Prevalence of Plasmodium species and factors associated with non-Plasmodium falciparum among malaria cases attending health centers of Bugesera district, Eastern province, Rwanda, September – December, 2018

Abstract

Background: Malaria disease caused by species of the genus plasmodia remains one of the leading causes of mortality and morbidity in Rwanda particularly in East Province localized Bugesera district where the prevalence of malaria in general population was 17% in 2017 according to Rwanda Malaria Indicators Survey (RMIS). The study aimed to determine the prevalence of Plasmodium species and determine the factors associated with non-Plasmodium falciparum among malaria cases. Methods: A cross-sectional study was conducted from September-December 2018 in health centers of Bugesera catchment area. A systematic random sampling was used to select 238 malaria positive cases among confirmed malaria. Socio-demographic, environmental and clinical information of confirmed malaria patients was collected in patients file and laboratory logbook. Data was recorded and entered into computer Microsoft Excel and analyzed using STATA software. The logistic regression was performed to estimate the strength of association between independents variables and non –Plasmodium falciparum. Results: Among 238 patients diagnosed malaria positive, 213(89.5%) was confirmed infected by Plasmodium falciparum, 13(5.5%) Plasmodium malariae and 12(5.0%) Plasmodium ovale. No P.vivax was found. All confirmed malaria received antimalarial coartem and quinine 98.7 and 1.3 % respectively. The multivariate analysis shows two factors associated with non-Plasmodium falciparum among people confirmed malaria. Public servant was 3 times more likely infected by non-Plasmodium falciparum [aOR= 3.39, CI (1.02 - 11.22)]; P. value=0.045. Patients diagnosed malaria positive more than one time within six months were 173 times more likely infected by non-Plasmodium falciparum [aOR= 173.74, CI (16.37-1842.92)]; P. value=0.001. Conclusion: Plasmodium falciparum was found dominant among malaria cases .However, other non-Plasmodium falciparum constituted a substantial proportion of the malaria cases. Most of the non-falciparum malaria cases were in Nzangwa health center catchment area. The main factor associated with non-falciparum malaria was multiple consultations.