Malaria Outbreak Investigation in Pastoral Communities of BenaTsemay District, Southern Ethiopia: A Case Control Study
American Journal of Health Research
Volume 7, Issue 3, May 2019, Pages: 31-37
Received: Mar. 4, 2018; Accepted: Jul. 10, 2019; Published: Jul. 26, 2019
Views 548      Downloads 174
Mebratu Shite Wondimu, School of Public Health, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
Endrias Markos Woldesemayat, School of Public Health, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
Tsehay Ayele Aselle, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
Article Tools
Follow on us
Over 60% (60 million) of Ethiopian populations live in areas at risk for malaria. On June 17 /2017, surveillance data from BenaTsemay district showed that the district was experiencing an unusual high number of malaria cases in three kebeles (lowest administrative unit). We investigated the outbreak to describe malaria epidemiology in the district, identify population risk factors, and guide intervention measures for the community. Malaria case records from the District Health Office were reviewed to describe the outbreak. Unmatched case-control study was conducted with 60 randomly selected cases and 119 controls using a semi-structured questionnaire. Malaria cases were confirmed by either microscopy or malaria rapid diagnostic tests (RDTs) from June 5 to July 23/2017. Controls were persons with no diagnosis of malaria, and lives in similar kebele. Environmental assessment, observation of ownership and utilization of insecticide treated bed-nets (ITNs) were carried out. Multivariable regression model analysis was conducted to identify independent malaria risk factors. There were 648 malaria cases (50.3%-males) from three kebeles with no deaths recorded. The overall attack rate (AR) was 114/1000 populations, and it was highest in Sille kebele (167/1000 populations) and among 5-14 years old (179/1000 populations). Age <5 years (AOR=8.5; 95%CI: 1.2-59), living near mosquito breeding sites (AOR=6.5; 95%CI: 1.15-36.5), irregular use of ITNs (AOR=8.7; 95%CI: 1.5-49.6), inadequate ITNs per family size (AOR=13.4; 95%CI: 1.9-93) predicted having of malaria. Wearing long sleeved clothes was a protective factor (AOR=0.6; 95%C.I: 0.004-0.96). Several unmanaged stagnated water sources with Anopheles mosquito larvae, and the use of ITNs for other purposes were observed. The outbreak was associated with presence of nearby vector-breeding sites, and poor access and utilization of ITNs. Adequate information should be given along ITNs for the community in addition to early management of nearby vector-breeding sites to prevent similar outbreak in future.
Malaria, Outbreak, Bena Tsemay District, Pastoral, Sothern Ethiopia
To cite this article
Mebratu Shite Wondimu, Endrias Markos Woldesemayat, Tsehay Ayele Aselle, Malaria Outbreak Investigation in Pastoral Communities of BenaTsemay District, Southern Ethiopia: A Case Control Study, American Journal of Health Research. Vol. 7, No. 3, 2019, pp. 31-37. doi: 10.11648/j.ajhr.20190703.11
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
World Health Organization (2014): World Malaria Report. [cited on July 15, 2017]. Available from:
World Health Organization (2016): World Malaria Report [Internet], cited on July 15, 2017]. Available from:
Ethiopian Federal Ministry of Health (2016): Malaria Diagnosis and Treatment Guidelines for Health Workers in Ethiopia, Addis Ababa, Ethiopia.
Ethiopian Federal Ministry of Health (2014). National Malaria Strategic Plan (2014-2020);. Addis Ababa 2014.
Ethiopian Federal Ministry of Health (1999): Guidelines for Malaria Epidemic Prevention and Control in Ethiopia,. Addis Ababa, Ethiopia.
Deressa W. et al.: Economic cost of epidemic malariato house holds in rural Ethiopia. Trop Med Int Health 2007; 12 (10): 1148-56.
Anthony E. Kiszewski T: A review of the clinical and epidemiological burds of epidemic malaria. American Society of Tropical Medicine and Hygiene. 2004; 71 (2): 128-35.
Debo W, Kassa H (2016): Prevalence of malaria and associated factors in Benna Tsemay district of pastoralist community, Southern Ethiopia.
Annual Review Meeting Report of South Omo Zone Health Department (2016), Jinka, Ethiopia.
Yeshiwondim A. et. al,: Spatial analysis of malaria incidence at the village level in areas with unstable transmission in Ethiopia. International Journal of Health Geographics. 2009; 8 (1): 5.
Gemechu B. et. al.: A Malaria Outbreak in Ameya Woreda, South-West Shoa, Oromia, Ethiopia, 2012: Weaknesses in Disease Control, Important Risk Factors. American Journal of Health Research. 2015; 3 (3): 125-9.
Worku M: Epidemiological Analysis of Malaria Outbreak in Ankesha District, Awi Zone, Amhara Region, Ethiopia, 2012: Weaknesses in Control Measures and Risk Factors. Science Journal of Public Health. 2016; 4 (2): 132.
Graves M. et. al.: Factors associated with mosquito net use by individuals in households owning nets in Ethiopia. Malaria Journal 2011 10: 354. 2011; 10: 354.
Woyessa A. Malaria risk factors in Butajira area, south-central Ethiopia: a multilevel analysis. Malaria Journal 2013; 12: 273.
Center for Disease Prevention and Control (2017): Factors Affecting Malaria Transmission: Accessed on July, 2017, available from:
Tarekegn N (2014): Malaria Outbreak Investigation, Chano-Mile kebele, Arbaminch Zuria Woreda, Gamogofa Zone.
Yadav K: Socio-economic determinants for malaria transmission risk in an endemic primary health centre in Assam, India; Infectious Diseases of Poverty. 2014; 3: 19.
World Health Organization (1997); Vector Control Methods: Available at:
USAID; President's Malaria Initiative Ethiopia Malaria Operation Plan (2017), Addis Ababa Ethiopia.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186