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 MADDA WALABU UNIVERSITY

SCHOOL OF GRADUATE STUDIES

COLLEGE SOCIAL SCIENCE AND HUMANITIES

MALARIA RISK HOT SPOT SITE MAPPING USING RS, GIS AND SOCIO ECONOMIC
DATA INTEGRATION; THE CASE OF SELECTED WOREDAS OF JIMMA ZONE,
OROMIA NATIONAL REGIONAL STATE, ETHIOPIA

A THESIS SUBMITTTED TO THE SCHOOL OF GRADUATE STUDIES OF MADDA

WALABU UNVERSITY IN THE PARTIAL FULFILLMENT OF THE REQUERMENTS
OF THE DEGREE OF MASTER OF SCIENCE IN GIS AND LAND RESOURCE
MANAGEMENT

BY:

MOHAMMEDREHA ABA JIHAD

ADVISOR:

M.RAJAMANICKAM (PhD)

September 2018

BALE ROBE, ETHIOPIA

iv
MALARIA RISK HOT SPOT SITE MAPPING USING RS, GIS AND SOCIO ECONOMIC DATA
INTEGRATION; THE CASE OF SELECTED WOREDAS OF JIMMA ZONE, OROMIA
NATIONAL REGIONAL STATE, ETHIOPIA

BY:

MOHAMMEDREHA ABA JIHAD

A THESIS SUBMITED TO THE SCHOOL OF GRADUATE STUDIES OF MADDA

WALABU UNVERSITY

BALE ROBE, ETHIOPIA

IN THE PARTIAL FULFILLMENT OF THE

REQUERMENTS FOR

THE DEGREE OF

MASTER OF SCIENCE IN

GIS AND LAND RESOURCE MANAGEMENT

UNDER THE GUIDANCE OF

Dr. M.RAJAMANICKAM

v
 CERTIFICATION
This is to certify that the thesis prepared by Mohammedreha Abajihad entitled as ‘Malaria risk hot
spot site mapping using RS, GIS and Socio economic data integration; the case of selected woredas
of Jimma zone, Oromia national regional state, Ethiopia ‘’ is submitted to in partial fulfillments for
the degree of master of science in GIS and land resource management complies with the regulations
of the university and meets the accepted standards with respect to the originality and quality

Approved by Board of Examiners

Chairman signature

Advisor

Internal Examiner

External Examiner

iii
 DECLARATION
I hereby declare that the thesis entitled ‘‘Malaria risk hot spot site mapping using RS, GIS and
Socio economic data integration; the case of selected woredas of Jimma zone, Oromia national
regional state, Ethiopia, has been carried out by me under the supervision of Dr.M.rajamanickam
Department of Geography and Environmental Studies, Madda Walabu University during the year
2017- 2018 as a part of Master of Science program in GIS and Land Resource Management
Specialization. I further declare that this work has not been submitted to any other University or
Institution for the award of any degree or diploma.

Mohammedreha Abajihad

Signature

Date: September,2018

iv
 ACKNOWLEDGEMENTS
My first sincere gratitude goes to Gods who gave me life and strength during my stay and who
made it possible for me, to start and finish my study successfully.

I would like to extend my heartfelt thanks and appreciation to my thesis advisor, Dr. M.
Rajamanikam for his valuable, wholehearted and constructive remarks and guidance throughout of
this study.

It is also my pleasure to express my deepest gratitude to Dr. Mersha Alemu in his valuable
comment, enriching support for formality and shape of the first draft research proposal.

I would also like to thanks those people who are working at National Meteorological Services
Agency, Ethiopia Mapping Agency and the study Woreda health office for their cooperation and
provision of the required data.

My special thanks go to my family for their encouragement and moral support throughout my
study.

I am also highly thankful FDRE ministry of education (MOE) for giving me full sponsorship to
attend this programme.

v
 TABLE OF CONTENTS
CERTIFICATION ........................................................................................................................... iii

DECLARATION ............................................................................................................................. iv

ACKNOWLEDGEMENTS .............................................................................................................. v

ACRONYMS ................................................................................................................................... ix

LIST OF TABLES ............................................................................................................................ x

LIST OF FIGURES ......................................................................................................................... xi

ABSTRACT...................................................................................................................................... xii

1. INTRODUCTION ........................................................................................................................ 1

1.1. Back ground of the Study ....................................................................................................................... 1

1.2. Statement of the Problem ........................................................................................................................ 3
1.3. Objective of the Study ............................................................................................................................ 5
1.3.1. General objective ............................................................................................................................. 5
1.3.2. Specific objective ............................................................................................................................. 5
1.4. Research Questions ................................................................................................................................. 5
1.5. Significant of the Study .......................................................................................................................... 5
1.6. Scope of the Study .................................................................................................................................. 5
1.7. Organization of the paper........................................................................................................................ 6
2. REVIEW OF RELATED LITERATURE .................................................................................... 7

2.1. Concepts and Distribution of Malaria at Global scale ............................................................................ 7

2.2. Global distribution of malaria ................................................................................................................. 8
2.3. Distribution of Malaria in Ethiopia ......................................................................................................... 9
2.4. Malaria Transmission in Ethiopia ......................................................................................................... 10
2.5. Determinants of Malaria Incidence ....................................................................................................... 11
2.5.1. Climatic variation........................................................................................................................... 11
2.5.2. Environmental factor...................................................................................................................... 14
2.5.3. Factors related to distance from water bodies ................................................................................ 16
2.6. Geographic Information System and Remote Sensing ......................................................................... 16
2.6.1. Geographic information system ..................................................................................................... 16
2.7. Application of GIS and Remote sensing technology in malaria risk mapping ..................................... 17

vi
 2.8. Multi criteria Decision Evaluations by Analytical Hierarchy Processes .............................................. 18
3. MATERIALS AND METHODS ................................................................................................ 19

3.1. Description of Study Area..................................................................................................................... 19

3.1.1. Location ......................................................................................................................................... 19
3.1.2. Topography .................................................................................................................................... 20
3.1.3. Climate ........................................................................................................................................... 20
3.1.4. Drainage pattern ............................................................................................................................. 21
3.1.5. Vegetation of the study area........................................................................................................... 21
3.1.6. Soil ................................................................................................................................................. 22
3.1.7. Socio Economic Condition ............................................................................................................ 22
3.2. Research Design.................................................................................................................................... 23
3.3. Sources and Types of Data.................................................................................................................... 23
3.4. Sampling Design ................................................................................................................................... 24
3.4.1. Sampling techniques ...................................................................................................................... 24
3.4.2. Sample size determination ............................................................................................................. 25
3.5. Instruments of Data Collection ............................................................................................................. 26
3.5.1. Questionnaire ................................................................................................................................. 26
3.5.2. Key informant interview ................................................................................................................ 26
3.5.3. Observation ................................................................................................................................... 27
3.6. Methods of Data Collection for Environmental Factor......................................................................... 27
3.7. Software and Materials ......................................................................................................................... 29
3.8. Methods of Data Analysis ..................................................................................................................... 29
4. RESULTS AND DISCUSSIONS ............................................................................................... 31

4.1. Data processing and classification .................................................................................................... 31

4.1.1. Elevation factor .............................................................................................................................. 32
4.1.2. Slope .............................................................................................................................................. 33
4.1.3. Distance from the rivers ................................................................................................................. 33
4.1.4. Distance to pond water site ............................................................................................................ 34
4.1.5. Proximity to swamps...................................................................................................................... 35
4.1.6. Soil ................................................................................................................................................. 36
4.1.7. Land use land cover factor ............................................................................................................. 37
4.1.8. Temperature ................................................................................................................................... 38

vii
 4.1.9. Rainfall ........................................................................................................................................... 39
4.1.10. Malaria vulnerability .................................................................................................................... 40
4.1.11. The overall development of malaria hazard ................................................................................. 41
4.1.12. Mapping of malaria risk hot spot site ........................................................................................... 44
4.2. General - Socio- economic Background of the Respondents................................................................ 47
4.2.1. Socio economic characteristics ...................................................................................................... 49
4.3. The Environmental Factors that Makes Suitable Condition for Mosquito Breeding Site..................... 52
4.3.1. Elevation ........................................................................................................................................ 52
4.3.2. Slope factors................................................................................................................................... 53
4.3.3. Soil type ......................................................................................................................................... 55
4.3.4. Proximity to pond water site .......................................................................................................... 56
4.3.5. Proximity to swamps...................................................................................................................... 58
4.3.6. Proximity to streams ...................................................................................................................... 59
4.3.7. Land use land cover factor ............................................................................................................. 61
4.4. Spatiotemporal Variation of Malaria .................................................................................................... 62
4.4.1. Relative abundance of malaria from 2013 to 2017 of selected woredas ........................................ 63
4.4.2. Seasonal variation of total malaria cases in selected Woreda, 2013-2017 ..................................... 64
4.4.3. Variation of temperature in relation to malaria .............................................................................. 66
4.4.4. Variation of rain fall in relation to malaria .................................................................................... 67
4.5. Developed Areas of Malaria Hazard ..................................................................................................... 69
4.6. Developed Areas of Malaria Risk ......................................................................................................... 71
5. CONCLUSION AND RECOMMENDATION .......................................................................... 73

5.1. Conclusion ............................................................................................................................................ 73

5.2. Recommendation .................................................................................................................................. 74
6. REFERENCE .............................................................................................................................. 76

Appendix 1 ...................................................................................................................................... 85

Appendix II ..................................................................................................................................... 89

viii
 ACRONYMS

CSA: Central Statistics Agency

DEM: Digital Elevation Model

DSS Health and Demographic Surveillance System

EMA: Ethiopian Mapping Agency

EOSAT: Earth Observing Satellite

FMoH: Federal Ministry of Health

GIS: Geographic Information System

GPS: Global Positioning System

IDW: Inverse Distance Weight

ITNs: Insecticide Treated Nets

KAPs: knowledge and practices

Km: Kilo Meter

LULC: Land Use Land Cover

m.a.s.l: Meter above Sea Level

M: Meter

MCDE Multi criteria decision evaluation

MCDE: Multi Criteria decision evaluation

Mm: Mile Meter

NMA: National Meteorological Agency

P. Plasmodium

RS Remote Sensing

WHO World Health Organization

WMR: World Malaria Record

ix
 LIST OF TABLES
Table 3. 1.Monthly Average Rainfalls in mm of study area (2007-20017) ....................................... 21
Table 3.2. Monthly Average Temperature 0C of the study area (2007-20017) ................................. 21
Table 3. 3.Source and types of data ................................................................................................... 24
Table 3. 4.Materials and Software’s .................................................................................................. 29

Table 4. 1.Characteristic of factors in relation to malaria hazard area identification ........................ 42

Table 4. 2. Analysis of malaria risk area identification. .................................................................... 45
Table 4. 3.Background characteristics of respondents....................................................................... 47
Table 4. 4. Socio economic characteristics ........................................................................................ 49
Table 4. 5.Elevation range and area in percentage ............................................................................ 52
Table 4. 6. Slope range and area percentage ...................................................................................... 53
Table 4. 7. Reclassified soil and Areas in Percentage ....................................................................... 55
Table 4. 8. Distance to pond water site and areas in Percentage ....................................................... 57
Table 4. 9.Proximity to swamp and area in Percentage ..................................................................... 58
Table 4. 10. Distance to streams, Area Coverage and Percentage ..................................................... 60
Table 4. 11. Lu/Lc, Area Coverage and Percentage .......................................................................... 61
Table 4. 12.Relative abundance of malaria and its rating .................................................................. 64
Table 4. 13.Temperature variation, area coverage and percent in relation to malaria (2007-2017) .. 66
Table 4. 14.Rain fall variation, area coverage and percentage in relation to malaria (2007-2017) ... 68
Table 4. 15.Hazard map ranks, Area Coverage and Percentage ........................................................ 69
Table 4. 16.Analyzed results of malaria-risk map and its area .......................................................... 71

x
 LIST OF FIGURES
Figure 3. 1. Map of the study area ..................................................................................................... 19
Figure 3. 2.Elevation map of the study area ...................................................................................... 20
Figure 3. 3.General flow of the study ................................................................................................ 28

Figure 4. 1.Reclassified elevation and the ranked value .................................................................... 32

Figure 4. 2.Reclassified slope percent and the ranking value ............................................................ 33
Figure 4. 3.Ranking values of distance from water body .................................................................. 34
Figure 4. 4.Breeding site map ............................................................................................................ 35
Figure 4. 5.Swamp areas ranked value map ...................................................................................... 36
Figure 4. 6.Classified soil map .......................................................................................................... 37
Figure 4. 7. Lu/Lc map ...................................................................................................................... 38
Figure 4. 8. Reclassified (a) average annual temperature (2007-2012) and (b) average annual
temperature (2012-2017) ................................................................................................................... 39
Figure 4. 9.Reclassified (a) average annual RF (2007-20012) and (b) (2012-17) respectively ........ 40
Figure 4. 10.Vulnerability map .......................................................................................................... 41
Figure 4. 11.Hazard map .................................................................................................................... 44
Figure 4. 12. Malaria Risk Map and ranks layer................................................................................ 46
Figure 4. 13.Elevation based malaria ................................................................................................. 52
Figure 4. 14.Slope based malaria ....................................................................................................... 53
Figure 4. 15.Soil based malaria.......................................................................................................... 55
Figure 4. 16.Proximity to Pond water sit based malaria .................................................................... 56
Figure 4. 17. Reclassified based on malaria ...................................................................................... 58
Figure 4. 18.Reclassified proximity to streams ................................................................................. 59
Figure 4. 19. LU/LC map ................................................................................................................... 61
Figure 4. 20.Malaria Trend of the selected Woreda from 2013-2017 ............................................... 63
Figure 4. 21.Seasonal recorded malaria cases (2013-2017) .............................................................. 65
Figure 4. 22.Reclassified average annual temp of (a) and (b), 2007-2012 and 2012-2017
respectively. ....................................................................................................................................... 66
Figure 4. 23.Reclassified annual RF (a) and (b) 2007- 2017 ............................................................. 67
Figure 4. 24.Hazard map .................................................................................................................... 69
Figure 4. 25.Final malaria risk map ................................................................................................... 71

xi
 ABSTRACT

Malaria is a vector-borne disease caused by protozoan parasites belonging to the genus

Plasmodium and transmitted by the bite of infected female Anopheles species mosquitoes. The aim
of this Research was malaria risk hot spot site mapping in the case of selected Woredas of Jimma
zone Oromia national Regional State, by using the applications of GIS and RS technology. To
achieve the objectives of the study a retrospective comparative study design was employed using
data from local health services (health centers and health posts) from study Woredas over five year
and climatic (rainfall and temperature) of study area over ten years, As well as environmental
factors and socio economic data responsible for this case was retrieved from their sources as in
put data. Socioeconomic data were collected by using household questionnaires and key informant
interviews from both woredas. Sample study kebeles for questioners and key informants for
interview was selected by using purposive sampling technique. Questionnaire members were
randomly selected and key informants interview were purposely selected from each kebele and at
Woreda level. The hazard, malaria prevalence is mapped based on the environmental factors,
computed using Multi Criteria decision Evaluation technique (MCDE).17.8%, 34.7%, 18.0%,
14.5% and 15.0% of the study area were subjected to very high, high, moderate, low and very low
malaria hazard area respectively. The final output based on this approach is malaria risk map.
Then it was produced from overlay analysis using (MCDE).The result showed that, out of the total
area (4136.9km2), 29.8% very high, 30.7% high, 26.6% moderate, 10.2% low, and 2.7% of the
area are very low malaria risk level respectively. In other words, according to the result of the
findings large area of the districts are in high risk area of malaria. This can help to take valuable
measures for malaria control and eradication program and considered as one of the very vital
input used for every aspect of planning, implementation, monitoring and evaluation of any
development processes as well as malaria eradication programs of the Woredas.

