.

Prevalence of malaria and associated factors among under five

children in Mana Sibu woreda,western Oromia,Ethiopia

Community based cross-sectional study

 By
Amenu Jalata (BSc)
January, 2023
Nekemte, Ethiopia

08/14/2023
 Presentation outline
2

 Background
 Statement of the problem
 Significance of the study
 Conceptual framework
 Objective
 Methodology
 Work plan and budget
 References
 Background
3

 Malaria continues to be a major public health problem world wide.

 3.3 billion people are at risk of malaria globally
 61% of them were children aged <5 years.
 In sub-Saharan Africa, an estimated 409,000 people died of
malaria
 Most (274,000) were young children,
 and 94% of infectious and death occur in Africa
 Background…
4

 In Ethiopia, approximately 52 million people (68%) live in

malaria risk areas, primarily at altitudes below 2,000 meters. (3,4)

 Children under five years old are among the most vulnerable to
malaria infection as they have not yet developed any immunity to
the disease.(5,6,7)
 Statement of the problem
5

Malaria is the most important parasitic disease that causes massive

morbidity and mortality and poses a higher burden of disease in the
tropics.

More than 90% of malaria burden occurs in sub-Sahara Africa

(SSA), causing severe morbidity and mortality among young
children of rural areas with little access to health services (9).
 Statement of the problem
6

In Ethiopia, peak malaria transmission occurs between September

and December in most parts, following the rainy season from June
to August, mainly affecting young children, and

 P. falciparum and P. vivax are the major malaria parasites.(7,8)

 Statement of the problem
7

 It mainly affects the poorest and most vulnerable communities

due to the least access to:

 effective services for prevention,

diagnosis, and

treatment.

 Theses malaria parasites are transmitted by the bite of female

Anopheles mosquito species (9,10)
 Statement of the problem
8

 Three quarters of Ethiopian landmass is considered endemic for

malaria, putting 68% of the total population more at risk for
infection (9,10,11).

In Ethiopia, malaria caused by P. falciparum and P. vivax, is a major

challenge to both public health and socio-economic development.

Children under five years are one of the most vulnerable groups
affected by malaria than adults (10,11,).
 Statement of the problem
9

 Mana Sibu woreda is located at altitude below 2000 meter and

stratified under high risk for malaria (12)

 Different intervention activities like distribution of Insecticide

Treated Nets (ITN), Indoor Residual Spray (IRS), and Health
information dissemination have been done in the study area to
prevent and control the burden of malaria,

 but the disease remain the major public health problem and one of
the leading causes of morbidity among under five-year children
(12,13,14)
 Statement of the problem
10

 Despite all these efforts malaria case continues to remain high

and one of the leading causes of ill-health and deaths .
 According to the records available in West Wollega Zonal heath
department, the trend for the last five years indicated that
malaria cases was at 10,019 in 2017,8,024 in 2018,13,376, in
2019, 32,147 in 2020, and 27,934 in 2021both outpatient and
inpatient were registered; of which of cumulative 32,940 (36%)
were from Mana Sibu woreda.(23,14)
 Statement of the problem
11

 The overall trend indicates that malaria is still a threat in the

zone and Mena Sibu is being one among affected areas still
has a high number of malaria cases being reported from
outpatient department.
 Hence, knowing the current prevalence of malaria and its
associated factors among under five years in the area has great
importance to scale up and design appropriate intervention
programs.
 Significance of the study

12

 Despite the availability of malaria control measures the morbidity

and mortality in children under five years is still unacceptably high
 This study therefore will help to identify the factors associated with
malaria prevalence.
 The study will help the concerned authorities to plan and sensitize
the community about the factors and put in place strategies to help
reduce on the number of malaria cases in the community.
 
 Significance of the study
13

 It will be an essential component in the effectiveness of

malaria control and elimination in the already existing
strategies
 that are being scaled up hence re- align the effectiveness in
the malaria control measures.
 The findings of this study will also be used as a
baseline/reference for further studies and planning purposes
 CONCEPTUAL FRAMEWORK OF THE STUDY

CARE GIVER FACTORS

 Age of the care giver.
 Health seeking behaviors.
 Knowledge about the disease.
 Care givers education level.
 Marital status. Malaria
 Occupation.
 Attitude and practices.
prevalence

Environmental Factors
House hold Factors
 Drainage system.
 Number of HH member
 Bushy surroundings.
 Level of income
 Garbage heaps.
 Sleeping pattern
 Climate and altitude.
 Number of U5 children
 Place of residence.
 per HH
Type of house.
 Use of ITNs
 Presence of stagnant water

14 Figure 1, conceptual framework o f the study adapted after reading different literatures.
 Study objectives
15

General objective
 To determine the prevalence of malaria and associated factors
among under five children in Mana Sibu woreda, west Wollega
zone, Ethiopia in 2023

