Malaria infection rates are rising sharply in Ethiopia, attributed to a combination of armed conflict, climate change, and increasing resistance of mosquitoes to drugs and insecticides. The country, which previously made strides in controlling the disease, is now facing more than 6.1 million recorded malaria cases and 1,038 deaths this year through September, a significant increase from 4.5 million cases and 469 deaths for all of 2023. The peak malaria season, driven by seasonal rains, is expected to exacerbate the situation.
Fitsum Tadesse, the lead scientist overseeing the malaria program at the Armauer Hansen Research Institute in Addis Ababa, noted the rapid backslide in malaria control, likening the current situation to a decade ago. The surge in cases in Ethiopia may indicate similar trends in other regional countries facing comparable biological and environmental challenges.
Dr. Tadesse highlighted that the rise in malaria cases is partly due to growing drug resistance among the parasites and increased resistance of mosquitoes to insecticides used in protective measures. Additionally, mosquitoes have adapted to evade common diagnostic tests.
The Oromia region has reported the largest increase in malaria cases, coinciding with ongoing civil conflict that has displaced over 1.5 million people. This conflict has weakened the health system, disrupted malaria control efforts, and made it difficult for displaced individuals to access care, further increasing their vulnerability to malaria.
Humanitarian organizations have struggled to provide essential resources such as bed nets and medications, which has allowed malaria to spread rapidly through communities. The changing climate has also introduced malaria to new areas, including highland regions that historically did not experience the disease.
Furthermore, the invasive Asian mosquito species Anopheles stephensi has established itself in Ethiopia, posing a new threat as it thrives in urban environments. This species has led to increased malaria cases in cities like Dire Dawa, raising concerns among public health officials.
Seada Ahmed from the Oromia Health Bureau reported that some urban areas in the region recorded their first malaria cases this year. Although the region previously saw a decline in malaria cases, recent numbers have surged, with 1.4 million diagnosed in just the last three months.
While some of the increase in cases may be attributed to improved detection efforts, the severity of infections has also escalated, with over 41,000 hospital admissions in the past three months compared to just 623 in all of 2023. Health workers in affected regions, like Ababaye Tilahun, have noted that this year's malaria situation is unprecedentedly severe.