Abstract
Evolution of incident malaria and frequency of anemia were analyzed over eight years in a rural hospital in southern Ethiopia. Capillary blood samples were tested for hemoglobin concentration, and in some instances for malaria parasites, at Gambo Rural General Hospital between January 2007 and September 2014, and the results recorded. Main demographic data were also recorded in subjects with Plasmodium sp. infections. Of a total of 54,493 blood samples taken from 45,096 different patients, 21,723 (39.9%) samples from 19,173 (42.5%) patients were tested for malaria parasites. Malaria was diagnosed in 825 (3.79%, 95% CI 3.55%, 4.06%) instances (58.3% P. vivax and 41.7% P. falciparum; one episode in 575 patients and two episodes in 125 patients). A sustained decrease in yearly incidence of malaria was observed between 2011 (6.1%) and 2014 (2.4%) (p < 0.01). Of all the malaria patients, those with hemoglobin levels less than 8 g/dL, were younger compared to those with levels of 8 g/dL or more (median age of 5 years vs. 18 years; p < 0.01) and more commonly infected with P. falciparum (57.1% vs. 34.8%; p < 0.001). In multivariate analysis, severe anemia (hemoglobin <8 g/dL) in the context of anemia was associated with P falciparum infection (adjusted odd ratio [OR] 2.48, 95% confidence interval [CI] 1.68, 3.65) and younger age (OR 1.06, 95% CI 1.04, 1.07).