Key Words: GIS, Remote Sensing, Malaria, MCDE, Risk map, weighted overly.

xii
 CHAPTER ONE
1. INTRODUCTION
1.1. Back ground of the Study
Malaria is a vector-borne disease caused by protozoan parasites belonging to the genus
Plasmodium and transmitted by the bite of infected female Anopheles species mosquitoes
(WMR, 2009). About 60 species of the genus Anopheles can transmit malaria. Until recently,
five species of Plasmodium, namely: P. vivax, P. falciparum, P. ovale (two sub species: P. ovale
curtisi and P. ovale wallikeri), P. malaria and P. Knowles are known to cause human disease
(Cox et al., 2010). It is a blood-borne disease which is transmitted through the bite of an infected
female Anopheles mosquito. It is a major public health issue which affects the global population
at large. (Ahmed, 2014). Malaria is typically found in warmer regions of the world, i.e., the
tropical and subtropical countries. Vectors (female Anophseles mosquitoes) require specific
habitats with surface water for production, humidity for adult mosquito survival and the
development rate of both vector and parasites are dependent on temperature (Ashenafi, 2013).

Malaria is essentially an environmental disease since the vectors require specific habitats with
surface water for reproduction, humidity for adult mosquito survival and development rates .The
increase in malaria prevalence is determined by several factors: mosquito resistance to
insecticides, parasite resistance to drugs, changes in land-use patterns, and reductions in funding
and manpower dedicated to control activities (Ashenafi, 2003). Most of the determinants are
heterogeneously distributed, changing over both space and time. Factors such as topography,
temperature, rainfall, land use, and degree of deforestation have a profound influence on the
temporal and spatial distribution of malaria vectors (FMoH, 2009).

Globally, about half of the world populations (3.3 billion) are at risk of malaria infection (World
Health Organization [WHO] 2011). Adult female mosquitoes of the genus Anopheles are vectors
for the Plasmodium parasites and are thus responsible for malaria transmission.

There are 490 species in the genus Anopheles, and 70 of these are vectors of malaria. In sub-
Saharan Africa, there are 140 Anopheles species of which approximately 20 are known to
transmit malaria parasites to human beings. Of these, Anopheles gambiae s.s, Anopheles
arabinoses Patton and Anopheles funfests are the most widely distributed and important malaria
vector species in tropical Africa (Coetzee et al., 2000).

1
According to Kaya et al. (2002), malaria remains one of the greatest killers of human beings,
particularly in the developing countries. The World Health Organization (2012) estimated over
one million malaria cases each year, where more than 80% of the cases are in Sub-Saharan
Africa countries.

Malaria is one of the main health problems in Ethiopia in which its cases are one of the highest
and it is increasing in an alarming rate. Ethiopians live at altitudes ranging from −100 to >4220
m, the topography made a fertile ground for the reproduction of the epidemic. More than 50
million (68%) of the population live in areas below 2000 m above sea level are at risk of malaria.
With consequent variation in minimum and maximum temperatures. In general, the main reasons
given for the increment are ecological and climatic changes. The peak of Malaria incidence
follows the main rainfall season in July, August, September, October and November each year.
(Negassi, 2008).

Several studies have used Geographical Information System (GIS) and Remote Sensing
techniques to map the distribution of vector species at different spatial scales such as in different
parts of African continent (Dongus et al., 2007).According to Tran et al.(2008), in endemic
areas, mainly in tropical and subtropical regions, these vector maps are designed to improve
vector control, which is currently one of the essential methods in limiting the burden of
important vector-borne diseases such as malaria or dengue fever. In disease free areas, analyzing
the link between the environment and potential vector distribution may help evaluate the risk of
emergence of the disease, and lead to better mitigation and control measure of the invasive
vector species. Therefore, GIS is the best way to answer questions regarding mosquito ecology
as well studies of risk as a function of distance from known breeding sites (Eskinder et al.,
2010). According to Hay et al. (2000), GIS in combination with remote-sensing (RS)
technology, has also been employed to predict areas of high productivity of mosquitoes and
potential malaria epidemics based on the detection of proxy ecological variables. Therefore, the
aim of this study will be to analyze malaria hazard and risk area in the study area.

2
1.2. Statement of the Problem

Globally, about half of the world populations (3.3 billion) are at risk of malaria infection (WHO,
2011). It has widely known impacts on the economic, social, and political sphere of the society
As a result wide range of measures were taken by national and international organizations to
reduce the impact of the epidemic, but most of the efforts were invested on managing the results
than prevention. Therefore, the cost of preventive plan and medical treatment becomes affect the
GDP and as well as the individual economy due to this infections.

An estimated numbers of billion peoples are at risk of this infections and 3000 to 5000 million
suffering a short period with the disease each year perhaps 90 percent of these occur in tropic of
Africa (WHO, 2012) and kills between 1.1 and 2.7 Million people per year. Of these deaths,
approximately one million are children in the tropic of Africa between the ages of 18 months and
5 years (Webb, 2009). Malaria risk becomes higher in developing countries (Donnelly et al.,
2005). According to Stratton et al (2008) mentioned, the multiplicity of malaria causing factors
in semi urban areas as the main cause of its prevalence as they are difficult to control at the same
time.

Because of its tropical area and accessibility of numerous streams and lakes, Ethiopia is suitable
for breeding of plasmodium (Womie, 2008).As a result, it is a major public health problem in
Ethiopia (FMoH, 2009). Accordingly, its occurrence in most parts of the country is unstable
mainly due to the country's topographical and climatic features. In order to reduce this impact of
the epidemic disease, wide range of measures were taken by national and international
organizations. Preventive measures are cost and time effective. One of the maine issues to be
considered as preventive is to work on the main factors contributing for the development and
expansion of the problem. In this case, Geographic Information System and Remote Sensing
(GIS and RS) application can used to analyze malaria hazard and risk area.

In Jimma zone, especially Limmu seka and Choraboter woredas are where malaria transmission
is the highest depending on seasons. They are also characterized by poor housing, lack of proper
sanitation, poor drainage of surface water, weak health services and wide spread economic
disparity, which independently or together pave the way for malaria transmission.

According to Limmu seka Woreda health office (2016), malaria was the second top disease
responsible for high morbidity and mortality in the Woreda. Seasonal rain, during high rainy

3
season impounded water and the geographic location which is typical for the breeding of
mosquito contributed a lot for the prevalence of malaria. The Severity of malaria increases at the
rainy seasons putting higher pressure on the activity of the local people whose livelihood is
totally dependent on crop production and livestock rearing. In general it reduces labor, time for
on farm follow up, livestock supervision and children school attendance, consequently resulting
in decline of agricultural production, economic dependency, school dropouts and social crisis of
the Woreda (JZHAO, 2017)

According to Jimma Zone Malaria Focal Person (2017), the zone is stratified into three climate
zones and among the total population more than 75% are at high and moderate risks of malaria
infection. Three district hospitals, 114 health centers and 523 health posts are found in the zone.
Looking at the malaria epidemiology p. falciparum is the most dominant species in the zone as is
seen in most parts of the country. Hence, among the woredas, Limmu Seka and Chora boter were
with the highest number. As a result, the spatial variation of malaria hazard and risk area based
on environmental factors is not identified, which could facilitate the malaria prevention and
control activities. So, this study used the application of GIS, RS and MCDE based analysis to
identify and mapping areas vulnerable to malaria epidemic. Generally, in the study area malaria
is prevalent, its hazard and risk analysis is not yet done and potentially prone areas are not
delineated. Thus, this study is an integrated concept and methods of the innovative development
and application of GIS and RS technology was used to map malaria risk hot spot site in the case
of selected Woredas of Jimma zone.

4
 1.3. Objective of the Study
The study was carried out to achieve the following objectives.

1.3.1. General objective

The general objective was malaria risk hot spot site mapping in the case of selected Woredas of
Jimma zone.

1.3.2. Specific objective

 To analyze the environmental factors that makes suitable condition for mosquito breeding
site.
 To analyze the spatiotemporal variation of malaria in the study area

 To develop malaria Hazard and Risk map of the study area

1.4. Research Questions

Considering the above listed research objectives, the following research questions were used as
the fundamental basis for this study:
1. Which areas of environmental factors suitable for mosquito breeding site?
2. What is spatiotemporal variation of malaria?
3. How malaria Hazard and Risk is developed?

1.5. Significant of the Study

This study have the ability of identifying malaria risk hot spote site using GIS and Remote
sensing application that greatly enhance the effectiveness of prevention efforts and will
contribute to cost-effective prevention method by providing mechanism of efficiently targeting
high risk areas, which help national and international organizations, medical geographers and
any stake holders working in the health and the selected woreda sectors in organizing their
efforts towards the fight against malaria efficiently and cost effectively. It also, expected to
enable decision maker’s use and ensure that the resource implemented to the most high risk areas
and can make the eradications and prevention task successful. It also shows way for the
application of GIS and Remote Sensing to the broader public health field.

1.6. Scope of the Study

The extent of this investigation is delimited both in topographical region and issue of concern.
Topographically, it is delimited to the selected Woredas of Jimma zone which is Limmu seka
and Choraboter of Oromia national regional state. With respect to region of concern, the

5
fundamental concentration of the exploration is building up the spatial variety of intestinal
sickness Risk and hazard delineation of the Woredas. Along these lines, this investigation is
confined to create GIS and remote sensing based intestinal sickness chance guide of the
examination territory utilizing ecological variables.

1.7. Organization of the paper

The study is organized in five chapters. The first chapter contains introduction, statement of the
problem, objectives, and research question: in the second part theoretical literature is reviewed
and the third chapter contains methodology and description of the study area. The fourth chapter
deals with result and discussion, in the last chapter conclusion and recommendation is
forwarded.

6
 CHAPTER TWO

2. REVIEW OF RELATED LITERATURE

2.1. Concepts and Distribution of Malaria at Global scale
Malaria is an ancient disease caused by parasites of the genus Plasmodium and transmitted by
several species of female anopheles mosquitoes. The term ‘malaria’ originates from malaria
(Italian) signifying ‘bad air’ or miasmas arising from marshes (Shumbullo, 2013).

Protozoan parasites of the genus Plasmodium are responsible for human malaria, of which four
species are primarily involved, plasmodium falciparum, Plasmodium vivax, Plasmodium
malaria, and Plasmodium ovale. Recent reports have suggested the possibility of a fifth species,
Plasmodium Knowles, as an important and common emerging zoonotic pathogen responsible for
human infections in Southeast Asia (Cox et al., 2010).

Globally, Falciparum is the most common cause of malarial infection, responsible for
approximately 80% of all cases and 90% of the deaths. Plasmodium transmission from
Anopheles vector to humanism accomplished through direct injection of the parasite contained in
salivary gland fluid during blood feeding. Of the 484recognized species of Anopheles
(Hardback, 2004), only about 20% or less are generally involved in malaria transmission (Bruce-
Chwatt, 1980). Anopheles females become infected by imbibing sexually mature gametocytes
present in the peripheral blood of the host. In the mosquito midgut fertilization produces the
ookinete which traverses the mosquito gut and forms oocytes under the outer most layer of the
gut wall. After repeated multiplication, each oocyst eventually ruptures releasing hundreds of
sporozoites into the mosquito body cavity, a proportion of which will invade the salivary glands
awaiting the opportunity to infect another human upon the next blood feeding by the mosquito.
This sporogonic cycle (ookinete–oocyst–sporozoites) within the mosquito takes on average 10–
14 days depending on the ambient temperature and Plasmodium species. Infective female
mosquitoes will generally remain infectious during their entire life which is spent repeating a
cycle of blood feeding, developing and lying eggs every two to three days per gonotrophic cycle.

According to WMR (2009), the global numbers of malaria cases in 2008 were an estimated 243
million. The vast majority of cases (85percent) were in the African Region, followed by the
South-East Asia (10percent) and Eastern Mediterranean Regions (4percent). And it accounted for

7
an estimated 863,000 deaths, of which 89 percent were in the African Region, followed by the
Eastern Mediterranean (6 percent) and the South-East Asia Regions (5 percent). Each parasite
has a distinctive appearance under the microscope and produces a somewhat different pattern of
symptoms. The infection can develop suddenly and produce several life threatening
complications. With prompt, effective treatment, however, it is almost always curable.
Plasmodium vivax is the most geographically widespread of the species, produces less severe
symptoms. A person asymptomatic (no symptoms) Plasmodium malaria, however, can infect 8
others, either through blood donation or mosquito bites. Plasmodium malaria has been wiped out
from temperate climates, but it persists in Africa .Plasmodium ovale: is rare, can cause relapses,
and generally occurs in West Africa (NIAID, 2007).

