◽  
P. P. Januraga
Keyword(s):  
Malaria Infection ◽  
Case Control Study ◽  
Public Health Problem ◽  
Case Control ◽  
Bed Net ◽  
Control Groups ◽  
Physical Conditions ◽  
Net Use ◽  
And Control ◽  
Control Study

Background and purpose: Malaria is a public health problem in Eastern Indonesia, especially in East Nusa Tenggara. Insecticide-treated bed net was massively distributed in 2014, however the incidence of malaria in Ende District remains high. This study aims to examine association between the use of insecticide-treated bed net and malaria infection.Methods: A case control study was conducted in Wewaria Subdistrict, Ende District in 2016 involving 67 cases and 134 controls. Data on the use of insecticide-treated bed net which include methods of net use, net use practice, net maintenance and its current conditions were obtained through interviews and observations. Physical conditions of respondent’s house that include conditions of the wall, floor, window, ventilation, ceiling and lighting were also documented through observations. Data were analysed using logistic regression. Results: Cases and control groups were comparable for gender (p=1), age (p=0.9), education level (p=0.9) and occupation (p=0.6). This study found that five variables were associated with malaria infection: irregular use of the insecticide-treated bed net (AOR=4.08; 95%CI: 1.87-8.89), torn net (AOR=2.23; 95%CI: 1.10-4.54), inadequate lighting (AOR=3.64; 95%CI: 1.77-7.47), humid floor (AOR=3.02; 95%CI: 1.24-7.34) and holes or broken ceiling (AOR=2.41; 95%CI: 1.02-5.72).Conclusions: The use of insecticide-treated bed net and physical conditions of the house are risk factors for malaria infection.

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