Volume 87, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



We assessed potential effects of local meteorological and environmental conditions, indoor residual spraying with insecticides, insecticide-treated nets (ITNs) use at individual and community levels, and individual factors on malaria incidence in a village in south Ethiopia. A cohort of 8,121 people was followed for 101 weeks with active and passive surveillance. Among 317 microscopically confirmed malaria episodes, 29.3% occurred among temporary residents. The incidence density was 3.6/10,000 person-weeks of observation. We observed higher malaria incidence among males, children 5–14 years of age, ITNs non-users, the poor, and people who lived closer to vector breeding places. Rainfall increased and indoor residual spraying with Deltamethrin reduced falciparum incidence. Although ITNs prevented falciparum malaria for the users, we did not find that free mass ITNs distribution reduced falciparum malaria on a village level.

[open-access] This is an Open Access article distributed under the terms of the American Society of Tropical Medicine and Hygiene's Re-use License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


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  1. World Health Organization, 2011. World Malaria Report. Geneva: World Health Organization. [Google Scholar]
  2. Jima D, Getachew A, Bilak H, Steketee RW, Emerson PM, Graves PM, Gebre T, Reithinger R, Hwang J, the Ethiopia Malaria Indicator Survey Working Group, 2010. Malaria indicator survey 2007, Ethiopia: coverage and use of major malaria prevention and control interventions. Malar J 9: 58.[Crossref] [Google Scholar]
  3. Regional Health Bureau, 2010. Medical Service Annual Report of 2009/10 Fiscal Year. Hawassa: Southern Nations and Nationalities Peoples' Regional Health Bureau, Ethiopia. [Google Scholar]
  4. Regional Health Bureau, 2011. Regional Health Bureau Plan and Achievement Annual Report of 2010/11 Fiscal Year. Hawassa: Southern Nations and Nationalities Peoples' Regional Health Bureau, Ethiopia. [Google Scholar]
  5. World Health Organization, 2010. World Malaria Report. Geneva: World Health Organization. [Google Scholar]
  6. Teklehaimanot H, Lipsitch M, Teklehaimanot A, Schwartz J, , 2004. Weather-based prediction of Plasmodium falciparum malaria in epidemic-prone regions of Ethiopia I. Patterns of lagged weather effects reflect biological mechanisms. Malar J 3: 41.[Crossref] [Google Scholar]
  7. Abeku TA, De Vlas SJ, Borsboom G, Tadege A, Gebreyesus Y, Gebreyohannes H, Alamirew D, Seifu A, Nagelkerke NJ, Habbema JD, , 2004. Effects of meteorological factors on epidemic malaria in Ethiopia: a statistical modeling approach based on theoretical reasoning. Parasitology 128: 585593.[Crossref] [Google Scholar]
  8. Martens P, Hall L, , 2000. Malaria on the move: human population movement and malaria transmission. Emerg Infect Dis 6: 103109.[Crossref] [Google Scholar]
  9. Stoddard ST, Morrison AC, Vazquez-Prokopec GM, Paz Soldan V, Kochel TJ, Kitron U, Elder JP, Scott TW, , 2009. The role of human movement in the transmission of vector-borne pathogens. PLoS Negl Trop Dis 3: e481.[Crossref] [Google Scholar]
  10. DeBeaudrap P, Nabasumba C, Grandesso F, Turyakira E, Schramm B, Boum Y, 2nd Etard J-F, , 2011. Heterogeneous decrease in malaria prevalence in children over a six-year period in south-western Uganda. Malar J 10: 132.[Crossref] [Google Scholar]
