Abstract:
Background; The burden of malaria in endemic areas is highly attributed to its recurrent
infection. In Ethiopia, the incidence of malarial recurrence and its determinants were unknown.
So, this study determines the incidence of malarial recurrence and its determinants among
patients with malaria in the Andabiet district of northwest Ethiopia.
Objective; To assess the incidence of malarial recurrence and its determinants among patients
with malaria in Andabiet district Northwest Ethiopia, 2024.
Methods; An institution-based retrospective follow-up study was employed among 649 patients
with malaria from July 1, 2022, to June 30, 2023, who were selected by using multistage
sampling. Data were collected using structured and pretested questionnaires. Kaplan–Meier and
Log-Rank test was used to compare survival differences among categories. In bi-variable
analysis p-values < 0.25 were entered into a multivariable analysis. The multivariable Weibull
regression model was used to measure the risk of recurrence and identify predictors of
recurrence. Significancy was declared at p-value <0.05.
Result: The incidence rate of recurrence was 1.79 (95% CI, 1.51-2.12) per 1000-person day of
observations. The median survival time of malaria patients without recurrence was 239 days with
an interquartile range of (170 -334). Being males (AHR=1.75; 95% CI= 1.04-2.95), family size
of ≥ 5 (AHR= 1.76; 95%CI 1.10-2.79), early diagnosis and treatment (AHR= 0.48; 95% CI 0.32-
0.71), with no primaquine treatment (AHR=3.91; 95%CI= 2.66- 5.76), good medication
adherence (AHR= 0.52; 95% CI= 0.34-0.80) and slept under ITN (AHR= 0.55; 95% CI 0.37-
0.82) were significantly associated with incidence of recurrence.
Conclusion & recommendation: The incidence of recurrent malarial attacks was high and more
than half of the recurrences were attributed to re-infection. Promoting early detection and
treatment, adherence to treatment and other vector control activities such as proper bed net
utilization could play an important role in reducing malarial recurrence and then facilitating
malaria elimination in the district
