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

Abstract

Background: Malaria is the major public health problem in low-income countries like Ethiopia. Despite extensive interventional studies being conducted 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 Northwest Ethiopia.

Methods: This study was conducted in two health centers, Kolla Diba and Forhe-Sankira, located in Dembia and North Achefer Districts, from April to June 2024. Data was collected from 460 study participants who presented with signs and symptoms and from parasitologically confirmed patients. Malaria was confirmed using microscopy and rapid diagnostic tests (RDT). The parasitologically confirmed patients were appointed on the 3rd, 7th, 14th, and 28th days to determine treatment outcomes for those who were parasitemic on the preceding visit or symptomatic at each visit. The collected longitudinal data was entered and cleaned by Epi-data 4.1 and then analyzed using SPSS 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 was considered significant.

Results: Of the 460 study participants, 234 (50.9%) were parasitologically confirmed. Treatment outcomes were determined for 224 (95.7%) patients. Ten patients were lost to follow-up. The overall unsuccessful treatment rate was 18.8%. No 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 two times for 3 days plus primaquine for 14 days (AOR = 4.84; 95% CI: 1.83, 12.79) were the identified factors for unsuccessful treatment outcomes.

Conclusions and recommendations: This study revealed that a higher proportion of patients had an unsuccessful treatment outcome. No previous malarial attack, being infected by Plasmodium vivax, and coartem plus primaquine were the identified factors for unsuccessful treatment outcomes. We recommend that healthcare providers prescribe first-line antimalarial therapy and appoint patients for follow-up evaluation according to the national guidelines to identify treatment failure early.