2.2. Global distribution of malaria

Jungle fever is one of the world's most normal and genuine tropical sicknesses. In any case, on
the globe, it stretches out up to 60° north and 40° south of scopes. Its dissemination on the planet
isn't uniform. Diverse types of Plasmodium are found in various nations. Agreeing World
Malaria Report of 2012, around 70-90 for every penny of the danger of jungle fever is
considered because of natural components which thus impact the plenitude and survival of the
vectors (WMR, 2012)

This has persuaded the World Health Organization to seek after the advancement of new
strategies and models in which the part of natural is basic. Spatial innovation helps methodical
and normal checking of the world's natural conditions outfitting a lot of spatial and transient
information. Such data together with suitable field studies can demonstrate extremely productive
for early discovery and auspicious reaction to sickness administration. About 90% of all malaria
deaths in the world today occur in Sub Sahara Africa countries. This is because the majority of
infections in Africa are caused by Plasmodium falciparum, the most dangerous malaria species
of the four types. It is the most widespread in Africa and the most difficult to control. About one
million people in Africa die from malaria each year, where most of them are children under 5
years old (WHO, 2011).

According to World Malaria Report of WHO (2012), the global malaria distribution has
th
progressively been reduced since the mid 19 century, especially from 1945 to 1977, when 37
countries were freed of malaria thanks to the efforts of the global eradication programme.

8
Success in malaria elimination occurred mainly in countries in Europe and North America,
where malaria transmission was lower.

2.3. Distribution of Malaria in Ethiopia

The presence of jungle fever in Ethiopia is verifiable because of its tropical area. Other than its
tropical area, 75% of the territory that lies beneath 2000 m a.s.l height, where around two-third
of the populace living is on is likewise gives good common habitat to the event of jungle fever
and thus it is malarious (Woime, 2008).

In Ethiopia, the assessed frequency rate for jungle fever (i.e., the evaluated likelihood of getting
the infection in a year) is 15%, which is low in respect to whatever is left of sub-Saharan Africa
(Where the normal rate is 0.33), however higher than some other nation outside of sub-Saharan
Africa, Panama, Laos, Myanmar, and the Solomon Islands (WHO, 2012).

Regardless of the fairly low rate, this nation is an engaging spot to complete an examination on
jungle fever for no less than two reasons. To begin with, intestinal sickness is as yet a vital
general medical issue: Ethiopia is thought to encounter somewhere in the range of 10 million
cases for every year, the fourth most astounding case numbering sub-Saharan Africa (behind
Nigeria, the DRC, Tanzania, and Uganda (WHO, 2012).The second explanation behind
considering jungle fever in Ethiopia is that, not at all like most other African nations, there is
broad nearby variety in intestinal sickness occurrence.

Among plasmodium species, Plasmodium falciparum and Plasmodium vivax are the most
dominant malaria parasites in Ethiopia, distributed all over the country and accounting for 60%
and 40% of malaria cases, respectively. Plasmodium malaria accounts for less than 1% and
Plasmodium ovale is rarely reported. The parasite is principally transmitted by the major
mosquito vector known as Anopheles arabinoses. In some areas, Anopheles pharoensis,
Anopheles funestus and Anopheles nili also transmit the disease (Adugna, 2011).

In Ethiopia, malaria has a personality, geographic character, and impact quite different from
other parts of Africa and global malaria (Getachew et al.,2006) they put forward, Ethiopia’s
malaria is unstable-the high seasonal fluctuations in temperature and moisture result in malaria
appearing in epidemic form and with great variation across landscapes. The instability of
Ethiopia’s malaria means that populations in most areas have never attained a significant level of
protective immunity (ashas been the case in endemic areas of West Africa) and thus a higher rate

9
of death and morbidity among adults. In each of those early to mid-twentieth-century analyses
medical field observations confirmed Ethiopians’ own folk epidemiology about malaria as an
endemic disease of the moist lowlands and river valleys and its highly seasonal character that
followed closely the annual life cycle of its mosquito vectors (FMoH 2009). The malaria
landscape followed closely elevation, slope and the seasonal cycle of temperature and moisture
(Getachew et al., 2006).

2.4. Malaria Transmission in Ethiopia

The Anopheles species breads in stagnant water, in fallow fields, rice fields, irrigation channels,
field channels, and seepage water collection sites etc (Aruna, 2004). The major transmission of
malaria follows the June – September rains and occurs between September and December, while
the minor transmission season occurs between April and May following the spring (belg) rains,
which occurs between February and March. Areas with bimodal pattern of transmission are
limited and restricted to a few areas that receive bimodal rainfall, i.e., the small (Belg) and main
(Kiremt) rains. Hence, the major transmission season occurs in large part of the country
(Adugan, 2011).

The reason for jungle fever is a protozoan parasite having a place with the class Plasmodium
which is acquainted in with a people's blood while a mosquito chomps him. As indicated by
Beanland T, which is referred to by Negassi (2008), there are more than 120 types of the parasite
variety Plasmodium. Be that as it may, just four of these taint people to cause jungle fever. The
four types of the parasite in human are Plasmodium (P.) falciparum; P. vivax, P. malaria and P.
applaud P. falciparum and P. vivax represent more than 95 percent of instances of intestinal
sickness on the planet.

As per FMoH (2008), the transmission examples and the study of disease transmission of jungle
fever in Ethiopia is for the most part occasional and exceedingly flimsy because of spatial
varieties in geology and precipitation designs. This extent fluctuates from place to put and from
season to season. P. falciparum represents 69 percent of affirmed intestinal sickness cases in
SNNPR, while in Harari accounts 84percent. Anopheles arabinoses is the fundamental vector
and Anopheles pharoensis, Anopheles funestus and Anopheles nili are viewed as optional
vectors (Getachew, 2006). In intestinal sickness pandemic circumstances, P. falciparum is the
reason for the serious type of the sickness and all jungle fever passings occur because of disease
by this parasite (FMoH, 2004)

10
Source: WHO Country Office for Ethiopia, 2005

2.5. Determinants of Malaria Incidence

2.5.1. Climatic variation

The combined influence of rainfall and temperature re-grouped underneath weather (short-term)
and climate (long-term) on malaria is very complex, especially for extreme weather conditions
(Lindsay, 1998), as an outcome direct effects of climate on vector and parasite development are
easy to see but indirect effects may also be important such as the effects of previous exposure
(related to direct effects), nutritional status, and co-infection may help determine the disease
outcome. Just as climate is one of the determinants of malaria endemicity, climate variability is
one of the main factors behind inter-annual fluctuations of malaria. Literature abounds with
examples of how unusual, anomalous or extreme weather conditions have led directly and
indirectly (through destructive crop pests and diseases) to human malnutrition and in turn to
health problems or to both at the same time (Gimnig et al., 2003).

As Ethiopia is located in the tropical region, most parts of the country have high temperature
throughout the year and High amount of seasonal rainfall in most parts, and year round rainfall in

11
some areas, are mainly related to the tropical location of the country. However, the seasonal
rainfall with high temperature is responsible for the occurrence of unstable and seasonal malaria
transmission after the onset of the rainfall in most part of the country (Woime, 2008).
2.5.1.1. Temperature
Temperature ranges between 22° C and 30°C are optimal as they lengthen the life-span of the
mosquitoes and increase the frequency of blood meals taken by the female, as well as an
increased frequency of host-vector contact. The female can then have a blood meal once every
48 hours (Gemperli, 2003; Montosi et al., 2012).It is one of the key climatic variables that
determine the range of malaria transmission. Hence, global warming is likely to result in an
increase in malaria prone areas (Chirebvu et al., 2014). In high temperatures, the egg, larval and
pupil stages of mosquito development will be Shortened thereby increasing the turnover which
then affects the length of the saprogenic cycle of the parasite within the mosquito host i.e. when
temperature increase, the period of the saprogenic cycle will be shorted (Ahmed, 2014).

Low temperatures have a limiting effect on the spread of malaria (Kumi et al., 2015). Usually, at
temperatures below 18˚C, transmission of malaria is highly unlikely to occur since the few adult
mosquitoes, about 0.28 %, survive the 58 days required for sporogony at that temperature and
mosquito abundance is limited by long larval duration. Temperatures between 22°C and 32°C
are the best to complete sporogony in less than three weeks and mosquito survival is sufficiently
high (15 %) for the transmission cycle to be completed. Temperatures higher than 32 °C have
been reported to cause high vector population turnover, but also cause high mortality. Thermal
death for mosquitoes occurs around 41-42 °C (Chikodzi, 2013).

Temperature has significant influences on mosquito density and malaria transmission. Climate
variability, specifically temperature, impacts the incubation rate and breeding activity of certain
species of mosquitoes and is considered as one of the key environmental contributors to
mosquito propagation (Wilder, 2007).High temperature speeds up the development of the life
cycle of a mosquito and accelerates the length of the development of the life cycle of malaria
parasite within the mosquito host (FMoH, 2003).

The development of the parasite within the mosquito depends on temperature (Yazoume et al.,
2008).Vector species adapts to different temperature threshold depending on the area it occurs.
Low temperature, when duration of parasite development in mosquitoes exceeds 30 days that

12
isbeyond average life span of mosquitoes, limits active malaria transmission. At higher
temperatures the longevity of mosquitoes is reduced.

The development rate of immature mosquitoes is very much temperature dependent. Below
16°C, development of Anopheles gambiae, the main malaria vector in most parts of Africa, will
completely stop, and the larvae will die in wet temperature below 14°C. In low temperature
conditions, mosquito larval development is severely delayed and has high mortality incurs. In the
adult stage, increase in ambient temperature accelerate the digestion of blood meals taken by
Mosquitoes, leading to increased human biting frequency and malaria transmission (Afrane et
al., 2011).

2.5.1.2. Rainfall

The sum and the regularity of precipitation are essential parameters in deciding the area of
mosquito reproducing living spaces and in addition the aggregate thickness of grown-up
mosquitoes. Amid times of overwhelming precipitation, reproducing might be hampered because
of the abundance water came about because of substantial rain influence the streams and the
pools to move quick and exuberant, so it flushing ceaselessly the eggs and hatchlings.
Intemperate downpours may likewise have the contrary impact increment vector populaces by
and large by expanding accessible Anopheles reproducing destinations. Intestinal sickness case is
1958 scourge episode in Ethiopia was related with strange high measure of rain. Likewise in
Nairobi, Kenya episodes of jungle fever happened in 1940 after overwhelming precipitation.
Periods with low precipitation may initiate mosquito reproducing by transforming streams into a
series of pools in which mosquito can breed (Yazoume et al. 2008). According to (FMoH,
2004)Apart from creating mosquito breeding sites, rainfall also affects malaria transmission
through increasing humidity, which in turn will help to increase the longevity of the adult
vectors. Rainfall is considered to be the most important malaria triggering parameter causing soil
saturation and a rise in pore-water pressure. Excessive rainfall in warm, arid areas can lead to
increased transmission due to creation of vector breeding sites (Abeku, 2006).

According to Ceccato et al. (2005) increasing precipitation may increase vector populations in
many circumstances by increasing available anopheles breeding sites, excessive rains may also
have the opposite effect by flushing out small breeding sites, such as ditches or pools or by
decreasing the temperature, which in regions of higher altitude can stop malaria transmission.

13
Humidity also makes condition suitable for transmission, because it affects the survival rate of
mosquitoes. Rainfall apart from creating mosquito breeding sites, affects malaria transmission
through increasing humidity, which in turn will help to increase the longevity of the adult
0 0
vectors. The optimum temperature for development of malaria parasite is between 25 C to 30 C
and average relative humidity at least 60percent. These temperature and relative humidity
conditions increase the longevity and density of mosquitoes and thus initiate malaria
transmission, if parasite load exists in the community (Yazoume et al, 2008).

2.5.2. Environmental factor

2.5.2.1. Elevation
There is a proven relation between elevation and mosquito abundance (Ebi et al., 2005). Due to
lower temperatures at higher elevations, it becomes unfavorable for mosquitoes to breed, since
mosquitoes prefer to live at places with relatively high temperatures. Also, since it is very airy at
higher altitudes, it is almost impossible for mosquitoes to fly, hence, not favorable for
mosquitoes to live at higher altitudes (Crees et al., 1985).

Based on altitude, traditionally Ethiopia is divided in five agro-ecological climatic zones. These
are Wurich/kur, Degas, Woina Dega, Kola and Bereha. The Dega zone with elevation above
2500 m.a.sl is malaria free. Malaria frequently occurs in areas below 2000 meters elevation and
the transmission is very intense in areas below 1500 meters elevation (Adugna, 2011). Now a
day due to temperature increase (global warming) and other factors malaria is emerged in high
altitude areas of Ethiopia including those above 2000 m a.s.l, during malaria non-epidemic year
(Woyessa et al., 2012). On the other side in Ethiopia lowland deserts (Bereha) areas have an
altitude < 500 m.a.s.l. and annual rainfall < 900mm (MOA,1998).So, these regions are not
suitable for mosquito breeding as a result of low annual rainfall amount and very high
temperature above 30oc.

2.5.2.2. Slope
Slope is together with rainfall amounts received at a place can influence the spread of malaria.
Areas on flat ground are most likely to accumulate and dam rain water thereby increasing the
risk of malaria. Where the slope is steep, the water is likely to wash the eggs away there by
preventing them from developing where as if the slope is gentle the eggs can stay and go through
all the maturity stages required (Freeman et al, 1995) The spread of malaria could also be

14
influenced by the slope of an area coupled with the amount of rainfall it receives. Flat areas are
highly prone to accumulation of rain water and therefore increase the risk of malaria (Chikodzi,
2013). Slope is a measurement of the steepness of the ground surface. The steeper the surface
represent, the greater the slope. Steeper slope does not favor plant and animal dwelling relative
to gentle slopes (Lemessa, 2011). Mosquito larvae need stagnant water pools to survive, and
these pools are less likely to form in sloped areas. Moreover, larvae developing in water pools in
sloped areas are more likely to be washed away during downpours.

