| dc.description.abstract | Malaria is the leading cause of mortality and morbidity in Sub Saharan Africa. Various
intensive control strategies and measures have been put in place to reduce and ultimately
eradicate malaria but it still exists at disproportionately high levels in many regions of
Kenya. The study in Mbale town and its environs was carried out at Mbale Provincial
Rural Training Health Center in Vihiga County, Western Kenya. The study determined
spatio- temporal distribution of Plasmodium species by microscopy, effect of genotype of
P. falciparum kelch 13 on efficacy of artemether-lumefantrine by P. falciparum’s DNA
extraction from dry blood spots using Qiagen method, DNA genotyping by polymerase
chain reaction and Sanger sequencing and influence of socio-economic factors on
malaria prevalence done by structured questionnaire. A total of 768 malaria confirmed
patients were purposively recruited from December 2019 to November 2020 and
stratified according to demographic status and their geographical locations. Data was
analysed using SPSS software version 17. Descriptive and inferential statistics were used
to compare variables in the study population. In all tests p-value ≤ 0.05 was considered
statistically significant. Out of 768 malaria patients recruited, 98.7% recorded P.
falciparum positive, while P. ovale, P. malariae and P. vivax accounted for 1.3%. Edzava
ward recorded all the four Plasmodium species. Lugaga/Wamuluma ward recorded more
malaria patients than Edzava and Central Maragoli wards. Male malaria patients
accounted for 49.3% recording all Plasmodium species while female constituted 51.7%
without Plasmodium ovale. All age groups were diagnosed with P. falciparum while P.
malariae and P. ovale were not identified among 14-18 years old age group. Children
below 5 years old were not diagnosed with P. ovale. Multinomial regression analysis
showed effect of wards, age and gender to malaria prevalence was ([F (3,764) = 1.854],
< 0.136). Wards according to multinomial regression (p = 0.034) and Chi-Squared p
value = 0.036) were statistically significant to malaria prevalence as opposed to gender
and age. Multiple linear regression analysis showed effect of time trend on malaria
prevalence was ([F (3, 8) = 2.976], p < 0.097). Months however had a statistically
significant effect on malaria prevalence (p = 0.036) as opposed to rainfall and
temperature. Correlation between average temperature and months were statistically
significant (p = 0.013). From the results obtained synonymous mutations identified in P.
falciparum kelch 13 among study population did not compromise the efficacy of
Artemether-lumefantrine in the study area. Chi- squared analysis showed influence of
socio-economic factors on malaria prevalence in the study area as follows: - level of
education (p-value = 0.014), wealth (p-value = 0.000), size of land (p-value = 0.035),
house type (p-value = 0.006), salary (p-value = 0.043) and ventilation in the house (p
value = 0.000) were statistically significant to malaria prevalence as opposed to
household size. Space, time trend and socio-economic factors influenced malaria
prevalence in the study area as opposed to P. falciparum kelch 13. Malaria management
bodies should strengthen malaria control strategies in relation to space, time trend,
antimalarial efficacy and socio-economic factors at household level. | en_US |
