Evidence map›Paper›PMID 41286876›Full record

ArticleMalaria journal2025

Resurgence of malaria in the Amhara Region, Ethiopia (2014-2024): trends, spatial expansion, and control challenges.

Mastewal Worku Lake, Mulusew Andualem Asemahagn, Teshager Zerihun Nigussie, Kassahun Alemu Gelaye, Kindie Fentahun Muchie, Hailemariam Awoke Engedaw, Muluken Azage Yenesew

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Article in Malaria journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

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9citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Mastewal Worku LakeAmhara Public Health Institute, Bahir Dar, Ethiopia. matewal.worku@gmail.com.
Mulusew Andualem AsemahagnDepartment of Health System and Health Economics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Teshager Zerihun NigussieDepartment of Statistics, College of Natural and Computational Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Kassahun Alemu GelayeDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Kindie Fentahun MuchieDepartment of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Hailemariam Awoke EngedawDepartment of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Muluken Azage YenesewDepartment of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite substantial control gains over the past 2 decades, malaria remains a major public health threat in Ethiopia. The Amhara Region has recently experienced a significant resurgence, threatening to reverse previous progress. However, comprehensive analyses of this resurgence integrating long-term trends, parasite species dynamics, and spatiotemporal patterns are limited. Therefore, this study examines trends, spatial expansion, and control challenges associated with malaria resurgence in the Amhara Region.

methodsA retrospective analysis of 11 years (January 2014-December 2024) of weekly malaria surveillance data from 166 districts in the Amhara Region, Ethiopia. Joinpoint regression was employed to detect significant temporal trend changes. A resurgence threshold was defined a priori as a ≥ 20% increase in cases compared to the 3-year average baseline for the same period (Sep-Dec 2021-2023), based on an expert consensus survey. Auto-regressive integrated moving average modelling was used to characterize and forecast the test positivity rate (TPR). The Getis-Ord Gi* statistic was used to identify spatial clustering and detect transmission hotspots.

resultsDuring the study period, 7,710,733 malaria cases and 162 deaths were reported. Adults (≥ 15 years) contributed 62% of cases. A single trend inflection point occurred in late 2018, marking a shift from a significant decline (Annual Percent Change [APC]: -13.2%) to a sharp resurgence (APC: + 12.6%, 2018-2024). The Annual Parasite Incidence (API) rose from 10.9 (95% CI 10.8-11.0) per 1000 in 2018 to 74.8 (95% CI 74.72-74.93) per 1000 in 2024. Plasmodium vivax became increasingly prominent, with its contribution to the total case burden rising from 25 to 43% (χ

conclusionThe Amhara Region is experiencing a malaria resurgence characterized by intensified transmission, geographic expansion into urban and highland areas, and a significant shift toward Plasmodium vivax dominance. These findings exemplify an "elimination-resurgence paradox," where prior success increases vulnerability to threats such as invasive vectors, conflict, and climate shifts.

Indexed as

MalariaMalaria, FalciparumMalaria, VivaxAdolescentAdultChildChild, PreschoolEthiopiaFemaleHumansIncidenceInfantMaleMiddle AgedPlasmodium vivaxRetrospective StudiesEliminationEpidemiological transitionEthiopiaMalaria resurgencePlasmodium vivaxSpatial epidemiologyTransmission hotspots

Identifiers

PMID41286876
PMCPMC12645681

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.