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Plasmodium vivax and Plasmodium falciparum infections in the Republic of Djibouti: evaluation of their prevalence and potential determinants

Bouh Abdi Khaireh12345, Sébastien Briolant12, Aurélie Pascual12, Madjid Mokrane12, Vanessa Machault67, Christelle Travaillé1, Mohamed Abdi Khaireh12, Ismail Hassan Farah3, Habib Moussa Ali3, Abdul-Ilah Ahmed Abdi3, Souleiman Nour Ayeh4, Houssein Youssouf Darar48, Lénaïck Ollivier9, Mohamed Killeh Waiss10, Hervé Bogreau12, Christophe Rogier1112 and Bruno Pradines12*

Author Affiliations

1 Unité de Parasitologie, Département d’Infectiologie de Terrain, Institut de Recherche Biomédicale des Armées, Marseille, France

2 Aix Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM 63, CNRS 7278, IRD 198, Inserm 1095, Marseille, France

3 Service de Santé des Forces Armées Djiboutiennes, Djibouti, République de Djibouti

4 Service des Maladies Infectieuses et Tropicales, Hôpital Général Peltier, Djibouti, République de Djibouti

5 Institut de Recherche Médicinale, Centre d’Etude et de Recherche de Djibouti, Djibouti, République de Djibouti

6 Observatoire Midi-Pyrénées, Laboratoire d’Aérologie, Centre National de le Recherche Scientifique, Université Paul Sabatier, Toulouse, France

7 Centre National d’Etudes Spatiales, Service Applications et Valorisation, Toulouse, France

8 Institut National de Santé Publique de Djibouti, Ministère de la Santé, Djibouti, République de Djibouti

9 Bureau Expertise des risques sanitaires, Sous-direction Action Scientifique et Technique, Direction Centrale du Service de Santé des Armées, Paris, France

10 Faculté des Sciences, Université de Djibouti, Djibouti, République de Djibouti

11 Institut Pasteur de Madagascar, Antananarivo, Madagascar

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Malaria Journal 2012, 11:395  doi:10.1186/1475-2875-11-395

Published: 28 November 2012



Formerly known as a hypoendemic malaria country, the Republic of Djibouti declared the goal of pre-eliminating malaria in 2006. The aim of the present study was to evaluate the prevalence of Plasmodium falciparum, Plasmodium vivax and mixed infections in the Djiboutian population by using serological tools and to identify potential determinants of the disease and hotspots of malaria transmission within the country.


The prevalence of P. falciparum and P. vivax within the districts of the capital city and the rest of the Republic of Djibouti were assessed using 13 and 2 serological markers, respectively. The relationship between the immune humeral response to P. falciparum and P. vivax and variables such as age, gender, wealth status, urbanism, educational level, distance to rivers/lakes, living area, having fever in the last month, and staying in a malaria-endemic country more than one year was estimated and analysed by questionnaires administered to 1910 Djiboutians. Multivariate ordinal logistic regression models of the immune humeral response were obtained for P. falciparum and P. vivax.


The P. falciparum and P. vivax seroprevalence rates were 31.5%, CI95% [29.4-33.7] and 17.5%, CI95% [15.8-19.3], respectively. Protective effects against P. falciparum and P. vivax were female gender, educational level, and never having visited a malaria-endemic area for more than one year. For P. falciparum only, a protective effect was observed for not having a fever in the last month, living more than 1.5 km away from lakes and rivers, and younger ages.


This is the first study that assessed the seroprevalence of P. vivax in the Republic of Djibouti. It is necessary to improve knowledge of this pathogen in order to create an effective elimination programme. As supported by recent observations on the subject, the Republic of Djibouti has probably demonstrated a real decrease in the transmission of P. falciparum in the past seven years, which should encourage authorities to improve efforts toward elimination.

Malaria; Plasmodium falciparum; Plasmodium vivax; Seroprevalence; Serological marker; Djibouti