2.5.2.3. Soil

The type of soil which is Impermeable allows water stagnation and creates grounds for mosquito
breeding and thus favors malaria. Porous soil is devoid of stagnant water bodies, hence
unfavorable for Anopheline mosquito breeding (Aruna, 1995)

2.5.2.4. Land Cover

The land use land cover was taken as element at risk that affect by malaria incidences,
Vegetation type and growth stage may play an important role in determining vector abundance
irrespective of their association with rainfall. The type of vegetation which surrounds the
breeding sites, and thereby provides potential resting, sugar feeding supplies for adult
mosquitoes, and protection from climatic conditions, may also be important in determining the
abundance of mosquitoes associated with the breeding site. Irrigation schemes may provide
excellent breeding sites for An. gambiae s.l. early in the growth cycle of the plants –this change
mature and form a dense canopy over the water (Lindsay et al., 1998). Mosquitoes feed on the
nectar of plants therefore there is a very high possibility of mosquitoes being found in vegetated
areas. The presence of vegetation creates microclimatic conditions (moderate temperature and
humidity) suitable for mosquito survival (Yazoume et al., 2008). The more the vegetation, the
more the mosquitoes (Texier et al., 2013).

2.5.2.5. Surface Water

Distribution of water bodies is an important factor influencing the occurrence and distribution of
malaria cases. Water bodies play an important role as larval breeding sites for malaria vectors.
The identification of water bodies is thus a direct indicator for malaria risk (Zhou et al., 2012).
Surface water provides the habitat for the juvenile stages (egg, larvae, and pupae) of malaria

15
vectors. Irrigated farming increases nutrients and temperature which are favourablefor the
mosquito breeding and larvae survival (Munga et al., 2006).

2.5.3. Factors related to distance from water bodies

One of environmental covariate significantly related to transmission intensity was distance from
the water and wetland, indicating high transmission in the areas within 2 km of the water source
(WHO, 2002). The result of seasonal variation in rainfall, the rivers and lakes of Ethiopia have
seasonal characteristics. During the rainy season both the rivers and lakes are full and sometimes
they flow over their banks and these lead to flooding. During the dry season their volume is
decreased and they create different pockets of water body that is favorable ground for the
breeding of different disease vectors such as mosquito. Most Lakes of Ethiopia are found in the
rift valley.Due to high Temperature, which is favorable for the breeding of different disease
vectors and pathogens, the habitats of the Lakes region are highly affected by vector born
diseases especially by malaria (Woime, 2008). Water body, particularly not moving is a typical
place for mosquito breeding (Lemessa, 2011).

2.5.3.1. Proximity to Rivers

One of the main parameters that plays important role to increase malaria parasites and malaria
disease is the distance to river. The closeness of the populated area to main river (vector
breeding) source is an area of malaria risk (Kumar et al., 2012).

2.6. Geographic Information System and Remote Sensing

2.6.1. Geographic information system

GIS is a multipurpose computer based information system for retrieval, administration,
processing, integrated analysis and graphic, cartographic and Statistical presentation and
combination of data which can be defined in time and space as science it presents a framework
for using information theory, spatial analysis and statistics, cognitive understanding, and
cartography. As system focuses on the processes and methods that are used to sample, represent,
manipulate and present information about the world (Clarcke, 1986).
Mapping of Malaria is based on estimating the relation between malaria transmission and
environmental or climatic factors as the biological parameters that are directly influenced by
meteorological variables, therefore this relation can be used to predict malaria transmission at
locations where information is not available (Thomson et al., 1997).

16
 2.6.2. Remote sensing
Without direct contact, some means of transferring information through space must be utilized.
In remote sensing, information transfer is accomplished by use of electromagnetic radiation
(Lillesand et al., 2004).

2.7. Application of GIS and Remote sensing technology in malaria risk mapping

GIS and remote sensing data from earth-observing satellites can facilitate the kind of
epidemiological research by improving aptitudes for spatially-explicit risk profiling and early
warning systems (Yang et al., 2010).

Prior to the advancement of GIS innovation, the best way to survey human hazard was physically
screen larval and grown-up mosquito populaces. This tedious and tedious hand on work has been
expensive and not as often as possible put by and by particularly in nations with fewer assets
(Allen, 2002). GIS has numerous applications to the investigation of vector-borne illnesses, the
same number of the basic procedures affecting the dissemination of bug vectors of ailment are
spatially heterogeneous. Mosquitoes require pools of water in which to breed and the short flight
scope of numerous species confines the grown-up populaces to regions encompassing their
reproducing destinations. As of late, there has been enthusiasm for applying GIS to think about
the mainland and worldwide dissemination of jungle fever and the mosquitoes that transmit
intestinal sickness (Coetzee et al., 2000). This landmass scale thinks about have additionally
been utilized to evaluate the effect of an unnatural weather change on the dissemination of
mosquitoes and intestinal sickness. The survival and life span of tainted mosquitoes and the
predominance of the ailments is spatially decided and controlled by the geo-climatic factors. The
remote detecting abilities have been utilized to examinations vector natural surroundings zones
and mapping vector plenitude (Dale, 2002).

The remote sensing resource satellite data (red and infrared / near infrared spectral data) has been
significantly used for mapping the malaria, JE and kala-azar, filariasis, schistosomiasis etc.,
vector breeding habitats with spatial consistency of 90 per cent accuracy (Tucker et al., 1985).
Many researchers agree that the location and population of mosquitoes is associated with
environmental factors, such as elevation, temperature, precipitation, humidity and the type and
distribution of vegetation, which can influence mosquito populations. It is clear that this
approach can help to target malaria vector control much more cheaply and efficiently than older

17
manual field methodologies. GIS has many applications to the study of vector-borne diseases, as
many of the underlying processes influencing the distribution of insect vectors of disease are
spatially heterogeneous. Mosquitoes require pools of water in which to breed and the short flight
range of many species limits the adult populations to areas surrounding their breeding sites.
Recently, there has been interest in applying GIS to study the continental and global distribution
of malaria and the mosquitoes that transmit malaria (Coetzee, et al., 2000). These continent-scale
studies have also been used to estimate the impact of global warming on the distribution of
mosquitoes and malaria. As malaria is a complex disease related to the interaction among
parasites, vectors, human hosts and environment, it is fundamental to study these factors together
to try to control it. The combination between human factors and relevant environmental
information to the malaria biology might indicate a predominant epidemiologic situation, making
the action of health services easier. These technologies, allow them to relate disease occurrence
indexes and environmental characteristics, enabling the exact observation of geographic area and
the determination of how some physical factors (rivers, mountains, vegetation) can influence the
spreading or controlling of the disease. Besides that, the use of these techniques can improve the
ground data acquisition and information accuracy (Evlyn, 2004).

2.8. Multi criteria Decision Evaluations by Analytical Hierarchy Processes

A well-known weight evaluation method is the Analytic Hierarchy Process (AHP). AHP method
has been shown as a useful and rational way to determine weights for various destination
attributes through prioritization using pair wise comparisons. This method has steps including
specify the hierarchical structure, determining the relative importance weights of the criteria and
sub-criteria, assigning preferred weights of each alternative and determining the final score. Pair‐
wise comparisons should use the Saaty’s scale, which ranges from 1 (equal value) to 9 (extreme
different) (Saaty, T.L. 1996, 2000).

18
 CHAPTER THREE
3. MATERIALS AND METHODS

3.1. Description of Study Area

3.1.1. Location
The study was conducted in selected Woredas of Jimma zone, Oromia national regional state. It
falls in two woredas namely Limuseka and Choraboter woredas. Geographically, both are
situated north of 8◦10′0″ to 8◦50′0″ N Latitude and 36◦40′0″ to 37◦30′0″ east of longitude
covering a total area of 4136.4km2.The woredas are located 440km from Addis Ababa and 90
km far from Jimma town.

Figure 3. 1. Map of the study area

19
 3.1.2. Topography
The altitude of the study area ranges 1094 to 3045 m above sea level (Figure 3.2).The woredas
fallen under the tertiary volcanic of madalaqa and the land feature of it, is characterized by
plateaus, some plains and relative valleys. It consists of alkali olivine basaltic turfs that make the
districts conductive for agricultural activities. The woredas was characterized by 13% highland
and 55% mid-highland and 32% lowlands (SWADO, 2017)

Figure 3. 2.Elevation map of the study area

3.1.3. Climate
Climatically, the woredas are classified into Dega/cool (25%) Woina Dega/subtropical (65%)
and Kolla/tropical (10%) Zones. Regarding to its temperature, the western part do have Badaa
daree (subtropical) agro-climate with the mean annual temperature ranges between 20-230c
While, the vast part of the district does classified to badda (cool) with mean annual temperature
ranges between18- 200c. Only isolated central mountain ranges have mean annual temperature

20
less than15.The rainfall of the district is weakly bi-modal with spring a small rainy season during
the months of April and May while summer a long rainy season during the months of June, July
and August. The rainfall of the district is weakly bi-modal with spring a small rainy season
during the months of April and May while summer a long rainy season during the months of
June, July and August. Annual Rain fall which lies less than 1300 mm to 1700 mm, and covers
most of the western parts, around gibe and didesa valleys (SWADO, 2017)
Table 3. 1.Monthly Average Rainfalls in mm of study area (2007-20017)

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
31.2 54.2 95.8 131.199 247 332 451 453 269.2 159 41.2 17.2
Source, Selected woreda meteorological station, 2017
Table 3.2. Monthly Average Temperature 0C of the study area (2007-20017)

Jan Feb mar Apr May Jun Jul Aug Sep Oct Nov Dec
17.94 19.9 22.5 23.8 21.76 21.5 20.1 21.5 20.78 19.72 15.6 17.5
Source, Selected woreda meteorological station, 2017

3.1.4. Drainage pattern

The main River of the study area is a part of the sub catchment following towards the Gibe River
which is one of the big rivers in the zone as well as well-known river in the region. Among the
major rivers that drain to Gibe River: Gibe, Dembi, Awettu, Indris and Degdege are perennial,
while the rest are intermittent streams and springs. There is distinctly known by being always
unclean. Drainage density of the catchments is highly concentrated in the boundary between two
Woredas and the northern part of the study area.
3.1.5. Vegetation of the study area
The vegetation areas of the woredas consists of natural vegetation and very sample man made
vegetation covers. The vegetation covers of the districts consists densely forest, Bush land,
scrublands and woodlands. The forest covers of the vegetation of the districts consist of 20.84 %
of the total land area of the districts. The forest consists of trees such as broad leafed rain forest
tree predacious forest tree, Juniper tree and low land tree. Among the trees found in the forest of
the districts natural coffee (coffee Arabica) oleo Africana (ejeersa) Anineria alhssima (kerero),
cordial Africana (waddeessa), producarpus faleatus (Biribirsa) Juni peres procera (gatira), ficus
sur(harbu), Acacia(lafto) coroton macro stochyus (makkannisaa), ficus vist(qilxuu and etc trees
are found in the forest.

21
 3.1.6. Soil
The types of soil distribution of the study area are dominated by five major soil types. Those are:
Dystric cambisols, pellic vertisols, orthic Acrisols, Chromic vertisols and Lithosols. Dystric
cambisols and orthic Acrisols are the major soil types of the study area (FAO, 1999).

3.1.6.1. Vertisols

Vertisols are heavy clay soils in flat areas. During dry season they shrink and have deep cracks in
a polygonal pattern, but on the contrary during the wet season the clay swells and causes
pressure in the sub-soil. Chromic vertisols are brownish and better drained. But, in general,
vertisols have fairly good, but limited agricultural potentialities. Land preparation is difficult, dry
soils are hard and wet soils are sticky. The moisture condition of the surface layer is only during
for a short period favorable to prepare land. Another difficulty is that the permeability of the
subsoil is very low. The soil has high water retention, but relatively a small amount of water is
available for plant growth. Rooting depth might be restricted because of the swelling and
shrinking properties of the soil (FAO, 1999).

3.1.6.2. Dystric Nitosols/Orthic acrisols

Nitosols are deep, well-drained, red, tropical soils. It has moisture storage capacity. They are
finely textured weathering products of intermediate to basic parent rock. These soils are
predominantly found in level to hilly land under tropical rain forest or savannah vegetation.
Nitosols are deep, clay red soils with an argillic B horizon. They have rather good potentialities
for agriculture. These soils have very good physical properties. They have a uniform profile, are
porous, have a stable structure and a deep rooting volume. Their moisture storage capacity is
high (FAO, 1999).

3.1.7. Socio Economic Condition

3.1.7.1. Population
According to Population Projection of Ethiopia for All Regions at woreda level from 2014 –
2017, the total population of Woreda is 359,767 of whom 180,002 were men and 179,765 were
women. The majority of the in habitants were Moslem with 65.26% of the population, while
29.27% of the population said the practiced Ethiopian orthodocs Christianity and 4.94% were
protestant.

22
3.1.7.2. Farming system
The farming system of the study area is mixed farming system, which includes both crop
production and animal husbandry. Fruits and sugar cane are also important cash crops. The
dominant cultivated annual crops are like cereal, legumes and purpose crops and poultry
production are, beef cattle, sheep, goat, horse and poultry production. Beef in rural area more
adapted in the area. In crops like teff, maize, wheat, bean and other crops to local farmers used
this type of production system to increase the source of income and living standard of the
community. Coffee is an important cash crop in the study woredas.

3.2. Research Design

A research design can be understood as the framework in which data will be collected and
analyzed (Bryman et al., 2008).This research was a retrospective comparative study design in
which the data was employed from local health services (health centers and health posts) as well
as individual households of study Woredas. Records of malaria episodes over five years were
retrieved from the local primary health care units (PHCUs) and climatic (rainfall and
temperature) of study area over ten years was collected from national meteorological agency. In
addition, an ecological element in charge of this case was selected from their sources. These
components include height (elevation), slope, soil, Lu/Lc, distance from swamp areas, distance
from pond water and distance from streams.

3.3. Sources and Types of Data

The study was used both qualitative and quantitative data. The required data were collected from
primary sources like socio economic data from sampled households key informants and GPS
point data and secondary source such as satellite images, soil map, digital elevation, climatic
data, topographic map and health centers point data of the study area.

Primary sources were used to understand the community perceptions and practices through
probing views of malaria as a risk to health, understanding of malaria transmission and treatment
seeking behavior, attitudes and practices of the use of malaria preventive measures. The primary
and secondary data that were used, their sources are described in the following table.

