Magnitude of malaria admissions and deaths at hospitals and health centers in Oromia, Ethiopia.

Health facility records are important sources of malaria data, not only to describe the disease patterns and trends, but also useful for planning malaria control and evaluating the impact of health interventions. The aim of this study was to assess the burden of malaria admissions and deaths on the services of hospitals and health centers in Oromia, over a period of five years, 1995-2000. A retrospective record review of data routinely collected on malaria admissions and deaths was conducted at all hospitals and health centers located in Oromia during March-May 2001. The total number of admissions and deaths from all causes registered at hospitals and health centers for the overall 1995-2000 period were 302,035 and 16,061. respectively. Malaria accounted for 11.20% of all admissions and 14.26% of all deaths. From 33,808 malaria inpatients, 2,291 (6.78%) died during the period Two thousand and one hundred thirty (92.97%) deaths occurred in hospitals and 161 (7.03%) deaths in health centers. A total of 78,062 (25.85%) admissions among children < 15 years occurred, of whom 12,273 (15.72%) had malaria. The overall percentage of malaria specific admissions during the period was higher for children in the age group of 1-4 (16.59%) and 5-14 years old (20.40%), compared to 7.93% for infants < 1 year and 9:62% for adults greater than 15 years old. Malaria specific admission ratios ranged from 2.95% in Jimma hospital to 47.12% at Merti hospital. Similarly, the proportionate malaria mortality ranged from 7.60% in Jimma hospital to 44.20% in Merti hospital. The majority of malaria admissions and deaths were due to Plasmodium falciparum. This retrospective analysis of records of hospitals and health centers reveals the heavy burden of malaria. Although cost-effective interventions for malaria are available, the burden of the disease is still unacceptably high. In this context, improving the quality of services at health care facilities for accurate diagnosis and effective antimalarial treatment, and increasing the accessibility of health services are crucial steps to reduce the burden of the disease. In addition, improving the quality of surveillance systems to pick up malaria cases and deaths at health care facilities enables decision makers to evaluate the impact of current interventions against the disease.