Title : Treatment outcomes of patients with uncomplicated malaria and associated factors in Northwest Ethiopia: A prospective follow-up study, 2024

Abstract:

Background:
Malaria is a devastating infectious disease caused by Plasmodium species. It is the major public health problem in low-income countries like Ethiopia. Despite extensive interventions to attain the 2030 malaria elimination goals, there is limited data on the treatment outcomes of uncomplicated malaria in Ethiopia. Thus, this study aimed to assess the treatment outcomes and associated factors of uncomplicated malaria in the Northwest Ethiopia, 2024.

Methods:
This facility-based prospective follow-up study was conducted in two (Dembia and north Achefer) districts of the Amhara region from April to June 2024. A total of 460 samples were purposively selected by physicians based on signs and symptoms. Then, malaria confirmatory tests (microscopy and RDT) were done and 234 patients were positive for malaria at day 0. These patients were appointed for 3^rd, 7^th, 14^th, and 28^th days of follow up to rechecking of malaria via blood film for those who remain parasitemic or symptomatic at each visit. The collected longitudinal data was entered and cleaned by Epi-data version 4.1 and then analyzed by SPSS version 25 software. Descriptive statistics were computed. A binary logistic regression model was fitted to identify factors associated with unsuccessful treatment outcomes at a 95%CI and a p-value ? 0.05.

Results:
In this study 234 patients were participated. During the follow up ten patients were lost to follow up. The overall unsuccessful treatment rate was 18.8%. Previous malaria attack (AOR=18.62, 95%CI: 5.15, 67.25), being infected by plasmodium vivax (AOR = 8.58; 95%CI: 2.85, 25.83), and coartem plus primaquine (14 days) taken (AOR=4.84; 95%CI: 1.83, 12.79) were the identified factors for unsuccessful treatment outcomes. 

Conclusions:
This study revealed higher proportion of patients had unsuccessful treatment outcome. Previous malarial attack, being infected by plasmodium vivax, and anti-malaria agent taken were the identified factors for unsuccessful treatment outcomes. Rigorous appointment for follow up and prescribing the first line antimalarial therapy is mandatory to avert the unsuccessful treatment outcome.

Keywords:
Treatment outcome, factors, uncomplicated malaria, cure, failure, lost to follow up, Ethiopia