23
Table 3. 3.Source and types of data

NO Types of data Source of data Spatial

resolution/scale
1 Landsat satellite image USGS 30m
2 Topographic Map Ethiopian mapping Agency

3 Digital elevation model (SRTM)Internet 30m

4 Clinical data(malaria case) Woreda health office -
5 Rainfall and temperature National meteorological services -
Agency
6 Soil map FAO -

7 GPS data pints Field survey -

8 Study area boundary shape file Central statistical Agency -
9 Socio economic data Field survey

3.4. Sampling Design

3.4.1. Sampling techniques

Both non-probability and probability sampling techniques was used in this study. The study was
conducted in two selected Woredas of Jimma zone; Limmu seka and Choraboter, due to malaria
prevalent and potential prone area. The woredas have18 and 20 kebeles respectively. For
identification of sample study kebeles, for questioners and key informants for interview,
purposive sampling was used. Firstly, the districts was divided in to agro-ecological categories;
Dega, Woina Dega and Kolla. Then, from the total kebeles of the woredas, three kebele of the
Woreda from Woina Dega and Kolla agro ecological zone was selected purposively which
accounted 10.8% of the entire villages. Availability of health posts, health extension workers
(HEWs) and accessibility were factors that determine the selection of kebeles. Then, the
household’s respondents were randomly selected and key informants interviewee was purposely
selected from each kebele.

The Participants of in-depth interviews was permanent residents with good knowledge of the
area; one persons for each kebele and at the Woreda level. Semi-structured questions were used

24
to collect data from the key informants, and the interview was face-to-face interview and
conducted by the researcher.

3.4.2. Sample size determination

It is difficult in time, labor and cost to carryout study in the whole population. Therefore, in order
to determine an adequate sample size. The simple and relevant questioners were prepared and
organized in simple language for the local communities. The number of samples depends
primarily on the cost versus suitability.

According to socio economic development office (2018), the three selected kebeles of both
woredas have 1900 total household heads. Hence, those are named Atinago (633), Mirkuz (620)
and yaba (649) HH kebeles respectively. According to the study Woreda healthy office report
(2018) the kebeles are highly affected by this case, due to the existence of Malaria hazards and
risk. Therefore, for the analysis of this problem it is important to get firsthand information from
the households of each kebele. In order to identify the sample size, the researcher used the
formula, that indicated by Bartlett and Higgins (2001).

Where,

n: designates the sample size.

N: designates/assign total number of Households of the study area= 1900.

e: designates maximum variability or margin of Error = 0.09

1: designates the probability of the event occurring.

= =115.92 ~ 116

The sample size of each kebele was calculated by using the following formulas:

n1 = (n)

Where,

25
n1, 2…... sample size of each kebele

N1: Total number of households of each kebele

= *116 = 37 (Mirkuz kebele)

= =40 (Yaba kebele)

= *116 = 39 (Atinago kebele)

In addition to this, one person from each kebele and at woreda level (five persons) was
interviewed.

3.5. Instruments of Data Collection

The study used the following data gathering instruments: questionnaire, semi- structured
interview and observation.

3.5.1. Questionnaire
The questionnaires were used to gather relevant firsthand information from the households. Two
different sets of questions were prepared: close-ended and open-ended questions. Close ended
questions used to get simple and short answers, and open ended question were used to get
detailed information about the incident cases. Questionnaires were related to current status about
the socio economic characteristics of the households related to Malaria disease. For those
respondents who do not understand English, the questionnaire was translated in to Afan Oromo
language, as the respondents could easily understand.

3.5.2. Key informant interview

The method was undertaken by the researcher just with well-experienced and informed
individuals to get information in depth on the socio-economic and physical data which the
investigator wants to go through. It was conducted with the kebele administrator, the head of the
health office, and the supervisors with principal investigator with malaria infestation, health
workers, elders, women, youth, experts and community leaders. Because, it was believed that
they would have more experience with malaria and the health seeking behavior of communities
around their catchment areas. Hence, they were able to contribute more to the interviews.

26
 3.5.3. Observation
This allows the investigator to develop confidence to speak and analyze what was being said and
what is really going on the actual setting. In this case, the investigator observed the current
condition of housing, living condition of the people and as well as general socio economic and
environmental condition of the study area in order to get existing reality on the ground.

3.6. Methods of Data Collection for Environmental Factor

To develop land use land cover factor as an input, it needs training sites and samples for land use
land cover classes. Therefore, in order to classify land use land cover, the boundary/map of the
Woreda is the target and which was used as sample frame. In addition, all environmental factors
are retrieved based on Shook model (1997).

27
 Overall analysis of the study

Satellite SRTM Data Topomap Climatic data

image Soil Data

Health
Landsat 8 OLI/TIRS DEM Preprocessing (geo-
C1 Level-1, 2018 referencing the study station
generation
area map)
Temp&Rainfall

Clipping the study area based Clipping

Reclassify
on pre-classification study area
Digitize:
 River data
+  Proximity to
Lu/Lc map water body
 Swamp Study area
 Pond water Interpolation
soil
GPS based
ground truth
Generation of:
 Elevation,
Raster
 Slope and Soil map

Reclassify
Reclassify
Reclassify
MCDE Weighted overlay
Element at risk analysis

Hazard
 Questionnaires
 Interview Vulnerability
MCDE Weighted overlay acause of

Socio economic data

Malaria
risk map
Figure 3. 3.General flow of the study
28
Malaria risk of the woredas was analyzed from the following general risk equation (Shook
model, 1997)

Risk = (Elements at risk)*(Hazard)*(Vulnerability)

Hazard (H) is the probability of occurrence of a potential damaging natural phenomenon within a
specified period of time and within a given area. Element at risk (E) includes, the socio-
economic characteristics, public services, utilities and infrastructures, etc., at risk in a given area.
Vulnerability (V) is the exposure of a given element or set of elements at risk resulting from the
occurrence of a damaging phenomenon of a given magnitude. Risk (R) is the expected degree of
loss due to a particular natural phenomenon. The susceptibility and lack of resilience as key
elements of social vulnerability to malaria. Susceptibility is determined by individual’s lacking
ability to withstand malaria infection. Lacking capacity to cope or to recover, like, Access to
health facilities, Health insurance coverage (Shook, 1997).

3.7. Software and Materials

The software types used for different types of activities in the process of analyzing and
generating of risk zone was shown in the following table:

Table 3. 4.Materials and Software’s

No. Materials and Software’s Purposes

1 ArcGIS 10.3 For factors development and map preparation

2 ERDAS IMAGINE 2010 For Image processing and land use/cover classification
3 Microsoft Office Excel 2007 For analysis of collected data’s
4 GPS Point data collection for Ground truth
5 IDRISI Software For analysis of MCDE

3.8. Methods of Data Analysis

In the process of data analysis different kinds of methods were utilized based on the nature data
available. The data collected from different sources were processed, analyzed and interpreted by
using relevant GIS tool and Microsoft Office Excel 2007. After the data is collected from various

29
sources, then it was analyzed qualitatively and quantitatively based on the nature of the data.
Accordingly, the socio-economic data that were obtained from questionnaires and in depth
interview was explained qualitatively in the form of statement and quantitatively. In addition, to
analyze the overall objective of the study Multi Criteria Decision Evaluation (MCDE) was used
i,e by reclassifying all the environmental factors and giving weight. The result was presented
using graphs and tables.

30
 CHAPTER FOUR

4. RESULTS AND DISCUSSIONS

This chapter is concerned with analysis of the main findings of the study conducted on
Malaria risk hot spote site mapping using RS, GIS and Socio economic data integrations; the
case of selected woredas of Jimma zone. In this study, socio economic and Environmental
factors causing malaria prevalence is identified. Then, the result is presented, interpreted and
discussed in line with the research objectives, conceptual frame work and the methodology of the
study.

4.1. Data processing and classification

Digital image processing involves the manipulation and interpretation of digital image with the
help of computer (Lillesand et al., 1994) Satellite imagery has to be well processed prior to use
for further applications. It is in fact essential to rectify the raw satellite image under the pre-
processing stage such as geometric and radiometric correction. Image restoration also involves
the correction of distortion, degradation, and noise introduced during the image processing.
Image restoration produces a corrected image that is as close as possible, both geometrically and
radio metrically, to the radiant energy characteristics of the original scene. To correct the
remotely sensed data, internal and external error must be determined (Jensen, 1996).

In pre-processing phase, it is usually necessary to georeference the images on projection and

datum that Ethiopia has already selected, UTM projection and Adindan datum. Moreover, the
images used WGS84 projection and projected in to the country’s datum and projection. This is
mainly because datum and projection conflict was undoubtedly limit the use of various themes
(layers) at time. In other way, if remotely sensed data are to be used in association with other
data within the context of a geographic information system, then the remotely sensed data and
the products derived from such data is needed to be expressed with reference to the geographical
coordinates that are used for the rest of the data in the information system (Jensen, 1996).

In the study area, Land-use/cover maps were a one factor to analyze the risk. So, the
unprocessed satellite images were processed by using Erdas imagine 10.The preprocessing
activities include Haze removal and dark subtraction. These are mainly meant to enhance the

31
image's readability and avoid wrong placement of reflectance signatures against the
ground reality during classification. The preprocessed images were classified into various land
uses based on the supervised classification technique by using Erdas imagine 10. And this was
land-use/cover maps. The software was also use for the classification to enhance spectral
response using false color composite before classifying. Landsat 8 OLI/TIRS C1 Level-1, 2018
with 30 meters resolution was used to identify the breeding site condition.

4.1.1. Elevation factor

Elevation map of the study area was generated from SRTM 30 meter resolution Digital Elevation
Model (DEM).Hence, it was classified in to five classes as 1094-1513, 1513-1708, 1708-1940,
1940-2286 and 2286-3045m a.s.l. and new values were assigned for each class as 1, 2, 3, 4 and
5, respectively supported on prior research works and literature. Finally elevation based malaria
is leveled as very high, high ,moderate, low and very low respectively.

Figure 4. 1.Reclassified elevation and the ranked value

32
 4.1.2. Slope
Slope map of the study area was generated from SRTM 30 meter resolution Digital Elevation
Model. Then, it was reclassified, based on suitability of the slope for mosquito breeding by using
spatial analyst tools in Arc GIS. The reclassified slope raster layer sub groups were ranked
accordingly to the degree of suitability for malaria incidence as: 0- 5, 5 – 11, 11 – 19, and 19 –
30 and 30 – 81%.So,assigned new values was given as 1, 2, 3, 4, and 5 respectively. This
described as very high, high, moderate, low and very low malaria area respectively. The steeper
slope values are related to lesser malaria hazard and the gentler slope area have high susceptible
for malaria incidences. (Stephen, 2006).

Figure 4. 2.Reclassified slope percent and the ranking value

4.1.3. Distance from the rivers

The Rivers in the study area are a tendency to create innumerable sites for malaria vector
breeding. This condition can result the occurrence of abundance of mosquitoes found around
rivers where there are still waters. The river network was digitized from 1:50,000 scale
topographic map of the study area (EMA, 2017). Therefore, taking the heed of the maximum

33
flying distance of anopheles mosquito from the distance to stream is 2 km as a basis for
reclassification distance to the stream layer. Then, Distance was computed from every river and
new values were assigned as 1, 2, 3, 4, and 5 in order to show the relative hazard of the class
ranges 0-500m, 500-1000m, 1000m-1500m, 1500m-2000m and > 2000m which is re assigned
as very high, high, moderate, low, and very low malaria hazard layer respectively.

Figure 4. 3.Ranking values of distance from water body

4.1.4. Distance to pond water site

Distance from the water and wet lands are the environmental factors significantly related to
transmission intensity, indicating high transmission in the areas within 2.5 km of the water
source (Palaniyandi, 2012).Therefore, taking heed of the maximum flying distance of anopheles
mosquito from the breeding site is the basis for reclassification of a quadric bodies distance
layers. Therefore, analysis tool was used to calculate the distance from the breeding site. Then

34
the stagnant water distance raster layer was further reclassified using natural breaks standard
reclassification method in ArcGIS. The reclassified sub groups of breeding site distance raster
were ranked as: very high, high, moderate, low and very low respectively.

Figure 4. 4.Breeding site map

4.1.5. Proximity to swamps

Swamps are digitized from1:50,000 scale topographic maps obtained from Ethiopian Mapping
Agency (EMA, 2017).Then, it was generated in Arc GIS analysis tool. The reclassification was done
on the basis of mosquito flight distance range. New values were assigned as 1, 2, 3, 4 and 5.Then,
reclassified as very high, high, moderate, low and very low malaria risk level, respectively.

35
Figure 4. 5.Swamp areas ranked value map

4.1.6. Soil
Impermeable soil allows water stagnation and creates grounds for mosquito breeding and thus
favors malaria. Porous soil is devoid of stagnant water bodies; hence unfavorable condition is
created for Anopheline breeding site (Aruna, et al., 2001). The types of soil in the study area are
generated from FAO classification based on their ability to hold moisture and or being permeable
or impermeable. Then, new values were assigned to chromic vertisols, pellic vertisols, Dystric
cambisols, Lithosols and Acrisols as 1, 2, 3, 4, and 5 respectively in order to show the relative
permeability of the soil.

36
Figure 4. 6.Classified soil map

4.1.7. Land use land cover factor

To identify the land use and land cover of the study area, Landsat 8 OLI (Operational Land
Imager) of the year 2018 was classified using a supervised classification method. The land use
land cover classification was verified by ground truth data (ground control points) collected for
each land use land cover types by field survey. The assessment was resulted, as an overall
accuracy of 84.6% and overall kappa statistics of 0.80 was achieved. All classes have higher
producer and user accuracy (Appendix II).As shown in figure 4.7 a total of 5 classes were
identified by this classification based on the order of susceptibility to be suitable breading site,
source of food and use as a shelter from climatic condition for the vector mosquito. Thus, the
new values were assigned to each class. Therefore, water body and wet lands are most suitable
for mosquito breeding so, they reclassified as very high, farm land as high; bare and shrub lands
as Moderate; settlement as low; and forest land as very low.

