title: Magnitude of Malaria and Factors among Febrile Cases in Low Transmission Areas of Hadiya Zone, Ethiopia: A Facility Based Cross Sectional Study.
abstract: Despite a remarkable decline in morbidity and mortality since the era of malaria roll back strategy, it still poses a huge challenge in Ethiopia in general and in Hadiya Zone in particular. Although, there are data from routine health management information on few indicators, there is scarcity of data showing magnitude of malaria and associated factors including knowledge and practice in the study area. Therefore, the aim of this study was to assess magnitude and factors affecting malaria in low transmission areas among febrile cases attending public health facilities in Hadiya Zone, Ethiopia.
  
  
  
  A facility based cross-sectional study was conducted in Hadiya Zone from May 15 to June 15, 2014. Simple random sampling was used to select the health facility while systematic random sampling technique was used to reach febrile patients attending public health facilities. Data were collected by a pre-tested structured questionnaire containing sections of socio demographic risk factors and knowledge and prevention practices of malaria. Data were entered to Epi-Info software version 3.5.4 and exported to SPSS version 16 for descriptive and logistic regression analysis.
  
  
  
  One hundred six (25.8%) of participating febrile patients attending at sampled health facilities were found to have malaria by microscopy. Of which, P.vivax, P.falciparum and mixed infection accounted for 76(71. 7%), 27 (25.5%) and 3 (2.8%), respectively. History of travel to malaria endemic area, [AOR: 2.59, 95% CI: (1.24, 5.38)], not using bed net, [AOR: 4.67, 95%CI:, (2.11, 10.37)], poor practice related to malaria prevention and control, [AOR: 2.28, (95%CI: (1.10, 4.74)], poor knowledge about malaria, [AOR: 5.09,95%CI: (2.26,11.50)] and estimated distance of stagnant water near to the residence, [AOR: 3.32, (95%CI: (1.13, 9.76)] were significantly associated factors of malaria positivity in the study.
  
  
  
  The present study revealed that malaria is still a major source of morbidity in the study area among febrile illnesses. Poor level of knowledge, poor prevention practices, not using bed net, travel history to endemic areas and residing near stagnant water were associated factors with malaria positivity in the study area. Therefore, implementers, policy makers and stakeholders should strengthen the services provided by the community health development army, health extension service and health facilities services focusing on increasing malaria intervention coverage and mobilization of information, education and communication to increase knowledge about malaria transmission, prevention and control practices.
authors.affiliation: Department of Clinical Nursing, Hossana College of Health Sciences, Hossana, Ethiopia.
authors.forename: Romedan Kedir
authors.initials: RK
authors.lastname: Delil
authors.affiliation: Department of Health Informatics, Hossana College of Health Sciences, Hossana, Ethiopia.
authors.forename: Temesgen Kale
authors.initials: TK
authors.lastname: Dileba
authors.affiliation: Department of Health Informatics, Hossana College of Health Sciences, Hossana, Ethiopia.
authors.forename: Yitagesu Aweke
authors.identifier: 0000-0003-3201-8101
authors.initials: YA
authors.lastname: Habtu
authors.affiliation: Department of Medical Laboratory Sciences, Hossana College of Health Sciences, Hossana, Ethiopia.|Department of Health Informatics, Hossana College of Health Sciences, Hossana, Ethiopia.
authors.forename: Terefe Fuge
authors.initials: TF
authors.lastname: Gone
authors.affiliation: Department of Public Health, Hossana College of Health Sciences, Hossana, Ethiopia.|Department of Health Informatics, Hossana College of Health Sciences, Hossana, Ethiopia.
authors.forename: Taye Janfa
authors.initials: TJ
authors.lastname: Leta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005334:Fever / Q000150:complications*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008288:Malaria / Q000150:complications* / Q000453:epidemiology / Q000635:transmission*; D008297:Male; D008875:Middle Aged; D055815:Young Adult