Population Movement as a Risk Factor for Malaria Infection in High-Altitude Villages of Tahtay–Maychew District, Tigray, Northern Ethiopia: A Case–Control Study

Mebrahtom Haile School of Water and Public Health, Ethiopian Institute of Water Resource, Addis Ababa University, Ethiopia;
Federal Ministry of Health, Addis Ababa, Ethiopia;

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Hailemariam Lemma Federal Ministry of Health, Addis Ababa, Ethiopia;
Public Health Department, College of Health Sciences, Mekelle University, Mekelle, Ethiopia;

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Yemane Weldu Department of Medical Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia

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Key goal and targets of the Ethiopia National Malaria Control Program are to achieve malaria elimination within specific geographical areas with historically low malaria transmission and to reach near-zero malaria transmission in the remaining malarious areas by 2020. However, back and forth population movement between high-transmission and low-transmission area imposes challenge on the success of national malaria control programs. Therefore, examining the effect of human movement and identification of at-risk populations is crucial in an elimination setting. A matched case–control study was conducted among 520 study participants at a community level in low malaria transmission settings in northern Ethiopia. Study participants who received a malaria test were interviewed regarding their recent travel history. Bivariate and multivariate analyses were carried out to determine if the reported travel was related to malaria infection. Younger age (adjusted odds ratio [AOR] = 3.20, 95% confidence interval [CI]: 1.73, 5.89) and travel in the previous month (AOR = 11.40, 95% CI: 6.91, 18.82) were statistically significant risk factors for malaria infection. Other statistically significant factors, including lower educational level (AOR = 2.21, 95% CI: 1.26, 3.86) and nonagricultural in occupation (AOR = 2.0, 95% CI: 1.02, 3.94), were also found as risk factors for malaria infection. Generally, travel history was found to be a strong predictor for malaria acquisition in the high-altitude villages. Therefore, besides the existing efforts in endemic areas, targeting those who frequently travel to malarious areas is crucial to reduce malaria infection risks and possibility of local transmissions in high-altitude areas of northern Ethiopia.

Author Notes

Address correspondence Yemane Weldu, Department of Medical Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia. E-mail: yemaneweldu@gmail.com

Financial support: University of Connecticut (USA), USAID, and Addis Ababa University/Ethiopian Institute of Water Resource: GRANT NUMBER: RES/ EIWR/009/2014.

Authors’ addresses: Mebrahtom Haile and Hailemariam Lemma, National Malaria Program at Federal Ministry of Health, Addis Ababa, Ethiopia, E-mails: mebrahtom2007@gmail.com and hailelm@gmail.com. Yemane Weldu, Mekelle University College of Health Sciences, Mekelle, Ethiopia, E-mail: yemaneweldu@gmail.com.

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