ASSESSMENT OF MAGNITUDE OF SEVERE MALARIA CASES AT WUSTH IN 2016E.C

Abstract

Background -In Ethiopia, Malaria burden have beenreduced over the last two decades due to improved coverage of key malaria interventions through-out the country (FDREMH report, 2015 and Tafesse et al, 2018). Even though these gains, in the previous years, Malaria still remains the leading cause of outpatient visits, health facility admissions and inpatient deaths (FMOH, 2012). In 2016, there were an estimated 2,927,266 new malaria cases and 4782 deaths (Girum et al, 2016).. Objectives: The main objective of the study was Facility-based retrospective cross sectional study of severe malaria cases in wolkite university specialized hospital, Gurage zone, Central Ethiopia,2016 E.C. Methodology: A retrospective documentary review study will be conducted at an institution to evaluate magnitude of severe malaria cases among patients admitted at WUSH in 2016E.C.A sample size of 403 was taken by using systematic sampling method from patients who visited WUSTH..The data was analyzed using SPSS software version 27 and presented by tables, graphs and charts . Descriptive statistics and binary logistic regression was employed, and the degree of association was calculated using odds ratios with 95% CI. A p-value of less than 0.05 was considered significant for associations between dependent and independent variables Result: A total of 403 patients were involved in this study among the participants 11%(44) were <18years, 81.6%(329) were 18 to 65 years Among patient who were enrolled in this study, more than half of them 214(53.1%) were male. Highest proportion of patients in the survey 257 (63.8%) live in rural area. .From our study the most common presenting symptom of patient were cough and shortness of breath 21.8%(88),abdominal pain 17.6%(71),symptom ofmalaria(Fever,headache,chills, nausea,vomiting) 14.6%(59).Most of the patient visited the hospital after 3 days of experiencing symptoms 60.5%(244) as well as Most of malarial and severe malarial patients visited hospital after 3 days of experiencing symptoms.Out of 403 patients malaria accounts for 16.9%(68).Other common diagnosed diseases were Pneumonia 15.6%(63) ,Dyspepsia 12.4%(50) and CHF 8.4%(34).Most of Malarial cases were diagnosed microscopically 83.8%(57) and the remaining were diagnosed clinically by sign and symptom .Plasmodium falciparum account for most malarial diseases 47.1%(32) and plasmodium vivax was the next etiology responsible for it.Almost all cases of severe malaria 95%(19) were caused by Plasmodium falciparum .From our study those who was diagnosed with malaria(68) 29.4%(20) had severe malaria.The common severity features of severe malaria seen were severe anemia 40%(8),Prostration 25%(5),cerebral malaria 15%(3) and Hypoglycemia 15%(3).Most of malarial cases occur in autumn 57.4%(39) especially in September and October and spring season 23.5%(16)From those who had S.malaria about 70%(14) had previous history of malarial attack .From those who had S.malaria 15%(3) had comorbidity.5%(7) S.malaria patients had more than 3 days hospital stay.From patients diagnosed with severe malaria 20%(4) were died and 80%(16) fully recovered compared to other diagnosis that had 0.3% mortality rate Conclusion:Although prevalence of malaria seems decreasing due to intensive intervention and combined strategies approaches in the country, clinical data showed that, malaria is still a major health problem in the study area. Both P. falciparum and P. vivax were reported. Overall, P. falciparum was 47.1% followed by p.vivax 27.9% and mixed-infection cases 8.8% .Males were more affected than females. The highest malaria prevalence in age b/n 15 -45 yrs. The distribution of malaria showed seasonality with the highest prevalence in autumn followed by spring season. Severe malaria complications associated such as prostration, severe anemia, Cerebral malaria and hypoglycemia were observed in the study area. Regarding treatment outcome of Severe malaria 20% (4/20) was died the remaining 80% (16) are recovered and discharged.