Association between Recent Overnight Travel and Risk of Malaria: A Prospective Cohort Study at Three Sites in Uganda.


Arinaitwe, E; Dorsey, G; Nankabirwa, JI; Kigozi, SP; Katureebe, A; Kakande, E; Rek, J; Rosenthal, PJ; Drakeley, C; Kamya, MR; Staedke, SG; (2018) Association between Recent Overnight Travel and Risk of Malaria: A Prospective Cohort Study at Three Sites in Uganda. Clinical infectious diseases. ISSN 1058-4838 DOI: https://doi.org/10.1093/cid/ciy478

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Abstract

Human movement can undermine malaria control efforts. However, understanding of the association between travel and malaria infection in Africa is limited. We evaluated the association between recent overnight travel and malaria incidence in Uganda. All children aged 0.5-10 years and one adult living in 266 randomly selected households within 3 different regions of Uganda were followed prospectively. Information on overnight travel was collected in 2015 - 2016. Malaria, defined as fever with parasites detected by microscopy, was measured using passive surveillance. At least one overnight trip was reported by 64 of 275 (23.3%) participants in Walukuba, 37 of 317 (11.7%) in Nagongera, and 19 of 314 (6.1%) in Kihihi. Among individuals who traveled, the incidence of malaria was higher in the first 60 days after traveling, compared to periods without recent travel at all 3 sites (overall 1.15 vs 0.33 episodes per person-year, incidence rate ratio 3.53, 95% confidence interval [CI] 1.85-6.73, p<0.001). Risk factors for malaria within 60 days following overnight travel included young age (19.5% in children vs 4.9% in adults, odds ratio [OR] 5.29, 95% CI 1.34-21.0, p=0.02) and not using an insecticide treated net (ITN) during travel (18.0% for no use vs 4.1% for any use, OR 5.10, 95% CI 1.07-24.5, p=0.04). Recent overnight travel was associated with a higher incidence of malaria. Individuals who travel may represent a high-risk group that could be targeted for malaria control interventions, particularly use of ITNs.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Immunology and Infection
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Research Centre: Malaria Centre
PubMed ID: 29868722
URI: http://researchonline.lshtm.ac.uk/id/eprint/4648008

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