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 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.

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 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 Factors associated with malaria infection in Mudzi District, Mashonaland East Zimbabwe, 2019: a case-control study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
T. T. Masango ◽  
T. K. Nyadzayo ◽  
N. T. Gombe ◽  
T. P. Juru ◽  
G. Shambira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Case Control ◽  
Stagnant Water ◽  
Tall Grass ◽  
Effective Prevention ◽  
Outdoor Activities ◽  
Factors Associated ◽  
Malaria Outbreak ◽  
Control Study

Abstract Background Kondo Rural Health Centre recorded 27 malaria patients between the 27th of January 2019 and the 2nd of February 2019 against an epidemic threshold of 19 with the malaria outbreak being confirmed on the 5th of February 2019. Indoor residual spraying as part of integrated vector management control activities had been done in the district before the onset of the rainy season as well as social behaviour change communication but residents were contracting malaria. We, therefore, investigated the risk factors associated with this outbreak to recommend scientifically effective prevention and control measures. Methods We conducted a 1:1 unmatched case-control study. A case was a resident of Mudzi from the 4th of February 2019 who had a positive rapid diagnostic test for malaria randomly selected from the clinic’s line list whilst controls were randomly selected from the neighbourhood of cases. Pretested interviewer-administered questionnaires were used to collect information on demographic characteristics, knowledge and practices of residents in malaria prevention. Data were analysed using Epi info 7. Results A total of 567 confirmed malaria cases was recorded with an overall attack rate of 71.7 per 1000 population. Sixty-three case-control pairs were interviewed. The majority of cases 78% (49/63) were from Makaza, Chanetsa and Nyarongo villages which are within 3 km from Vhombodzi dam. A stagnant water body near a house [aOR = 8.0, 95%CI = (2.3–28.6)], engaging in outdoor activities before dawn or after dusk [aOR = 8.3, 95%CI = (1.1–62.7)] and having a house with open eaves [aOR = 5.4, 95%CI = (1.2–23.3)] were independent risk factors associated with contracting malaria. Wearing long-sleeved clothes when outdoors at night [aOR = 0.2, 95%CI = (0.1–0.4)] was protective. Conclusion A stagnant water pool close to the homestead and engaging in outdoor activities before dawn and after dusk were modifiable risk factors associated with the malaria outbreak despite the community being knowledgeable on the transmission and prevention of malaria. Community sensitisation and mobilisation in the destruction of stagnant water bodies and cutting of tall grass around homesteads were recommended measures to contain the outbreak.

scholarly journals Epidemiology of cutaneous leishmaniasis in the endemic area of Jericho, Palestine

2003 ◽  
Vol 9 (4) ◽  
pp. 805-815
Author(s):  
A. Al Jawabreh ◽  
F. Barghuthy ◽  
L. F. Schnur ◽  
R. L. Jacobson ◽  
G. Schonian ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Leishmania Major ◽  
Case Control Study ◽  
Refugee Camp ◽  
Case Control ◽  
Bed Nets ◽  
Enzyme Linked Immunosorbent Assay ◽  
Level Of Education ◽  
Factors Associated ◽  
Control Study

Thistudy of cutaneous leishmaniasis in Jericho city and the adjacent Aqbat-Jaber refugee camp investigated the seroprevalance of Leishmania major and the risk factors associated with acquiring the disease. Clinical and parasitology identification of cases showed children and young men were more affected, with the head most affected in children. Enzyme-linked immunosorbent assay [ELISA] was used to test sera from 190 individuals. The overall seroprevalence of cutaneous leishmaniasis was 26.3%. A case-control study of 247 individual in 37 households showed that a higher level of education of the head of the household and having children sleep under bed nets were significantly related to a lower incidence of cutaneous leishmaniasis

scholarly journals Malaria Outbreak –in Hitsats Refugee Camp, Tigray Region, Ethiopia- 2017, A Case-Control Study

2020 ◽  
Author(s):  
Mekonen Gebrekidan Gebremichael ◽  
Samuel Gebresilassie Aregay ◽  
Kissanet Wedearegay Tesfay ◽  
Getahun Embaye Kebede ◽  
Alefech Gezihagn Adissu
Keyword(s):  
Risk Factor ◽  
Malaria Infection ◽  
Case Control Study ◽  
Signs And Symptoms ◽  
Refugee Camp ◽  
Case Control ◽  
Refugee Camps ◽  
Malaria Outbreak ◽  
Control Study ◽  
At Home

Abstract Background: Over 80% of current refugee camps worldwide are located in malaria-endemic areas and malaria accounts for up to 50% of all deaths among refugees. In 2016, 3,152 malaria cases were reported from Hitsats Refugee Camp located in northern Ethiopia. A malaria outbreak was reported from Hitsats Refugee Camp (Population=8498) on June 19th, 2017. We investigated to describe the epidemiology, identify risk factors, and implement control measures.Methods: We defined a malaria case as any person a resident of Hitsats Refugee camp with fever or fever with headache, rigor, back pain, chills, sweats, myalgia, nausea, and vomiting, or confirmed microscopically or by Rapid Diagnostic Test to have malaria parasites from June 6th to July 3rd, 2017. We identified cases by reviewing the refugee clinic records and conducted a 1:1 case-control study from July 3rd to 14th, 2017. Cases were selected randomly using the patient registration book and recruited neighborhood controls who have no signs and symptoms of malaria and tested negative for Plasmodium species during the outbreak period from the same camp. We collected socio-demographic, behavioral, and risk factor information using a pre-tested structured questionnaire. Data were entered and analyzed using Epi-Info version 7.2.2. Multivariable logistic regression analysis was conducted to identify independent factors associated with malaria infection. Result: We identified 4,911 malaria cases with no death. Of those cases, 3,290 (67%) were males, and 4,322 (88%) were aged ≥5years. The overall attack rate (AR) was 58% (4911/8498) and was highest among <5years (84%) and was 55% among people ≥5years. Seventy-eight malaria cases and 78 controls were interviewed. The presence of patient/s with similar signs and symptoms at home (Adjusted Odds Ratio (AOR) =3.5, 95% Confidence Interval (CI) =1.6-7.8) was an independent risk factor associated with malaria. Owning insecticide-treated mosquito nets (ITNs) (AOR=0.17; 95%CI=0.07-0.4) and using personal protective equipment (PPE) to prevent mosquito bites when staying outdoors (AOR=0.18; 95%CI=0.08-0.4) were disease protective factors.Conclusion: The presence of patient/s with similar signs and symptoms at home, lack of ITN ownership and not using PPE were variables associated with malaria infection. Prevention strategies that target ITN distribution and the use of PPE to prevent mosquito bites may mitigate and prevent further outbreaks of malaria in refugee camps.

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