Community-based malaria control programme in Tigray Region, Northern Ethiopia: Results of a mortality survey of rural under-five children

Abstract

Abstract: A mortality survey of children under five years of age was undertaken in Tigray Region, in rural areas covered by a community-based malaria control programme. A multistage cluster sampling technique was used to define the sample. Trained Malaria Control Programme personnel conducted interviews in 4660 households. Total under-five population sampled was 7335, in which 190 deaths were reported in one year. Median duration of illness before death was 14 days, mean age at death 1.5 years, and 53% of those who died were male. Forty five percent died without being taken to a Community Health Worker (CHW) or to a health facility before death, and 92% of the deaths occurred at home. Overall, 12% of deaths were reported by families due to fever or malaria. Death rate (age 0-4) was 25.9%. Estimated age specific mortality rate (age 0-4) was 26.3%, underfive mortality rate (U5MR) was 163%, and malaria-specific mortality rate based on lay reporting was 3.3%. Two districts were found to have very high mortality with estimated U5MRs of 372% and 290%. Based on these findings, increased efforts are being made in the Community-Based Malaria Control Programme to educate families about the importance of early diagnosis and treatment and the use of CHW services for ill children. Areas for investigating the determinants of the marked district mortality differentials are discussed. [Ethiop. J. Health Dev. 1998;12(3):203-211]