  11. Gahutu J-B, Steininger C, Shyirambere C, Zeile I, Cwinya-Ay N, Danquah I, Larsen CH, Eggelte TA, Uwimana A, Karema C, Musemakweri A, Harms G, Mockenhaupt FP, , 2011. Prevalence and risk factors of malaria among children in southern highland Rwanda. Malar J 10: 134.[Crossref] [Google Scholar]
  12. Krefis AC, Schwarz NG, Nkrumah B, Acquah S, Loag W, Sarpong N, Adu-Sarkodie Y, Ranft U, May J, , 2010. Principal component analysis of socioeconomic factors and their association with malaria in children from the Ashanti Region, Ghana. Malar J 9: 201.[Crossref] [Google Scholar]
  13. Winskill P, Rowland M, Mtove G, Malima RC, Kirby MJ, , 2011. Malaria risk factors in north-east Tanzania. Malar J 10: 98.[Crossref] [Google Scholar]
  14. Bates I, Fenton C, Gruber J, Lalloo D, Lara AM, Bertel Squire S, Theobald S, Thomson R, Tolhurst R, , 2004. Vulnerability to malaria, tuberculosis, and HIV/AIDS infection and disease. Part 1: determinants operating at individual and household level. Lancet Infect Dis 4: 267277.[Crossref] [Google Scholar]
  15. Sachs J, Malaney P, Sachs J, Malaney P, , 2002. The economic and social burden of malaria. Nature 415: 680685.[Crossref] [Google Scholar]
  16. Otten M, Aregawi M, Were W, Karema C, Medin A, Bekele W, Jima D, Gausi K, Komatsu R, Korenromp E, Low-Beer D, Grabowsky M, , 2009. Initial evidence of reduction of malaria cases and deaths in Rwanda and Ethiopia due to rapid scale-up of malaria prevention and treatment. Malar J 8: 14.[Crossref] [Google Scholar]
  17. Graves PM, Osgood DE, Thomson MC, Sereke K, Araia A, Zerom M, Ceccato P, Bell M, Del Corral J, Ghebreselassie S, Brantly EP, Ghebremeskel T, , 2008. Effectiveness of malaria control during changing climate conditions in Eritrea, 1998–2003. Trop Med Int Health 13: 218228.[Crossref] [Google Scholar]
  18. Lengeler C, Lengeler C, , 2004. Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev 2: CD000363. [Google Scholar]
  19. Killeen GF, Smith TA, Ferguson HM, Mshinda H, Abdulla S, Lengeler C, Kachur SP, , 2007. Preventing childhood malaria in Africa by protecting adults from mosquitoes with insecticide-treated nets. PLoS Med 4: e299.[Crossref] [Google Scholar]
  20. Okumu FO, Moore SJ, Okumu FO, Moore SJ, , 2011. Combining indoor residual spraying and insecticide-treated nets for malaria control in Africa: a review of possible outcomes and an outline of suggestions for the future. Malar J 10: 208.[Crossref] [Google Scholar]
  21. Yakob L, Dunning R, Yan G, Yakob L, Dunning R, Yan G, , 2011. Indoor residual spray and insecticide-treated bednets for malaria control: theoretical synergism and antagonisms. J R Soc Interface 8: 799806.[Crossref] [Google Scholar]
  22. Yewhalaw D, Wassie F, Steurbaut W, Spanoghe P, Bortel WV, Denis L, Tessema DA, Getachew Y, Coosemans M, Duchateau L, Speybroeck N, , 2011. Multiple insecticide resistance: an impediment to insecticide-based malaria vector control program. PLoS ONE 6: e16066.[Crossref] [Google Scholar]
  23. Zhou G, Afrane YA, Vardo-Zalik AM, Atieli H, Zhong D, Wamae P, Himeidan YE, Minakawa N, Githeko AK, Yan G, , 2011. Changing patterns of malaria epidemiology between 2002 and 2010 in Western Kenya: the fall and rise of malaria. PLoS ONE 6: e20318.[Crossref] [Google Scholar]
  24. Keating J, Locatelli A, Gebremichael A, Ghebremeskel T, Mufunda J, Mihreteab S, Berhane D, Carneiro P, , 2011. Evaluating indoor residual spray for reducing malaria infection prevalence in Eritrea: Results from a community randomized control trial. Acta Trop 119: 107113.[Crossref] [Google Scholar]
