Malaria in Ethiopia.

Between 1 January and 20 October 2024 more than 7.4 million cases of Malaria were reported in Ethiopia, with 1157 deaths recorded, a case fatality rate of 0.02%, according to a press release issued by the World Health Organization on 31 October 2024. On these infections, 95% were causes by Plasmodium falciparum. This is the highest number of cases reported in Ethiopia in seven years, and part of an ongoing rising trend of Plasmodium falciparum infections; in 2023, 4.21 million Malaria infections, with 527 deaths, with 70% caused by Plasmodium falciparum.

The overwhelming majority of cases occurred in the west of the country, with four regions accounting for 81% of all recorded infections and 89% of known deaths, with 44% of cases and 667 deaths in Oromo, 18% of cases and 56 deaths in Amhara, 12% of cases and 250 deaths in Southwest Ethiopia, and 7% of cases and 45 deaths in South Ethiopia. 

Geographical distribution of Malaria cases as of 20 October 2024. World Health Organization.

Of Ethiopia's 523 worodas (districts), 222 have been identified as having a high Malaria burden, together accounting for 75% of recorded Malaria cases in 2023. Fifty of these high-burden worodas are considered to be hard-to-access due to ongoing conflicts.

A slight majority of cases are males, who accounted for 56% of cases treated as outpatients and 52% of inpatient admissions. Children accounted for 16% of outpatients and 25% of inpatient admissions. This age and sex distribution is thought to be due to patterns of seasonal migration, with large numbers of adult male migrant workers seeking work in high-risk areas during the peak of the Malaria season. 

From 2000-onwards, Ethiopia had a steady reduction in the number of Malaria cases each year, driven by improved surveillance, roll-out of malaria interventions, and community health extension program. The number of cases fell to an all-time low in 2019, when only 900 000 cases were recorded, and there was no wide-ranging major epidemic, only sporadic local outbreaks. However, the country began to suffer a resurgence of the disease from 2021 onwards, with 1.3 million cases in 2021, 3.3 million cases in 2022, and 4.1 million cases in 2023. This return appears to have been driven by the Plasmodium falciparum strain of the disease, which caused 70% of the infections in 2023, and which appears to have become endemic in areas where it was not previously known.

Weekly trend of malaria cases in Ethiopia, 01 January 2021 to 13 October 2024. World Health Organization.

Malaria is caused by parasitic unicellular Eukaryotes of the genus Plasmodium, and affects a wide range of terrestrial Vertebrates. Five different species of Plasmodium can cause Malaria in Humans, with most infections caused by either Plasmodium falciparum or Plasmodium vivax, both of which are endemic to Ethiopia. The parasites are primarily spread via the bite of the female Anopheles Mosquitoes (males do not bite), but can also be spread through blood transfusions, organ transplants, or practices such as needle-sharing.

Photomicrograph of a blood smear containing a macro- and microgametocyte of the Plasmodium falciparum parasite. Both macro- and microgametocytes are products of the erythrocytic life cycle. Within a few minutes after the Anopheles sp. vector ingests the gametocytes, microgametocytes develop into microgametes, which are able to fertilize gametes. Centers for Disease Control and Prevention/Wikipedia Commons.

Malaria manifests with approximately 10-15 days after infection, as a fever, headache, and chills. Mild cases often pass soon, and can be difficult to identify as Malaria, however, more severe cases can be fatal in as little as 24 hours after the onset of symptoms. 

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Landslide kills three in the Amhara Region of Ethiopia.

Three people have died following a landslide at Jan Amora area of the Amhara Region of Ethiopia on Monday 16 September 2019. The three dead are reported to all be members of the same family, with the youngest being an eighteen-month-old toddler. This is the latest in a series of fatal landslides in the Amhara Region over the past two months, linked to the exceptionally heavy rains falling across northern Ethiopia. Landslides are a common problem after severe weather events, as excess pore water pressure can overcome cohesion in soil and sediments, allowing them to flow like liquids. Approximately 90% of all landslides are caused by heavy rainfall.

 

The approximate location of the 16 September 2019 Jan Amora landslide. Google Maps.

The landslides have been caused exceptional rainfall in the mountains of Ethiopia this year, which has in turn been caused by high temperatures over the Gulf of Oman, leading to higher levels of evaporation there. High levels of evaporation in the Gulf of Oman leads to more rainfall in Ethiopia, and higher waters on the River Nile, and recent years have seen a series of exceptionally hot summers in the region, with consequent increases in flooding and water born disease along the course of the Nile.

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