37
Figure 4. 7. Lu/Lc map

4.1.8. Temperature
The temperature data of the study area, from the year 2007-2017 was retrieved from national
meteorological agency (NMA, 2017), then, it was interpolated in ArcGIS in order to know
unknown spatial references. So, it was reclassified based on the favorable amount of temperature
extent for the prevalence of malaria at different altitudes given by FMoH (2009).The average
annual Temperature variation of the area in relation to malaria, was reclassified in to two classes
and new values were assigned to each class. So, classification values were given to the area
based on the level of vulnerability of those areas to malaria incidence. Then, temperature below
0 0
20 C and above 20 C and it represented as very high, and low respectively

38
Figure 4. 8. Reclassified (a) average annual temperature (2007-2012) and (b) average annual
temperature (2012-2017)

4.1.9. Rainfall
In the study area, ten year rainfall data was collected from national meteorological agency
(NMA, 2017).It includes eight stations, two of them are found in the study area and the other
stations are found in the surrounding Woredas. But, the layer was created by Inverse Distance
Weight (IDW) in ArcGIS in order to know unknown spatial references. Then; it was reclassified
in to two classes, based on the favorable amount of rainfall extent for the prevalence of malaria
at different altitudes given by FMoH (2009).Then; new values were assigned to each class.
Based on this classification, values were given to the area of the mean annual rainfall above
900mm and below 900mm and represented very high, and Low respectively, based on the level
of vulnerability of those areas to malaria incidence. High annual malaria incidence coincide with
high rainfall and relatively warm conditions while low incidence years coincide only with low
rainfall (WHO, 2011).
.

39
Figure 4. 9.Reclassified (a) average annual RF (2007-20012) and (b) (2012-17) respectively

4.1.10. Malaria vulnerability

Vulnerability is the exposure of a given element or set of elements at risk resulting from the
occurrence of a damaging phenomenon of a given magnitude (shook, 1997). According to
Stratton (2008), Malaria vulnerability is influenced by, access to health facilities and
socioeconomic conditions. Malaria vulnerability can be reduced by the advancement of vector
control mechanisms. The people that live far from health care facilities were identified the most
vulnerable to malaria. In this study, health station was digitized after georeferencing GPS field
collected data on Topographic map in ArcGIS. Then, vulnerability map was developed and
reclassified in to 5 sub class. The reclassified sub groups of vulnerability raster layer were ranked
as: very high, high, moderate, low and very low.

40
Figure 4. 10.Vulnerability map

4.1.11. The overall development of malaria hazard

Hazard is the probability of occurrence of damaging natural phenomenon within specified period
of time. Malaria suitability area is mapped depending on the environmental factors which
contribute for the survival of Anopheles mosquitoes represented as a hazard. The malaria
incidence and transmission requires the environment with lower elevation (higher temperature),
abundance of wet lands, gentle slopes and availability of still waters around rivers (Negassi,
2008).

For the purpose of identifying areas of malaria hazard, the study focused on distance to Pond
water factor, elevation factor, slope factor, soil factor, distance to stream factor, temperature,
Rainfall and, distance to swampy, as the factors of malaria incidence in the study area.

41
Therefore, processing of the overall hazard map requires, estimating weight for each individual
hazard parameters. In order to develop malaria hazard map, the study used MCDE for each
hazard parameters in IDRISI software based on appraisable value for their importance to the
vector mosquito survival and the prevalence of malaria. The pair wise comparison of the eight
parameters was carried out to develop the pair wise comparison matrix in IDRISI. The
consistency ratio (CR) of the calculated Eigen vector was 0.10 which is acceptable (Appendix
II). The computed Eigen vector was used as a coefficient for the respective factor maps to be
combined in Weighted Overlay in Arc GIS.

Table 4. 1. Characteristic of factors in relation to malaria hazard area identification

Factor Weight Value Ranking Hazard level

Elevation 0.306 1094-1500 1 Very high

1513-1708 2 High
1708-1940 3 Moderate
1940-2286 4 Low
>2286 5 Very Low
Temperature 0.2153 >200c 1 Very high
<200c 4 Low
Rain Fall 0.1545 >900mm 1 Very high
<900mm 4 Low
0.1138 0-5 1 Very high
Slope 5-11 2 High
11-99 3 Moderate
19-30 4 Low
30-81% 5 Very Low
Distance from 0.1076 0-3000 1 Very high
pond water 3000-6000 2 High
6000-8000 3 Moderate
8000-1200 4 Low
>1200 5 Very Low

42
Distance from 0-2500 1 Very high
swamp 0.0450 2500-7500 2 High
7500-10500 3 Moderate
10500-13000 4 Low
>13000 5 Very Low
Distance from 0.036 0-500 1 Very high
River(Streams) 500-1000 2 High
1000-1500 3 Moderate
1500-2000 4 Low
2000-2500 5 Very Low
1 Very high
2 High
Soil 0.0257 3 Moderate
4 Low
5 Very Low

43
Figure 4. 11.Hazard map

4.1.12. Mapping of malaria risk hot spot site

Risk (R) is the expected degree of loss due to a particular natural phenomenon. In other words, it
is the probability of developing a given disease over a specified period of time (WHO,
2013).Thus, Malaria risk is the probability that an individual will be attacked by malaria in a
given interval of time and in a known area. The development of malaria risk map of the study
area was done on the basis of risk computation model (shook, 1997).It may be expressed as the
product of hazard (H), vulnerability (V), and element at risk (E).The three components of
malaria risk analysis are hazard, element at risk and vulnerability layers. A malaria risk map was
produced in an overlay weighted process in ArcGIS indicating the potential risk of malaria at any
point within the study area in relation to the combined three parameters. The corresponding
weight assigned to each of the factors was computed in IDRISI which is based on the pair wise
comparison of those three parameters. The consistency ratio (CR) of the calculated Eigen vector
was 0.08 which is acceptable (Appendix II).

44
Table 4. 1. Analysis of malaria risk area identification.

NO Factors Weight Ranks Risk level

1 Hazard 0.5368 1 Very high
2 High
3 Moderate
4 Low
5 Very Low
2 Vulnerability 0.3643 1 Very high
2 High
3 Moderate
4 Low
5 Very Low
3 Element at risk 0.0989 1 Very high
2 High
3 Moderate
4 Low
5 Very Low

45
Figure 4. 12. Malaria Risk Map and ranks layer

46
 4.2. General - Socio- economic Background of the Respondents
Table 4. 3.Background characteristics of respondents

General Characteristics Particular feature No of Percent (%)

respondent
Sex Male 66 56.9
Female 50 43.1

Total 116 100

Age 15-35 61 52.6

36-55 40 34.4

>55 15 13

Total 116 100

1-4 52 44.9

Family size 5-6 47 40.5

7 and above 17 14.6

Total 116 100.0

Educational status Illiterate 41 35.4

Reade and write 28 24.1
Grade 4-8 33 28.5
High school & above 14 12
Total 116 100.0
<3000 101 87

4000-10,000 15 13
Income of the respondents
>10000_15000 0 0

>15000 Birr 0 0
Total 116 100.0
Poor 41 35.3

47
Knowledge About Malaria Adequate 44 38

Good 31 26.7
Total 116 100.0

Source: Field Survey 2018

As the above table 4.3 shows, from a total of 116 household heads, 66 (56.9%) were males and
50 (43.1%) were females. The family size of the population ranged from 1 to 4 with an average
of 52(44.9%) and those who have 5-6 are 47(40.5%). As well as 17(14.6%) are participants who
have family size greater than 7. About 41 (35.5%) of the study participants were illiterate while
28(24.1%) can read and write, 33(28.5) are Grade 4-8 and 14(12%) of them were high school
and above. From the total participants 101(87.5%) of the participants were supposed to have a
monthly income less than 3000 (Table 4.3), this indicated majority of the household heads are
poor, hence they are affected by Malaria.

According to Ayele, (2012) and Amegah, (2005), malaria as a disease of the poor, which is
substantiated by the fact that the malaria burden is often concentrated in the poorest continents
and countries. Significantly more malaria cases were observed among poor people who had a
Low monthly income, as compared to those who had high income group. Malaria cases
decreased with an increasing monthly income. Similarly in-depth interview participants from
individual health workers, point out that those people who live in low standard of life are mainly
affected by this case

Knowledge and awareness of the community on malaria significantly influence on malaria

control and occurrence among the participants. Based on the household survey, 41 (35.3%) of
the participants are poor knowledge on malaria and 44(48%) are adequate, as well as 31(26.7%)
are good knowledge about malaria. So, it was prevalent among the participants who had a poor
knowledge about the case. According to Dhiman, (2009), individual knowledge, awareness and
beliefs may also affect malaria occurrence. The misconception and beliefs about malaria among
some communities continuously battle with the correct scientific information and pose major
setbacks in malaria control efforts.

48
4.2.1. Socio economic characteristics
Table 4. 2. Socio economic characteristics

General Characteristics Particular feature No of respondent Percent (%)

Pit latrine 47 40.5
Toilet facility Open pit latrine 69 59.5
Total 116 100.0
Main source of drinking water Tap water 51 44
Unprotected water 65 56

Total 116 100.0

Availability of television Yes 30 25.8

NO 86 74.2
Total 116 100.0
Mud block/stick wood 114 98.2
Main materials of rooms walls Corrugated metal 2 1.8

Total 116 100.0

Main materials of Room’s Corrugated iron sheet 53 45.7
Roof. Stick and mud 63 54.3
Total 116 100.0
Main materials of rooms Earth 98 84.4
floor Cement 18 15.6
Total 116 100.0

Windows with plastic 15 12.9

Type of windows Windows with no covered 101 87.1
Total 116 100.0
Distance to Nearest Health <1 Km 25 21.6
Centre 1–3 Km 34 29.3
>3 Km 57 49.1
Total 116 100.0
Source: Field Survey 2018
49
The above table, 4.4 indicated the socio economic characteristics of the study participant’s in
relation with malaria vulnerability. Based on this table, out of total respondents of the study
population 69(59.5%) have open pit latrine (unstandardized toilet) facility and only 47(40.5%)
have pit latrine or standard. So, majority of the population have toilet facilities which are not
clean. Those which are not clearly managed are the homes for insects which transmit malaria.
The study conducted by Snow et al. (2000), found that the major challenges in the control of
malarial infection was the use of toilet facilities. Similar to this, the informants of the in-depth
interview from principal investigator of malaria, stated that, households with uncleaned toilet
facilities were more likely to be positive for malaria diagnosis test and a high proportion of the
population at any age is vulnerable to malaria due to lack of acquired infrastructures.

As it is shown in table 4.4 65(56%) of population are using unprotected water and only 51(44%)
the respondents are saved or protected water. So, this indicated majority of the populations are
not having saved water. 86(74.2%) of the populations have no availability of television, so only
30(25.8%) have availability of television. Currently, there are many information that we can get
from the media, therefore, more of people have no information about malaria, that released from
the media, specially the community towards malaria causation, transmission, treatment seeking
behavior and presence of mosquito control activities.

In addition to this, having a cement floor and corrugated iron roof of the house was found to be
one means of reducing the risk of malaria. From this view, out of the total participants,
114(98.2%) are main materials of rooms walls with stick wood and only 2(1.8%) are Corrugated
metal with cement. However, Main materials of rooms floors 98(84.4%) and 18(15.6%) are
Earth and Cement respectively. And also, 53(45.7%) and 63(54.3%) are type of rooms roofs with
Corrugated iron sheet and Stick respectively.as well as type of windows constructions of houses
are windows with plastic and Windows with no covered materials ,which accounted 15(12.9%)
and 101(87.1%) respectively. As result, with those houses constructed of poor quality materials
having an increased risk and used as a habitat for mosquito insects. Moreover, the presence of
particular structural features of houses with good quality materials limit contact with the
mosquito vectors, hence, reduces infection. With face to face interview administered, one of the
key informants stated ‘’the risk of malaria is higher for households in a lower socio-economic

50
bracket than for those that enjoy a higher status and who are able to afford to take measures to
reduce the risk of transmission’’.

The study conducted by Tilaye (2007) and Ameyu (2008), shows the transmission of malaria is
determined by main factors such as human behavior and the existence of malaria parasite, as well
as facility factors such as housing condition, occupation, KAPs of the community towards
malaria causation, transmission, treatment seeking behavior and presence of mosquito control
activities can affect malaria prevalence. The result of household survey of the current study also
shows that unstandardized facilities available in the study area (unclean water, unstandardized
toilet and unfavorable housing condition) were the major factors for malaria causation,
transmission, treatment seeking behavior and presence of mosquito control activities.

Devi et al. (2006) in his study found that distance to health centers influenced the treatment
seeking behavior of individuals, compounding the malaria situation. The results of the data
collected from sample households of the study kebeles also confirms with this and reveals that
distance from the house to the nearest health facility was another risk factor for malaria
occurrence. As it were presented in table 4.2 out of the study participants, 57 (49.1%) are >3km
from the nearest to health center, 34 (29.3%) are the population 1–3 Km, and 25 (21.6%) are
participants with in <1 Km from healthy center. The distance to a health center could be regarded
as a factor for health facility accessibility for which the cost of reaching a health center is met by
the patients. A problematic distance to a health center may result in a household not assessing the
health facility frequently due to the cost and loss of work time. The findings suggest that
household members whose houses are close to health centers have more and more timely access
to health care as compared to those whose houses are far away from health centers. Further, the
households who live closer to health centers have more knowledge and awareness as they have
more interaction with the health staff. Similar studies also conducted as distance to health centers
and education levels of the household heads can influence malaria treatment seeking behaviors
and in the understanding and selection of malaria intervention for the household (Lowassa et al.,
2012).

51
4.3. The Environmental Factors that Makes Suitable Condition for Mosquito Breeding Site

4.3.1. Elevation

Figure 4. 13.Elevation based malaria

Table 4. 3.Elevation range and area in percentage

NO Ranks Elevation range Count value Area in Km2 Percent (%)

in meter
1 Very high 1094-1500 16177 647.1 15.64
2 High 1513_1708 39351 1574.0 38.05
3 Moderate 1708-1940 25634 1025.4 24.79
4 Low 1940-2286 16767 670.7 16.21
5 Very low 2286-3045 5447 219.8 5.31
Total 103376 4136.9 100.00

As the above figure 4.5 indicated, the reclassified elevation of the study area was covered
15.64%, 38.05%, 24.79%, 16.21% and 5.31% that represented very high, high, moderate, low

52
and very low malaria of the total area respectively. From this map, it is possible to understand
that about 53.7 % of the study areas are high and very high malaria. 24.79% of the area
accounted moderate malaria zone. As well as 16.21% and 5.31% of the area is in the Low and
very low malaria hazard. The malaria frequently occurs in areas with elevation below 2000
m.a.s.l. and its transmission is extremely high in areas below 1500 m.a.s.l. in Ethiopia (old
national Atlas map of Ethiopia, 1988). Thus, about 71% of the area is below 1500 m.a.s.l., which
is likely under the risk of malaria prevalence.

