Community participation in malaria epidemic control in highland areas of southern Oromia, Ethiopia

Abstract

Background: Satisfactory strategies for the timely and effective control of malaria epidemics have not yet been established in epidemic-prone areas. A devastating malaria epidemic occurred in mid 2000 in four districts of Borena Zone in Oromia Regional State. Objective: To assess and highlight the importance of community participation particularly that of village malaria workers (VMWs) in the control of malaria epidemics. Methods: Epidemic-affected peasant associations (PAs) were initially identified from each of the affected districts. One VMW residing in the PA was selected, and training on health education, diagnosis of suspected malaria cases and treatment by Sulfadoxine-Pyrimethamine (SP), referral of severe cases, source reduction of mosquito breeding sites, registration and reporting of treated cases, consumed antimalarials, registration of deaths and assessment of the overall status of the epidemic in their particular PAs was given for three days. Results: One hundred twenty-four epidemic affected PAs were identified by the study, that and 115 VMWs were deployed to control the epidemic. A total of 72,998 suspected malaria patients were treated by VMWs using SP. Only 11,994 clinical cases of malaria were treated by ordinary health workers at field levels from June–August 2000. A total of 1,323 deaths were reported both by health professionals and the VMWs. Five hundred sixty eight confirmed malaria cases were treated during out patient consultations at Hagere Mariam Hospital during the three month period. In addition, 191 admitted malaria patients and 36 malaria deaths were identified from the Hospital during the JuneAugust 2000 epidemic. The case fatality rate and proportionate mortality ratio for malaria were 20.8% and 90.9% in August, respectively, in the Hospital. Conclusion: Although health professionals of various categories were mobilized, the epidemic covered wide geographical areas and caused high morbidity and mortality within a short period of time. Therefore, mobilizing of the necessary human and material resources, particularly the community itself is extremely important in the control of malaria epidemics. [Ethiop.J.Health Dev. 2005;19(1):3-10]