Assessment Of The Persistence Of Malaria To Control Measures In Dembia District Northwestern Ethiopia A Retrospective And Longitudinal Prospective Study

Despite more than six decades of continued control effort, malaria remains a major public health problem in Dembia District. In order to determine the causes for the persistence of malaria to the control measures, retrospective and longitudinal prospective studies were conducted in the District. A retrospective data on monthly malaria incidence, malaria control interventions and meteorological variables were collected for the period 2001 to 2015. For the prospective parasitological surveys, all consenting family members selected randomly from four rural Kebeles were examined for the presence of malaria parasites following standard parasitological procedures. Knowledge, attitude and practice survey was conducted in parallel with parasitological surveys. Adult and larval mosquito surveys were undertaken in four selected Kebeles following standard entomological methods. Adult mosquitoes were collected indoors and outdoors and identified into species morphologically based on keys; their host preference and sporozoite infection rates were determined by enzyme linked immuno sorbent assay. The identification of Anopheles arabiensis was confirmed by polymerase chain reactions. In spite of increased indoor residual spraying coverge, retrospective data showed high malaria incidence in most years, except a sharp decline in 2006, 2007, 2008 and 2014. The incidence of monthly total malaria due to Plasmodium falciparum significantly (P

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