Research

Factors associated with contracting malaria in Ward 29 of Shamva District, Zimbabwe, 2014

Gladwin Muchena, Notion Gombe, Lucia Takundwa, Mufuta Tshimanga, Donewell Bangure, Nyasha Masuka, Tsitsi Juru

Abstract


Background. Malaria cases at Wadzanayi Clinic in Shamva District, Zimbabwe, increased drastically, surpassing the epidemic threshold, in week four of December 2013. This rise was sustained, which necessitated an investigation of the outbreak.

Objectives. To identify risk factors and system weaknesses to improve epidemic preparedness and response.

Methods. An unmatched 1:1 case-control study was conducted in Ward 29 of Shamva District in Zimbabwe. Epidemic preparedness and response were assessed using the Zimbabwean epidemic preparedness and response guidelines.

Results. The sociodemographic characteristics of all participants were similar, except for gender. The risk factors for contracting malaria were performing early morning chores (odds ratio (OR) 2.75; 95% confidence interval (CI) 1.20 - 6.32), having a body of water near the home (OR 3.41; 95% CI 1.62 - 7.20) and having long grass near the home (OR 2.61; 95% CI 1.10 - 6.37). Protective factors were staying indoors at night (OR 0.13; 95% CI 0.06 - 0.28) and staying in a sprayed home (OR 0.36; 95% CI 0.21 - 0.92). All cases were diagnosed with a malaria rapid diagnostic test. All complicated cases were treated with quinine. Four out of 58 uncomplicated cases were treated with quinine. The rest were treated with co-artemether. There was no documentation of the outbreak response by the district health executive. Respraying (indoor residual spraying) was carried out, with a coverage of 78% of rooms sprayed. One nurse out of seven at Wadzanayi Clinic was trained in integrated disease surveillance and response, and malaria case management. District malaria thresholds were outdated. Malaria commodities such as drugs and sprays did not have reorder limits.

Conclusion. This study re-emphasises the importance of environmental- and personal-level factors as determinants of malaria. Poor out­break preparedness and response may have propagated the malaria outbreak in this setting. Health education and the use of mosquito repellants should be emphasised. Larvicide may reduce the malaria burden. Epidemic preparedness and response need to be strengthened. Outbreak investigation remains important. This study emphasises the need for malaria interventions to be tailored to locally prevailing determinants to avert outbreaks.

 


Authors' affiliations

Gladwin Muchena, Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe

Notion Gombe, Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe

Lucia Takundwa, Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe

Mufuta Tshimanga, Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe

Donewell Bangure, Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe

Nyasha Masuka, Provincial Medical Directorate, Matabeleland North Province, Ministry of Health and Child Care, Bulawayo, Zimbabwe

Tsitsi Juru, Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe

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Keywords

Malaria; Shamva District; Zimbabwe; Case control; Risk factors

Cite this article

South African Medical Journal 2017;107(5):420-423. DOI:10.7196/SAMJ.2017.v107i5.12204

Article History

Date submitted: 2017-04-25
Date published: 2017-04-25

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