Trend and determinants of treatment outcome of severe malaria among under-five children admitted in karat primary hospital, konso zone, southwest Ethiopia, 2021: Retrospective Cross-sectional study
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Date
2021-10
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Addis Abeba University
Abstract
Background: Despite rigorous global and national efforts, malaria remains a significant
cause of morbidity and mortality among under-five children. It causes a serious health
and economic burden globally, in sub-Saharan countries including Ethiopia in particular.
In 2019, children alone contribute 67% of the global malaria mortality burden. Few
studies were conducted to determine the trend, treatment outcome of severe malaria and
its determinants among under-five children in Ethiopia.
Objectives: The main aim of this study was to assess trend and determinants of treatment
outcome of severe malaria among under-five children in karat primary hospital, konso
zone, Southwest Ethiopia, 2021.
Methods: An institution based retrospective cross-sectional study was conducted.
Consecutive sampling was applied for the trend analysis of five-year malaria incidence
from Feb 08-Mar 08 2021. 254 charts were selected by systematic random sampling
technique from June10-30,2021. Data was collected by trained data collectors using a
pre-tested checklist. The collected data was cleaned and entered using Epi-data 4.6 and
analyzed using SPSS version 25. Descriptive statistics was used to summarize the study
variables. Bivariate and multivariable logistic regressions was used to determine the
association between determinants and outcome variable. Odds ratio with 95% CI was
used to show the direction and strength of association. P-value <0.05 was used to declare
statistical significance.
Result: From a total of 7663 malaria suspects, 2572 was confirmed positive making over
all positivity of 33.5%. Plasmodium falciparum attributed for 1904(74%) of confirmed
cases. Fluctuating up and down trend with seasonal variation with highest cases was
observed in autumn and the lowest in winter of the all years. Among 254 children
admitted with severe malaria 37(14.6%) was died. Children in age group of 48-59
months AOR =0.04 (95% CI 0.00-0.87), government employed mothers AOR=0.19
(95% CI 0.04-0.92), co-morbidity AOR=14.08 (95% CI 3.04-65.27), prolonged hospital
stay AOR=10.31(2.55-41.67) and late treatment seeking AOR=6.37 (95% CI,1.67- 25)
were more likely to die.
Conclusion: Malaria remained the common public health challenge in the study area
with no significant reduction during the five-year period. The mortality due to sever
malaria was also high with various factors such as age of the child, maternal
employment, co-morbidity, prolonged hospital stays and late treatment seeking was
some of the factors that increased the odds of death. Therefore, intensification of key
intervention activities should be implemented with the focus on the identified risk
factors.
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Keywords
Severe malaria, Treatment outcome, Under-five children, Trend, Konso, Ethiopia