  25. Pulford J, Hetzel MW, Bryant M, Siba PM, Mueller I, , 2011. Reported reasons for not using a mosquito net when one is available: a review of the published literature. Malar J 10: 83.[Crossref] [Google Scholar]
  26. Trape J-F, Tall A, Diagne N, Ndiath O, Ly AB, Faye J, Dieye-Ba F, Roucher C, Bouganali C, Badiane A, Sarr FD, Mazenot C, Touré-Baldé A, Raoult D, Druilhe P, Mercereau-Puijalon O, Rogier C, Sokhna C, , 2011. Malaria morbidity and pyrethroid resistance after the introduction of insecticide-treated bednets and artemisinin-based combination therapies: a longitudinal study. Lancet Infect Dis 11: 925932.[Crossref] [Google Scholar]
  27. World Health Organization, 1991. Basic Malaria Microscopy. Geneva: World Health Organization. [Google Scholar]
  28. World Health Organization, 2009. WHO Recommended Insecticides for Indoor Residual Spraying against Malaria Vectors. Geneva: World Health Organization. [Google Scholar]
  29. Loha E, Lindtjørn B, , 2010. Model variations in predicting incidence of Plasmodium falciparum malaria using 1998–2007 morbidity and meteorological data from south Ethiopia. Malar J 9: 166.[Crossref] [Google Scholar]
  30. Vyas S, Kumaranayake L, , 2006. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan 21: 459468.[Crossref] [Google Scholar]
  31. Howe LD, Hargreaves JR, Huttly SR, , 2008. Issues in the construction of wealth indices for the measurement of socio-economic position in low-income countries. Emerg Themes Epidemiol 5: 3.[Crossref] [Google Scholar]
  32. Ministry of Health of Federal Democratic Republic of Ethiopia, 2004. Malaria Diagnosis and Treatment Guidelines for Health Workers in Ethiopia. Second edition. Addis Ababa: Ministry of Health. [Google Scholar]
  33. Dunn CE, Mare AL, Makungu C, , 2011. Malaria risk behaviors, socio-cultural practices and rural livelihoods in southern Tanzania: implications for bednet usage. Soc Sci Med 72: 408417.[Crossref] [Google Scholar]
  34. Killeen GF, Smith TA, , 2007. Exploring the contributions of bed nets, cattle, insecticides and excito-repellency to malaria control: a deterministic model of mosquito host-seeking behavior and mortality. Trans R Soc Trop Med Hyg 101: 867880.[Crossref] [Google Scholar]
  35. Gu W, Novak RJ, , 2009. Predicting the impact of insecticide-treated bed nets on malaria transmission: the devil is in the detail. Malar J 8: 256.[Crossref] [Google Scholar]
  36. World Health Organization, 2011. WHO Recommended Long-Lasting Insecticidal Mosquito Nets. Geneva: World Health Organization. [Google Scholar]
  37. Abdalla SI, Malik EM, Ali KM, , 2007. The burden of malaria in Sudan: incidence, mortality and disability– adjusted life – years. Malar J 6: 97.[Crossref] [Google Scholar]
  38. O'Meara WP, Mwangi TW, Williams TN, McKenzie FE, Snow RW, Marsh K, , 2008. Relationship between exposure, clinical malaria, and age in an area of changing transmission intensity. Am J Trop Med Hyg 79: 185191. [Google Scholar]
  39. Smith T, Hii JL, Genton B, Muller I, Booth M, Gibson N, Narara A, Alpers MP, , 2001. Associations of peak shifts in age-prevalence for human malarias with bednet coverage. Trans R Soc Trop Med Hyg 95: 16.[Crossref] [Google Scholar]

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Supplementary PDF

  • Received : 08 Mar 2012
  • Accepted : 12 May 2012
  • Published online : 05 Sep 2012

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