Abstract
BackgroundMalaria remains the leading communicable disease in Ethiopia, with around one million clinical cases of malaria reported annually. The country currently has plans for elimination for specific geographic areas of the country. Human movement may lead to the maintenance of reservoirs of infection, complicating attempts to eliminate malaria.MethodsAn unmatched case–control study was conducted with 560 adult patients at a Health Centre in central Ethiopia. Patients who received a malaria test were interviewed regarding their recent travel histories. Bivariate and multivariate analyses were conducted to determine if reported travel outside of the home village within the last month was related to malaria infection status.ResultsAfter adjusting for several known confounding factors, travel away from the home village in the last 30 days was a statistically significant risk factor for infection with Plasmodium falciparum (AOR 1.76; p=0.03) but not for infection with Plasmodium vivax (AOR 1.17; p=0.62). Male sex was strongly associated with any malaria infection (AOR 2.00; p=0.001).ConclusionsGiven the importance of identifying reservoir infections, consideration of human movement patterns should factor into decisions regarding elimination and disease prevention, especially when targeted areas are limited to regions within a country.
Highlights
Malaria remains the leading communicable disease in Ethiopia, with around one million clinical cases of malaria reported annually
Previous research has shown that a history of travelling was a risk factor for Plasmodium falciparum malaria infection in refugee settings, coastal areas, urban areas and river basins [13,14,15,16], reinforcing the importance of investigations into how human movement may be interacting with malaria infection incidence
While travel to a malaria-endemic area in Ethiopia is recognized as a risk factor for malaria infection, much of the country is endemic for malaria transmission and little attention has been paid to whether or not routine human movement patterns can lead to higher risks of malaria infection, even on a small geographic scale within endemic areas
Summary
Malaria remains the leading communicable disease in Ethiopia, with around one million clinical cases of malaria reported annually. Malaria is the leading cause of morbidity in Ethiopia, with more than one million clinical cases of malaria reported annually [1] Control tools such as indoor residual spraying of households with insecticide (IRS) and insecticide-treated mosquito nets (ITNs) are highly effective at reducing exposure to infectious mosquito bites, and the concomitant burden of malaria disease [2,3,4,5]. Past evidence from the study area in Ethiopia shows that there may be meaningful heterogeneity between villages located at small geographic distances from each other [17] This implies that human movement, even at small spatial scales, could act as a risk factor for exposure to malaria infection. Differences in risk of malaria infection within the study area may be driven by heterogeneity in human factors, climate factors, altitude or the vector factors as well as by the built environment including urbanization and irrigation schemes [17,18]
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