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Open Access Research

Travel history and malaria infection risk in a low-transmission setting in Ethiopia: a case control study

Joshua O Yukich1*, Cameron Taylor2, Thomas P Eisele1, Richard Reithinger34, Honelgn Nauhassenay5, Yemane Berhane5 and Joseph Keating1

Author Affiliations

1 Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, New Orleans, LA, USA

2 ICF International, Beltsville Drive, Calverton, MD, USA

3 United States Agency for International Development, Addis Ababa, Ethiopia

4 RTI International, Washington, DC, USA

5 Addis Continental Institute of Public Health, Kirikos sub-City, Addis Ababa, Ethiopia

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Malaria Journal 2013, 12:33  doi:10.1186/1475-2875-12-33

Published: 24 January 2013

Abstract

Background

Malaria 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.

Methods

An 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.

Results

After 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).

Conclusions

Given 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.

Keywords:
Malaria; Travel; Human movement; Importation; Plasmodium vivax; Plasmodium falciparum; Ethiopia; Reservoir infection