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Incidence of Plasmodium infections and determinant factors among febrile children in a district of Northwest Ethiopia; a cross-sectional study.

Background: According to the Ethiopian national malaria indicator survey of 2015, the highest burden of Plasmodia infection resided among the school-age children. Even though several studies revealed various determinant factors of childhood malaria, consistent findings are not reported across the nation and elsewhere. This in turn creates obstacles in implementing exactprevention and control measures in the study area in particular and the country at large.

Objectives: The aim of this study is to determine the incidence of Plasmodium and determinant factors among febrile children in Northwest Ethiopia.

Methods: This cross-sectional study was conducted from April-August 2016. Blood samples were collected from febrile children selected by systematic random sampling. Thin and thick blood films were prepared and stained with Giemsa. Statistical analysis was done via SPSS version 20 statistical software and data were summarized with percentages and frequencies. The bi-variate and multi-variate logistic regressions were used to measure strength of association between Plasmodium infection and determinant factors, and to rule out confounders, respectively.

Result: Among a total of 333 febrile children, 146 (43.8%) were positive for the Plasmodia. The prevalence of plasmodium infection was 47%, 50%, and 40%, among the age groups of 6-8, 9-10 and 11-14 years, respectively. Prevalence of plasmodium among male and female children was 44.2% and 43.5%, respectively. Shorter distance from stagnant water (AOR (adjusted odds ratio) =43, 95% CI (confidence interval):2.8-680.7; P  < 0.01), family size (AOR =14.7, 95% CI:(1.4-151.2; P  = 0.02), outdoor sleeping (AOR =36.6, 95% CI:2.4-554.2; P  < 0.01, irregular bed net use (AOR =21.1, 95% CI:2.9-154.7; P  < 0.01), and late bed time (AOR =31.9, 95% CI:2.8-371.3; P  < 0.01) showed statistically significant association with plasmodium infection.

Conclusion: The incidence of Plasmodium infection is high among febrile children in the study area. Shorter distance from stagnant water, larger family size, outdoor sleeping, irregular bed net use, and late night sleeping are the major determinant factors for the high incidence of malaria. Therefore, community mobilization and health education should focus on the specific determinant factors of plasmodium infection to alleviate incidence of malaria among the school children.

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