4.3.2. Slope factors

Figure 4. 14.Slope based malaria

Table 4. 4. Slope range and area percentage

Slope in Area in Percentage

No Ranks pixel Count (%)
% km2
1 Very high 0-5 40536 1621.4 39.2
2 High 5_11 33114 1324.6 32.0
3 moderate 11_19 18297 731.9 17.7
4 Low 19-30 8701 348.0 8.4
5 Very low 30-81 2727 111.0 2.7

53
 Total 103375 4136.9 100.0

In areas with low slopes, water tends to be logged and such conditions accelerate chances for
water stagnation, which in turn, encourages breeding and survival of mosquitoes (Stephen,
2006). As it was shown from table 4.6 out of the total area, 1621.4km2 (39.2%) is in a very high;
1324.6 km2 (32.0 %,) in high; 731.9km2 (17.7%) in moderate; 348.0km2 (8.4%) in low and 111.0
km2 (2.7 %) is very low hazard of malaria incidence. From the total study area, 71.2% is in high
and very high malaria hazard while the remaining 28.8% of the total area is in moderate, low and
very low malaria hazard. The bottom areas characterized by flat or gentle slopes are mostly
under swamps and water bodies. As slope increases from lower parts to middle and upper slopes,
mosquito populations cannot sustain. Areas leveled as high and very high malaria hazard, have
slope less than 0 – 5% and 5% – 11% that allow water stagnation and create suitable conditions
for mosquito breeding.

54
 4.3.3. Soil type

Figure 4. 15.Soil based malaria

Table 4. 5. Reclassified soil and Areas in Percentage

No Ranks Major soil Pixel count Area in km2 Percentage

(%)
1 Very high Chromic Vertisols 2243 277.5 6.7
2 High Pellic Vertisols 5703 705.4 17.0
3 Moderate Dystric Cambisols 13996 1731.3 41.8
4 Low Lithosols 451 55.8 1.3
5 Very low Orthic Acrisols 11051 1367.0 33.0
Total 33444 4136.9 100.0

55
As the above table 4.7 shows 23.7% of the area mapped as very high and high malaria hazard
level, as well as 41.8% and 1.3% are moderate and low hazard values. Lastly 33% of the total
soil areas are very low risk of malaria. The reclassification was based on water storage capacity
of soils by (FAO, 1999), which determines their suitability for mosquito breeding. Chromic and
Pellic Vertisols are typically impermeable or poorly drained soils and they represented as very
high and high risk level. Dystric Cambisols and Lithosols also have high moisture storage
capacity and reclassified Moderate and low hazard level respectively which accounted 761.2km 2
of the total area. .Lastly Orthic Acrisols accounted 1367km2

4.3.4. Proximity to pond water site

Figure 4. 16.Proximity to Pond water sit based malaria

56
Table 4. 8. Distance to pond water site and areas in Percentage

No Ranks Ranging values in Meter Area in km2 Percentage

(%)
1 Very high 3000 648.8 15.6
2 High 6000 1536.1 37.2
3 Moderate 8000 875.3 21.2
4 Low 12000 853.1 20.6
5 Very low >12000 223.6 5.4
Total 4136.9 100.0

The pond water is created close to the streams and rivers in order to store water for the dry
season. Such ponds act as resourceful areas for mosquitoes to develop and contribute to increase
malaria prevalence (Bautista et al., 2006).As table 4.8 above shows, based on the reclassified
distance to pond water, the majority of study area is in high and very high malaria that cover
52.8%. Moderate malaria areas accounted 21.2%.as well as, Low and very low areas accounted
20.6 % and 5.4%, respectively. Similarly, the study conducted by Palaniyandi (2012) Since,
mosquito can fly 2.5 km from its breeding site, areas are mapped as very high, high, moderate,
low and very low malaria hazard. People near breeding sites(less than the average mosquito
flight distance) are assumed a high risk of malaria while those beyond the average anopheles
mosquito flight distance are less likely to be attacked by malaria.

57
 4.3.5. Proximity to swamps

Figure 4. 17. Reclassified based on malaria

Table 4. 6.Proximity to swamp and area in Percentage

No Ranks Value Pixel Count Area in km2 %

1 Very high 0-2500 5283 653.5 15.8
1 High 2500-7500 11757 1454.3 35.2
2 Moderate 7500-10500 6529 807.6 19.5
3 Low 10500_13500 4680 578.9 14
4 Very low >13500 5195 642.6 15.5
Total 4136.9 100

58
The above table 4.9 shows based on the reclassified proximity to swamps, 653.5 km2 (15.8%), in
very high, 1454.3km2 (35.2%) in high, 807.6 km2 (19.5%) in moderate, 578.9 km2 (14%) in low
and 642.6 km2 (15.5%) in very low malaria area of the study area. From this table, it is possible
to understand the majority of study area is in very high and High malaria area that cover 2107.8
km2 (51%) and the remaining 2029.1 km2 (49%) of the total area represented moderate, low and
very low malarious area.

4.3.6. Proximity to streams

Figure 4. 18.Reclassified proximity to streams

59
 Table 4. 7. Distance to streams, Area Coverage and Percentage

Stream
Pixel Percentage
No Ranking distance Area in km2
count (%)
range
1 Very high 500 11715 1449.4 35
2 High 1000 9401 1163.1 28.1
3 Moderate 1500 6423 794.7 19.2
4 Low 2000 3806 470.9 11.4
5 Very low >2000 2090 258.6 6.3
Total 4136.9 100

Distribution of water bodies are an important factor influencing the occurrence and distribution
of malaria cases and contributes as larval breeding sites for malaria vectors, thus, it is a major
determinant of malaria risk incidence (Zhou et al., 2012). As it was shown from table 4.10 the
reclassified map of distance to streams indicates that very high malaria area which covers
1449.4km2 (35%) and 1163.1km2 (28.1%) in high malaria area as well as moderate area
accounted 794.7 km2 (19.2%). lastly low and very low malaria area covers an area of 470.9 km2
(11.4%) and 258.6 km2 (6.3%) respectively. This is based on flight range of mosquito, since
mosquito can fly 2 km from its origin (Verdonschot et al. 2013); areas mapped as very high, high
and moderate, low and very low.

60
 4.3.7. Land use land cover factor

Figure 4. 19. LU/LC map

Table 4. 8. Lu/Lc, Area Coverage and Percentage

Ranks Feature type Area in km2 percentage%

Very high Water body and wet land 773 18.7
High Farm land 1000.5 24.2
Moderate Bare land and shrub 1314.9 21.8
Low Settlement 392.7 19.5
very low Forest land 655.8 15.9
Total 4136.9 100.0

61
The type of land use land cover especially type of vegetation which surrounds the breeding sites
basically supply sugar feeding for adult mosquitoes, and provided ideal sites for resting and
protection from climatic conditions. Hence, enhancing longevity of the vectors. (Zhou et al.,
2012).
Table 4.11 shows reclassified land use land cover based malaria risk level. From the total area,
773km2 (18.7%) leveled as very high risk of malaria; 1000.5km2 (24.2%) as high, 1314.9km2
(21.8%) as moderate and 392.7 km2 (19.5%) as low risk and 655.8 km2 (15.8%) leveled as very
low malaria incidence as element at malaria risk and mosquito breeding. Therefore, from this
table, it is possible to understand water body and wet lands as well as farm lands are high
contribution to mosquito survival. Hence, on this area the malaria risk becomes high and very
high.

4.4. Spatiotemporal Variation of Malaria

As the following figure 4.20 clearly indicated, in 2013 and 2014, there is a huge variation
between the two woredas. Hence, the numbers are very high in Limmu seka Woreda. But the
prevalence is decreasing in both woredas. It is decreasing irregularly from 2014 due to several
preventive actions taken by the study Woreda administration health office and other concerned
bodies. Even though, these actions have been undertaking, malaria is still major health problem
in the study area.

62
 Limmu seka Chora boter

4500
4000
3500
No of Malaria cases

3000
2500
2000
1500
1000
500
0
YEARS 2013 2014 2015 2016 2017
Limmu seka 3909 3718 1146 845 401
Chora boter 2432 2422 1188 1194 1423

Figure 4. 20.Malaria Trend of the selected Woreda from 2013-2017

Source: The selected Woreda administration health office

4.4.1. Relative abundance of malaria from 2013 to 2017 of selected woredas

The relative abundance rate of malaria from both woredas was presented in the following table.
In both woredas the rate of abundance shows continuous different distribution throughout the
study periods (2013-2017) (table 4.12).The malaria cases of Limmu seka Woreda decreased from
39 % in 2013 to 37.1 in 2014 and 11.4% in 2015. Out of the total the numbers of malaria cases
throughout the years, the Woreda were 845 (8.5%) in 2016 and reduced almost by half and fall
to 401(4%) in 2017.The information obtained from key informants shows the reason for such
decrement of malaria incidents from year to year was due to the government attention to avoid
the cases by distributing the malaria control net for households. In addition to this the Woreda
health office officer explained that ‘’the numbers of malaria cases was reduced throughout recent
years mainly due to the accessibility of health facilities (health post) to nearby the residents’’.
Thus the residents of the Woreda may have awareness about the malaria causes, transmission
and control method as they live nearby the health facilities. This helped the reduction of malaria
cases in the Woreda.

63
Table 4. 12.Relative abundance of malaria and its rating

Limuseka Choraboter
No of cases % No of cases %
Years
2013 3909 39 2432 28.0
2014 3718 37.1 2422 27.9
2015 1146 11.4 1188 13.7
2016 845 8.5 1194 13.8
2017 401 4 1423 16.4
Total 10,019 100 8659 100

Source: The selected Woreda administration health office

In the second study Woreda Choraboter, The relative abundance rate of malaria shows
continuous decrement until 2015 and shows increment in 2016 and 2017. As it clearly seen from
the above table 4.12 the numbers of malaria cases for this woredas was 2432(28%) in 2013 then
decreased to 2422(27.9%) in 2014 and 1194(13.8%) in 2015. In 2017 it shows the increase of the
numbers of malaria incidents. In this year the numbers of incidents was increased by 229 cases
from 2016(1194) and reached 1423 in 2017 which accounted 16.4% of the total incident cases.
The information obtained from key informants shows the reason for such increment of malaria
incidents from the year 2016 to 2017 was ‘’due to community have not given attention to avoid
the cases because of while it is decreased from 2013-2015’’.

4.4.2. Seasonal variation of total malaria cases in selected Woreda, 2013-2017

The apparent fluctuation of recorded malaria case in the study area is showed as the following
(figure 4.21). As the figure shows malaria cases are occurred in almost every month of the year.
The highest peak of malaria cases in almost all years was observed during the autumn season
(September, October, and November) which is season with the highest average total malaria
cases occurrence. Next to autumn season, it was also recorded in March, April and may which is
spring season. Lastly, the minimum malaria cases was recorded during summer (June, July and
august) and winter (December, January and February) seasons respectively. Similarly, the study
conducted by Federal Ministry of health (FMH, 2006) National five-year strategic plan for
64
malaria prevention and control in Ethiopia, shows the transmission of malaria depends on
altitude and rainfall with a lag time varying from a few weeks before the beginning of the rainy
season to more than a month after the end of the rainy season. Malaria transmission peaks bi-
annually from September to December and April to May, coinciding with the major harvesting
seasons.

Limmu seka Chora boter

8000
Number of malaria cases

7000
6000
5000
4000
3000
2000
1000
0
Summer Automn winter spring
Seasons

Figure 4. 21.Seasonal recorded malaria cases (2013-2017)

Source: The selected Woreda administration health office

65
 4.4.3. Variation of temperature in relation to malaria

Figure 4. 22.Reclassified average annual temp of (a) and (b), 2007-2012 and 2012-2017
respectively.

Table 4. 9.Temperature variation, area coverage and percent in relation to malaria (2007-2017)

Area
No Rating Class Pixel(a) pixel(b) Area in km2(a) %(a) %(b)
in km2(b)
1 Very High >20c 9762 17566 2335.9 3236.1 56.5 78.2
2 Low <20c 12680 4876 1801 900.8 43.5 21.8
Total 4136.9 4136.9 100.0 100.0

In the area where temperature amount is less than 20°C Plasmodium falciparum that causes
severe malaria, cannot complete its life cycle while the average temperature above 20° to 24°C is
suitable for malaria incidence. (Afrane et al., 2011).
Figure 4.22 indicated 43.5% from 2007-2012 and 21.8% from 2012-2017 of the area is below
20°C.Therefore,this area is not suitable for the life cycle of plasmodium and it is low malaria
hazard area. An area which accounted 56% from 2007-2012 and 78% from 2012-2017 of the

66
area is above 20°C.hence; it represented very high malaria incidence area. As temperature and
relative humidity conditions increases, the longevity and density of mosquitoes will increase and
thus initiate malaria transmission, if parasite load exists in the community (Yazoume et al,
2008). The figure shows that malaria transmission areas remained high with occasional large
epidemics in space and time in the study are between 2012-2017, however the information
obtained from senior health expert of the woredas shows that the numbers of malaria incidents
decreased recent years due to many incident control mechanism practice and awareness creation
by healthy professionals of the woredas.

4.4.4. Variation of rain fall in relation to malaria

Figure 4. 23.Reclassified annual RF (a) and (b) 2007- 2017

67
Table 4. 10.Rain fall variation, area coverage and percentage in relation to malaria (2007-2017)

Area in Area
No Ranks class Pixel(a) pixel(b) %(a) %(b)
km2(a) in km2(b)

1 Very High >900mm 19186 12373 3534.4 2282 85.4 55.2

2 Low <900mm 3255 10069 602.5 1854.9 14.6 44.8

Total 4136.9 4136.9 100 100

In the area where rain fall amount is less than 800mm, Plasmodium falciparum that causes severe
malaria, cannot complete its life cycle while in areas where rainfall above 900mm is favorable
for breeding vectors. (Afrane et al., 2011).
Figure 4.23 shows from the total study area, 85.4% from 2007-2012 and 55.2% from 2012-2017
of the study area covered average annual rainfall above 900mm and it represented very high
malaria hazard area. As well as 14.6% from 2007-2012 and 44.8% from 2012-2017 of the total
area accounted Low malaria hazard respectively. The rainy pattern creates several breeding sites
for mosquitoes. As the vector population increases, the transmission of malaria increases. So
from this figure the variation of rain fall coverage area above 900mm is decreasing up to know.
The same is true as malaria breeding site.