Specific objectives
 To identify the prevalence of malaria among under five children
in Mana Sibu woreda west Wollega zone, Ethiopia from January
10, 2023 to February 9, 2023
 Study objectives
16

 To determine factors associated to malaria prevalence

among under five children in Mana Sibu woreda west
Wollega zone, Ethiopia from January 10, 2023 to February
9, 2023
 Method and Participants
17

Study area and period

 Mana Sibu woreda is located 596kms from Finfine
 According to 2007 census, population projection, 150,815
people are living in the woreda.
 The study will be conducted from January 10, 2023 to
February 9,2023

Study design
 A Community based cross sectional study will be conducted.
 Method
18

Source population

All under five children who reside in Mana sibu woreda

Study population
 All Under five children found in randomly selected kebeles to
be selected by lottery method
 …Method
19

Inclusion criteria

Under five children who reside in Mana Sibu woreda during the study

period and will be selected by lottery method

Exclusion criteria
 Children who were not residents of the woreda and whose family or

caregiver will not agree to participate in the study

 …Method
20

Sample size- For first objective



 The sample size was calculated with the assumption of 22.1%

malaria prevalence (for prevalence study) which is taken from

study done in Arbaminchzuria District southern Ethiopia,95%

confidence level, 5%margin of error, and 10% non-response

rate.
 …Method
21

 This brought a total sample size of 291 under five children.

 The sample size for associated factors was calculated by using
relevant factors from previous study and brought 54
 Finally the largest sample size will be used which is 291 for the

study.
Sampling procedure
40 Kebeles of the woreda

By simple random sampling

k1 k2 k3 k4 k5 k6 k7 k8 k9 k10 k11 k12

N40 N45 N32 N34 N27 N38 N36 N31 N42 N33 N28 N54

Proportional allocation by simple random sampling

n25 n29 n21 n24 n16 n30 n24 n19 n28 n21 n17 n37
By simple random
sampling

291
 Study variables

23

Dependent variable
 Malaria prevalence
 Cont’d
24

Independent variables
 Socio-economic and demographic characteristics; age, sex,
educational status, and employment status of the primary
caregiver of the child.
 Attitude and practice toward using malaria prevention and
control methods like using insecticide treated nets, health
seeking behavior and utilization of IRS activities.
 Cont’d
25

 Number of under five children per house hold,

 presence of stagnant water,
 level of income,
 type of house and
 place of residence.
 Cont’d
26

Sampling technique
 Twelve kebeles will be selected from total 40 kebeles of the
woreda using lottery method
 From each selected kebeles one gote will be selected again by
lottery method.
 The study unit; number of under five years’ children will be
then proportionally allocated for the selected gotes.
 Cont’d
27

Data collection method

 Questionnaire of sociodemographic, economic,
environmental , determinant factors, and knowledge and
prevention practices of malaria will be prepared and reviewed
by the investigative team including data collectors.
 All information on questionnaire is standard and adapted from
the national malaria survey of Ethiopia and other published
research on reputable journals.
 Cont’d
28

Data quality management

 The principal investigator and supervisors will be making

supervision on the data collection process.

 The questionnaires will be checked for completeness and

consistency.

 All laboratory materials, reagents and sample transporting

system will be checked by trained laboratory professionals.
 Cont’d
29

 The specimens will be also checked for serial number, quality

and procedures of collection.
 The laboratory professionals involved in light microscopy
examination will be trained on malaria diagnosis and quality
assurance training.
 In addition, to minimize missed parasite identification and
discrepancy each microscopic slide will examined by the two
trained professionals in each five health centers.
 Cont’d
30

 Data Management and Analysis

 Data will be entered into Epi Data version 3.1, cleaned,

edited and then exported to SPSS version 25 for statistical
analysis

 The correlates of malaria will be identified using bivariate and

multi variate logistic regression models.
 Cont’d

31

Variables which had a P-value of <0.2 in the bi variable regression will be also
included in the multivariable logistic regression analysis.

The presence of association will assessed using multivariate analysis with p-value <


0.05 will considered as statistically significant.

Finally, adjusted odds ratios (AOR) with a 95% confidence interval (CI) will be


computed to determine the strength of association of variables.


 Ethical consideration
32

 Ethical clearance will obtained from Wollega university

ethical review committee.

 A formal letter will be submitted to mana Sibu woreda health

office and subsequently to health facilities and kebele

administration of where the study takes place.

 Work plan and budget
33

 The study will be conducted from January 10, 2023

to February 9,2023 and
 It requires a total budget of 76,918.00 Ethiopian Birr.
 Acknowledgement
34

 I am thankful to Wollega University Institute of Health

Science

 Department of Public Health for giving me the opportunity to

go through research undertaking process

 I would like to extend my deepest gratitude and appreciation

to my advisors for their valuable and constructive comments
throughout this research proposal development.
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35

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Thank you !