INCIDENCE OF MALARIAL RECURRENCE AND ITS DETERMINANT AMONG MALARIA PATIENTS IN ANDABIET DISTRICT, NORTHWEST ETHIOPIA: - RETROSPECTIVE FOLLOW-UP STUDY

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