Fact Ethiopia

Malaria is a major health problem in Ethiopia and is presently considered to be among the top major indirectly communicable diseases. Apart from being a health hazard, its impact on the socio-economic development of the country is considerable.

The settlement of the majority of the population on the highlands and plateaux can be considered a result of the presence of malaria in the fertile lowlands. This has brought about overcrowding in the highlands and the problems of overtilling.

Soil erosion and deforestation can be partially attributable to the effects and dread of malaria which restricted the free use of land.

There are two seasons of malaria transmission in Ethiopia. They follow the “small” rains of April-May and the “big” rains of June-August.

Transmission normally occurs below 2000 metres elevation. However, due to periodical climatological changes, this limit extends above this altitude, resulting in high morbidity and mortality casuality rates.

The periodic epidemics that the country has experienced in the past have claimed a large toll of life mainly around these fringe areas.

There are 42 Anopheles species recorded in Ethiopia whose distribution is shown in map 1. Among them, A.gambiae is the main vector responsible for the greater portion of malaria transmission with A.funestus, A.pharoensis and A.nili as secondary vectors.

Fur Plasmodium species that infect human beings viz. P.falciparum P.vivax, P.malaria and P.oval, are present.

The former two are dominant and are distributed all over the country whereas the latter two are found in localized areas. P.ovale is extremely rare.

The Malaria Control Programme (MCP), which was established in 1951 E.C. (1959), has brought down the prevalence and intensity of transmission significantly with the application of residual insecticide, supplemented with chemotherapy.

The initial task of the programme was to delineate malarious from non-malarious areas through parasitological and entomological surveys.

Once an area has been identified as malarious, the main activities of the programme include the mapping of the affected localities undertaking parasitological and entomological studies to determine the prevalence of the disease and the relative distribution of the Plasmodial and Anopheles vector species.

Such information will be useful to determine the intensity of transmission and general malariogenic potential of each empidemiological area. This is followed by the application of appropriate control measures which include residual spraying, chemoprophylaxis and chemotherapy.

The scope and the number of times of application of spraying is determined by the intensity of transmission, the prevalence rate and the general malariogenic potential of each empidemiological area.

DDT has been used continuously for the last 25 years in the malaria control operations and to date, the Anopheles vector species are still susceptible to the residual insecticide.

Likewise, chloroquine which is the primary drug of choice has also been utilized for an extended period of time.

The Plasmodium malaria species in Ethiopia are still sensitive to chloroquine in spite of the development of chloroquine-resistant Plasmodium falciparum in the neighbouring countries of Kenya and Sudan and other East African countries.

The opening up of the fertile arable lowland valleys for expanded agriculture, the development and rapid growth of many urban centres and the general population increase are a few of the many contributions attributable to the programme’s activities.

The programme is undertaking its malaria control activities having established a network of infrastructure in various parts of the country (map2), and is thus presently protecting about 12 million people from malaria infection. It has also planned to extend its services to areas in the south and southwestern parts of the country during the coming few years.

(Source: National Atlas of Ethiopia)