A cross-sectional study investigating malaria prevalence and associated predictors of infection among migrants to a newly established gold mining settlement in the Gambella Region of Ethiopia

Abstract

Background Malaria is a major disease burden in Ethiopia. Migration can influence malaria transmission dynamics, with individuals relocating from malaria-free highland regions to malarious lowlands potentially facing elevated risks of contracting malaria. Migrants may find it difficult to protect themselves against malaria and have limited access to diagnosis or treatment. Settlers in goldmining sites are one type of migrant and are often neglected in malaria research yet may have particularly high malaria risk. We conducted a malaria prevalence survey in a new goldmining settlement in the highly malarious Gambella Region, Ethiopia. Methods We interviewed participants for demographic information and their knowledge and practices of malaria. We also tested participants for malaria using rapid diagnostic tests and blood samples. Using logistic regressions, we analyzed the influence of demographic characteristics on malaria infections and bednet access. Interviews were also conducted among community members to comprehend the community living conditions and healthcare accessibility. Results The overall prevalence of P. falciparum was 39.7% (CI: 34.7%-44.4%). Young children were most likely to have malaria, with individuals aged 15–24 having 67% lower odds (aOR: 0.33; CI: 0.13–0.86) of infection compared to those aged 0–4 years old. Meanwhile, those age 25plus had 75% decreased odds of malaria infection (aOR 0.25; CI: 0.10–0.65). Individuals with bednets had approximately 50% decreased odds of testing positive for falciparum malaria than those reporting having no bednet (aOR: 0.47; CI: 0.22–0.97). Individuals who relocated from low elevation with high malaria test positivity rate areas were more prone to testing positive for malaria, as were those residing in densely populated households with multiple malaria cases. Conversely, individuals from higher elevations with low malaria test positivity rates, and those living in households with 5–10 occupants and < 2 malaria infections, were more likely to possess bednets. Conclusions This goldmining settlement provides an example of an oft-neglected atypical community where malaria is a significant, but under-addressed, health problem. Within this community, future interventions focused on distributing bednets, particularly to larger households and those with children, have great potential to alleviate the malaria burden. Efforts should also be made to provide affordable, and accessible, early diagnosis and treatment.