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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Addis Abeba University


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.



Severe malaria, Treatment outcome, Under-five children, Trend, Konso, Ethiopia