Malaria in Children Under Five Years in the Gushegu District Hospital Before and After Indoor Residual Spraying in Northern Ghana

Abstract

Background: Malaria is a major public health problem in Ghana, causing enormous burden to health and the economy. Malaria is the number one cause of morbidity accounting for 42.5% of outpatient attendance in the country, 48% of outpatient attendance in the northern region and 78.8% of all outpatient attendance in the Gushegu district.The General Objective of the study was to describe trends of malaria in children under five years reporting to the Gushegu district hospital from 2003 to 2013 before and after indoor residual spraying in the Gushegu district of the northern region. Methodology:A retrospective analysis of health facilityrecords pre- and post-communitybased indoor residual spraying interventions inthe Gushegu district was carried out from 2003-2013. The data collected covered the period 2003-2007 when the hospital was a poly clinic and also, the period from 2008 to 2013 when it became a full-fledged hospital.Data was collected on all children under five years for Out-Patient Department and admissions from 2003-2013 to be able to have a denominator to examine trends of malaria among children under five in the district. Results: Out of a total of 35,461 structures available, 31,957 were sprayed during the intervention (2008-2012). There were two rounds of spraying each year, the first round (May- July) and the second round (October-November).Out-Patient Department malaria cases and Out-Patient Department malaria cases diagnosed from 2003-2007 before the introduction of indoor residual spraying and during the intervention from 2008-2012; were observed to have an inconsistent trend. There was a consistent rise in malaria cases from 2003-2005(67.6%, 68.2%, 65.3% respectively) and a sharp decrease was observed in 2006(46.3%). Then an irregular pattern of high malaria cases was observed from 2007- 2010(65.6%, 68.6%, 61.7%, 63.3% respectively) but a decreasing trend in the proportion of malaria cases diagnosed was also observed from 2011-2012(53.7%,49.6% respectively) during the indoor residual spraying intervention. In 2013 however, there was further decline in proportion of malaria cases (43.9%)after the in indoor residual spraying was stopped. Conclusion: There is declining trend in proportion of malaria cases reported in children under five during the 2011-2012 year, when the indoor residual spraying was done in Gushing, demonstrating the indoor residual spraying exercise that took place in the district may have contributed to this decline. Therefore, indoor residual spraying when reintroduced and sustained will help control malaria in the area.