68
4.5. Developed Areas of Malaria Hazard

Figure 4. 24.Hazard map

Table 4. 15.Hazard map ranks, Area Coverage and Percentage

No Ranks Area in km Percentage

(%)
1 Very high 735.3 17.8
2 High 1434.3 34.7
3 Moderate 746.1 18.0
4 Low 601 14.5
5 Very Low 620.2 15.0
Total 4136.9 100.0

69
Hazard is the probability of occurrence of damaging natural phenomenon within specified period
of time. The malaria hazard is mapped based on the environmental factors which contribute for
the survival of Anopheles mosquitoes. The study conducted by Negassi (2008), Shows ‘the
existence and transmission of malaria incidence is determined by the environment with lower
elevation (higher temperature), abundance of wet lands, occurrence of gentle slopes, availability
of still waters around rivers, and areas of lower drainage density’’. Similarly, in this study the
overlay analysis was done for eight parameters namely;(elevation, slope, distance to streams,
distance to Pond water, distance to swamp, Rain fall, Temperature and soil types) and the
appropriate weight was given according to the degree of importance for the incidence of malaria.
Pair wise Comparison was used to develop the pair wise comparison matrix. After the overlay
analysis of those parameters, malaria hazard map was produced. As it was shown from figure
4.24 malaria hazard of the study area was mapped as, very high, high, moderate, low and very
low hazard which accounted 735.3km2 (17.7%); 1434.3km2 (34.7%); 746.1km18.0% 14.5% and
15.0% of the total area coverage respectively.

70
4.6. Developed Areas of Malaria Risk
The basis for the calculation of the map was the risk computation model (Risk = Hazard *
Element at Risk * Vulnerability) developed by shook (1997).

Figure 4. 25.Final malaria risk map

Table 4. 11.Analyzed results of malaria-risk map and its area

No Ranks Area in km2 Percentage

(%)
1 Veryhigh 1233.0 29.8
2 High 1271.1 30.7
3 Moderate 1100.4 26.6
4 Low 420.8 10.2
5 VeryLow 111.6 2.7
Total 4136.9 100.0

71
As the above table 4.16 shows, from the total area of 4136.9km2 by overlaying all environmental
factors, 29.8% in very high, 30.7% in high and 26.6% are moderate risk zone, 10.2% and 2.7%
are low and very low level of malaria risk zone respectively. This shows the majority of study
area fell in high and very high risk level which occupies (60.5%). Moderate risk level is 26.6%.
Low and very low malaria risk zone covers small area, which accounted only 532.4km2 (12.9%)
of the total area. Hence, it is possible to conclude that most of the area (over 60 percent) is under
high and very high risk of malaria. The risk level in this study was relatively greater than the
study reported by Tensaye, which discussed the majority of study area, fell in very high and high
risk level 54.5 % (Tensaye, 2016). Findings of the present study shows that, a model-based
malaria-risk map can be developed by establishing the relationship of various parameters using
remote sensing and geographic information system. It also reveals that remote sensing and GIS
techniques can be effectively used in mosquito larval habitat identification and risk area
mapping. The risk area identification map indicates affected areas. The final malaria-risk map of
the study area shows that the entire study area has malaria-risk factors. The study area falls under
very high, high, moderate, low and very low risk areas. The malaria-risk map developed can
support decision makers to take precautions in space and time. So, as to control and manage
malaria incidence.

72
 CHAPTER FIVE
5. CONCLUSION AND RECOMMENDATION

5.1. Conclusion
The initial aims of the thesis was malaria risk hot spot site mapping in the case of selected
Woredas of Jimma zone, that it can help to improve the management and control of malaria
vector. The study produced mapping of malaria risk area which can be used as an input for
policy makers and other responsible bodies. In addition, these groups, the experts in the field will
benefit more by acquiring information which serves as for national malaria eradication and
prevention program. This study has shown that GIS and remote sensing techniques was used to
maps malaria hazard and risk zone based on maps for environmental factors, reclassification,
overlaying and identification of risk level, as well as socio economic conditions of the
community in relation to malaria vulnerability was assessed.

Weighted of environmental factors was computed using pairwise comparison 9 point continuous
rating scale. In order to overlay the weighted factors in GIS, a Multi Criteria Decision Evaluation
technique was used for analysis of environmental factors, mapping of malaria hazard and risk
zones levels respectively. According to malaria hazard map, it was accounted that 52.5%of the
study area were subjected to very high and high malaria hazard area respectively. Generally, the
majority of study area fell in very high and high risk level (60.5 %).Moderate risk level are
26.6%. Low and very low malaria risk zone covers small area, which accounted only 10.2% and
2.7% of the total area respectively.

The transmission of malaria is determined by main factors such as human behavior and the
existence of malaria parasite, as well as social and health facility factors such as housing
condition, occupation, KAPs of the community towards malaria causation, transmission,
treatment seeking behavior and presence of mosquito control activities can affect malaria
prevalence. Importantly, a high proportion of the population at any age is vulnerable to malaria
due to lack of acquired infrastructures. Out of total respondents of the study population
69(59.5%) have unstandardized toilet facility and only 47(40.5%) have standard. As well as
65(56%) of population are using unprotected water and only 51(44%) the respondents are saved

73
or protected water. In addition to this, having a cement floor and corrugated iron roof of the
house was found to be one means of reducing the risk of malaria. From this view, out of the total
participants, 114(98.2%) are main materials of rooms walls with stick wood and only 2(1.8%)
are Corrugated metal with cement. However, Main materials of rooms floors 98(84.4%) and
18(15.6%) are Earth and Cement respectively. And also, 53(45.7%) and 63(54.3%) are type of
rooms roofs with Corrugated iron sheet and Stick respectively.as well as type of windows
constructions of houses are Windows with plastic and Windows with no covered materials which
accounted 15(12.9%) and 101(87.1%) respectively.

Therefore, GIS and remote sensing technology is vital tool for health related sector and
stakeholders, which could facilitate vector born disease control, prevention program and assist
the vector controlling organizations to identify hazard and risk areas for handling disease. For the
presence of malaria risk, the existence of suitable elevation, slope, proximity to water body, and
climatic condition for mosquito breeding site play major role.

5.2. Recommendation
The selected Woredas are mainly classified in to five malaria risk level, Very high, high,
moderate, low and very low. This classification is based on factors that create favorable
environment for mosquito breeding and malaria incidence. For this reason the followings are
recommended by the researcher

 The Woreda health office could make the awareness of the community with respect to
malaria prevention and provide like, anti-malaria drug provision, bed net distribution and
house spraying by prioritizing based on the risk level.
 Any decision makers should specifically use and apply the findings of this study to
prioritize risk areas and distribute the resource focusing on hot spot area.
 Providing more GIS and remote sensing based strategies to characterize spatial
heterogeneity with malaria risk at a fine scale for the effective identification of ecologies
of mosquito in case of eradication planning.

74
 To reduce the level of exposure to malaria in areas closer to swamps and other water
bodies, the community and other concerned bodies should design appropriate facilities to
drain swamps and stagnant water.
 Proper data bases about detail patient data, the numbers of seasonal incidence of
epidemics and the location of household that have been affected with malaria
insecticides should be obtained by GPS to determine more accuracy of the effectiveness
of spatial distribution of malaria.

75
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 Appendix 1
Dear respondents to questionnaire, key in formant interview and Focus Group Discussant.

My name is Mohammedreha Abajihad; I am a postgraduate student at Madda Walabu

University, Department of Geography and Environmental studies on field of specialization in
GIS and land resource management. Now I am writing my thesis on malaria risk hot spot site
mapping using Remote sensing GIS and Socio economic data integrations; the case of selected
woredas of Jimma zone, Oromia national regional state, Ethiopia.

You are selected purposively from Woreda agro ecological zone namely, Woina Dega and Kolla
agro ecological climates with three kebele as follows, atinago, mirkuz, and yaba kebeles, for
questionnaire and interviewed on the issue of interest .

Your kind responses are important and will be used for the analysis of this research and so
invited to participate only voluntarily. In any case, you won’t be identified by your name. You
are also free to refuse to respond to any questions you do not feel comfortable or to withdraw
from the research participation.

Part I: Survey Questioners

A. Questionnaire on socio-economic data

1. Demographic and social status

Head of household

Kebele

Age______ Sex_______ Family size in number

Occupation: ______________________________________________

1. Family Income/Month
A, <3000 B, 4000-10,000 C, >10000_15000 D, >15000 Birr
2. Educational Status of the household head

85
3. Knowledge About Malaria (do you know malaria)?
a) YES b) NO
4. If you answered YES, how is it?
a) Good b) adequate c) poor
5. What is the main source of drinking water for members of your household?

A, Unprotected Spring B) Public Tap/Standpipe C, Other, specify_____________________

6. What kind of toilet facility does your household use?

A, Pit Latrine (no cement slab) B, Pit Latrine with Cement C, Other,
specify_____________________

7. Does your household have any of the following?

A, Electricity B, Radio C, Television D, All E, none
8. Main material of the Room’s Walls
A, Mud Blocks B, Cement Blocks Sticks C, Wood Planks D, Corrugated Metal E, Other
(please specify) _________________
9. Based on question no.11. what are Main material of the Room’s Roof
A, Thatch B, Sticks and mud C, Corrugated iron sheet D, Other (please specify)
_________________
10. Type of windows (by observation)
Any window: a) YES b) NO
If you answered is yes, what type of windows?
A, Windows with plastic C, Windows with screens (metal) D, Windows with wood (no
covered materials) E, Other, Specify_____________________________
11. Main materials of the Room’s Floor.
A, Earth B, Local dung plasters C, Cement D, Wood E, Other (please specify)___________
12. Is there any availability of health facility?
A, YES B, No
If your answer is Yes, at how many Distance to Nearest Health Centre?
A, <1 Km B, 1–3 Km D, >3 Km E, other, specify

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13. At any time in the past 12 months, have the interior walls of this room been sprayed against
mosquitoes?
A, Yes C, No D, Don’t Know
If you answered No, please skip to Question 18
14. How many months ago was the room sprayed?
a) Less than one month
b) Months Ago
c) Don’t Know
15. Since your walls were sprayed can you show me if you covered the walls with anything such
as new paint or plaster or paper?
Square Room Round Room
a) Up to 1 Wall a) 25%ofRoom
b) Up to 2 walls b) 50% of Room
c) Up to 3 walls c) 75% of Room
d) Every Wall d) 100% of Room
e) No Cover e) No Cover
16, does your household have any mosquito nets?
a) YES b) NO.
If you answered No, please skip to Question 17.
17. At what time you use mosquito net?
A, every day B, when sleeping C, Morning D, at night time D, other (specify)…………………
A, no mosquitoes B, not available C, don't like to use nets D, too expensive
E, other (specify)………………………..______________________
Part II, Interview Guide.

1. Interview data _________________________

Interview sex _________Age ________Educational level ______Work experience _______
1. How about the awareness of malaria in the study area __________________________
2. How many peoples are affected by malaria? ___________________-
Why?________________________________________________________________
3. In which seasons and month of malaria manifestation appeared? _____________

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4. The trend of malaria in each year?
________________________________________________________________________
___________________________________________________________-
5. What are the environmental factories which affect malaria prove?
6. The human factories to affect malarias are? ____________________________
7. What are causes to increment of malaria incident?
8. What is the impact of malaria in study area? _____________________________
9. What is the role of government?
10. How many cost spends of incase of malaria? ____________________
11. Which kebeles is hot spot of malaria infection? _________________________________
Why?
________________________________________________________________________
________________________________________________________________________
________________________-

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 Appendix II
1, Weighted for Malaria hazard map

Elevation Temp Rainfall Slope D-Pond D- D-Streams Soil Eigenvecto Weigh

water swa rs of ts in %
mps weight
Elevation 1 0.3016 30.16

Temp. 1/2 1 0.2153 21.53

Rain fall 1/3 1/2 1 0.1545 15.45

Slope 1/4 1/3 ½ 1 0.1138 11.38
D-Pond 1/3 1/3 1/3 1/2 1 0.1076 10.76
water
D-swamp 1/7 1/5 ¼ 1/7 1/7 1 0.0450 4.5
D-Stream 1/7 1/5 1/3 1/2 1/5 1/2 1 0.0365 3.65
Soil 1/6 1/7 1/7 1/3 1/3 1/5 1/2 1 0.0257 2.57
Total 1 100
Consistency ratio =0.10 Consistency is acceptable

2, Weighted for malaria risk map

Hazard Vulnerability Element at Risk Eigenvectors Weights in %

Of weight
Hazard 1 0.5368 53.68
Vulnerability 1/2 1 0.3643 36.43
Element at Risk 1/4 1/5 1 0.0989 9.89
Total 1 100
Consistency ratio =0.08 Consistency is acceptable

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 3. Total accuracy of sampled data

Classified Water body Farm Bare and Settleme Forest Total User Kappa
data and wet land land schrub land nt land accuracy statisti
cs
Water body 21 0 1 0 2 24 87.5%
and wet
land
Farm land 0 31 4 2 0 37 83.7%

Bare and 0 3 23 1 1 28 82.1%

schrub land

Kappa statistics =0.80

Settlement 0 2 2 14 0 18 77.7%

Forest land 2 2 1 0 38 43 88.4%

Total 23 38 31 17 41 150

Producer 91.3% 81.5% 74.2% 82.3% 92.6% Over all accuracy

accuracy (84.6%)

90
 4. Average annual temperature of eight stations

No station Name Long Lati Temp 0c Temp 0c

From(2007-2012) From(2012-2017)
1 Botorbacho 37.27 8.367 19 19.3
2 Atnago 37.011 8.311 18 20
3 Genet 36.941 8.038 18.5 19.5
4 Sekoru 37.535 8.169 20 21.1
5 Nono 37.415 8.546 17.5 20.3
6 Sayo 37.275 8.779 20.5 19.5
7 Ijaji 37.343 9.01 17 20.4
8 Arjo 36.54 8.657 18 19.5

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