Travel history and malaria infection risk in a low-transmission setting in Ethiopia: a case control study.
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.
Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, New Orleans, LA, USA. jyukich@tulane.edu
Joshua O
JO
Yukich
Cameron
C
Taylor
Thomas P
TP
Eisele
Richard
R
Reithinger
Honelgn
H
Nauhassenay
Yemane
Y
Berhane
Joseph
J
Keating
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology*; D016780:Malaria, Vivax / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D014195:Travel; D055815:Young Adult