Malaria incidence in Zimbabwe, 2021: A secondary data analysis

Introduction: Malaria remains a public health burden in Zimbabwe despite considerable efforts in reducing the incidence. We determined the malaria incidence in elimination districts as well as the proportion of malaria cases that were managed by community health care workers in control districts during the year 2021. Methods: We conducted a mixed methods study comprising of key informant interviews and secondary data analysis on malaria data from DHIS2 and verified electronic databases. A standard questionnaire was used to obtain information from key informants. QGIS software was used to generate maps. Key informant results were reported as text. Results: A total of 63 583 suspected cases were recorded in the 29 elimination districts of which 76.5% were above the age of five. The incidence of malaria among the elimination districts was 9.1 cases per 10 000 population. Incidence was highest (48/10 000 population) in the districts that share borders with high malaria burden districts and lowest among the rest of the districts. The Community Health Workers (CHW) in control districts managed 75 505 malaria cases out of a total of 24 6281 (30.6%) in 2021. Mudzi District had the highest contribution of malaria cases treated by CHW. Conclusion: Malaria incidence is high in the districts that share boarders with high burden areas. The majority of suspected cases of malaria were above the age of five years as compared to the under five-year age group. The proportion of malaria cases managed by community health workers in 2021 was lower than the cases managed at health facilities. We recommend capacitation of CHW with malaria commodities required for testing and treatment.