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 Poor housing construction is associated with contracting malaria 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 ◽  
Rural Health Center ◽  
Entry Points ◽  
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 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 still associated with getting sick from malaria (AOR: 5.88; 95%CI: 1.11-31.30; p=0.038). Those who had mosquito nets did not use them consistently. The district health team and the rural health center were well prepared for an outbreak 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.

Malaria Associated Risk Factors Among Adolescent Living in Areas With Persisting Transmission in Senegal: a Case Control Study.

2021 ◽  
Author(s):  
FASSIATOU OLUWATOSIN TAIROU ◽  
Abdoulaye Diallo ◽  
Ousmane Sy ◽  
Aminatou Kone ◽  
Isaac Akhenaton Manga ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Case Control Study ◽  
Preventive Measures ◽  
Clinical Malaria ◽  
Case Control ◽  
Vulnerable Groups ◽  
Malaria Episode ◽  
Stepwise Logistic Regression ◽  
Factors Associated ◽  
Control Study

Abstract Background: In Senegal, malaria morbidity has shapely felt down over these past years. However, malaria epidemiology remains heterogeneous with persisting transmission in the southeastern part of the country and more important number of cases arising among older children and adolescents. Little is known about factors associated with clinical malaria among this group. A better understanding of malaria transmission among this new vulnerable group will guide future interventions targeting these key populations. This study aimed to identify factors associated with clinical malaria among adolescents in Senegal. Methods: A case control study was conducted from November to December 2020 in four health posts located in Saraya district. Cases were defined as adolescents (10-19 years) with uncomplicated malaria episode with fever (Temperature>37.5°) or history of fever and a positive malaria RDT. Controls were from the same age group, living in the neighborhood of the case, presenting a negative RDT. A standardized, pre-tested questionnaire was administered to each participant followed by home visit to assess participant’s living conditions. Factors associated with clinical malaria was assessed using a Stepwise Logistic regression analysis.Results: In total, 492 individuals were recruited (246 cases and 246 controls). In a multivariate analysis, factors associated with clinical malaria included non-use of bed net (aOR=2.65; 95% CI =1.58 - 4.45), non-use of other preventive measures (aOR=2.51; 95% CI=1.53 - 4.11) and indoor sleeping (aOR=3.22; 95%CI =1.66- 6.23). Protective factors included age of 15-19 years (aOR=0.38; 95% CI 0.23 - 0.62), absence of stagnant water around the house (aOR=0.27; 95% CI=0.16 - 0.44), having a female as head of household (aOR=0.47; 95% CI=0.25 - 0.90), occupation such as apprentice (OR=0.24; 95%CI=0.11 - 0.52).Conclusions: The study revealed that environmental factors and non-use of malaria preventive measures are the main determinant of malaria transmission among adolescents living in areas with persisting malaria transmission in Senegal. Strategies aiming at improving disease awareness and access to health care interventions such as LLIN are thus needed to improve malaria control and prevention among these vulnerable groups.

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 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 Prevalence of Balance Impairment and Factors Associated with Balance among Patients with Stroke. A Cross Sectional Retrospective Case Control Study

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 320
Author(s):  
Fayaz Khan ◽  
Mohamed Faisal Chevidikunnan
Keyword(s):  
Case Control Study ◽  
Binary Logistic Regression ◽  
Berg Balance Scale ◽  
Case Control ◽  
Knee Extensors ◽  
Retrospective Case ◽  
Cross Sectional ◽  
Balance Impairment ◽  
Factors Associated ◽  
Control Study

Stroke is a major cause of disability worldwide, and balance impairments are common disabling factors in patients with stroke, leading to falls. Thus, the study objectives were as follows: (i) To find the prevalence of balance impairment among patients with stroke. (ii) To find out the factors associated with balance impairment in patients with stroke. This cross-sectional retrospective case control study involved eighty-one post stroke patients with a mean age of 58.36 ± 14.06, recruited from six hospitals, who underwent an assessment of balance, walking speed, depression and isometric strength of the ankle and knee. These patients were later categorized into subjects with good balance (<45) in the Berg balance scale (BBS) and those with poor balance (≥45), as cases and controls, to assess the factors associated with balance impairment using binary logistic regression. The prevalence of balance impairment among patients with stroke was 48.1%. The reduction in power of knee flexors (OR = 0.858), knee extensors (OR = 0.880) and ankle dorsiflexors (OR = 0.820) was found to be significantly associated with balance impairment, along with speed (OR = 1.187 (95% CI = 1.100, 1.280)), depression (OR = 1.331 (95% CI = 1.055–1.679)) and activities of daily living (OR = 0.313 (95% CI = 0.150–0.650)). In summary, around half of the patients with stroke exhibited balance impairments, with females being more prone.

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