Abstract
BackgroundThe impact of importation of falciparum malaria from mainland Equatorial Guinea on malaria infection in non-travellers and travellers on Bioko Island was examined.MethodsMalaria indicator surveys were conducted in 2013 and 2014 to assess the association between malaria infection and travel to the mainland. Infection in non-travellers was compared in neighbourhoods of high travel and neighbourhoods of low travel. Boat passengers leaving from and arriving on the island were tested for infection.ResultsChildren who had travelled to the mainland in the previous eight weeks were at greater risk of infection than those who had not travelled (56 vs 26% in 2013; 42 vs 18% in 2014). Children who had not travelled, living in localities with the highest proportion of travellers, were significantly more likely to be infected compared to those in localities with the smallest proportion of travellers (adjusted odds ratios 7.7 (95% CI 2.3-25) and 5.3 (95% CI 2.5-11) in 2013 and 2014, respectively). Infection in arriving boat passengers was substantially higher than in those departing (70 vs 38%, p = 0.017).DiscussionMalaria importation by travellers poses a serious public health challenge affecting non-travellers as well as travellers.
Highlights
The impact of importation of falciparum malaria from mainland Equatorial Guinea on malaria infection in non-travellers and travellers on Bioko Island was examined
Effect on non-travellers living in neighbourhoods with a high proportion of travellers In both the two to year and the and over age groups, infection with malaria in non-travellers was significantly associated with the proportion of people in their community who travelled to the mainland (Table 3 and Figure 2)
Children who had not travelled in the previous eight weeks living in localities with the highest proportion of travellers were more likely to be infected with malaria parasites compared to those in localities with the smallest proportion of travellers (38 vs 10%, adjusted OR 7.7 in 2013; 19 vs 5%, adjusted OR 5.3 in 2014)
Summary
The impact of importation of falciparum malaria from mainland Equatorial Guinea on malaria infection in non-travellers and travellers on Bioko Island was examined. This study, examined whether the importation of Plasmodium falciparum malaria parasites by travellers from the mainland part of Equatorial Guinea (EG) to Bioko, the main island of EG, contributed to the malaria burden in Bioko, in travellers and non-travellers. Bioko is located 32 km off the coast of Cameroon (Figure 1) with a population of approximately 250,000 Both the island and mainland EG have year-round malaria transmission. This study is based on data from annual household malaria indicator surveys (MIS) in 2013 and 2014 and surveys of travellers on boats. Both the vulnerability (i.e., the rate of importation of infected individuals) and the receptivity (i.e., the potential for these travellers to transmit malaria to others) of Bioko to imported malaria infection are assessed in this study [13]
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