PLoS ONE
Volume 10, Issue 11, 2015

A venue-based survey of malaria, anemia and mobility patterns among migrant farm workers in amhara region, Ethiopia (Article) (Open Access)

Schicker R.S. , Hiruy N. , Melak B. , Gelaye W. , Bezabih B. , Stephenson R. , Patterson A.E. , Tadesse Z. , Emerson P.M. , Richards F.O., Jr. , Noland G.S.
  • a Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
  • b Carter Center, Addis Ababa, Ethiopia
  • c Carter Center, Addis Ababa, Ethiopia
  • d Amhara Regional Health Research Laboratory Center, Bahir Dar, Ethiopia
  • e Amhara National Regional State Health Bureau, Bahir Dar, Ethiopia
  • f Department of Health Behavior and Biological Sciences, School of Nursing, Center for Exuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
  • g Carter Center, Atlanta, GA, United States, Agnes Scott College, Public Health Epartment, Decatur, GA, United States
  • h Carter Center, Addis Ababa, Ethiopia
  • i Carter Center, Atlanta, GA, United States, International Trachoma Initiative, Task Force for Lobal Health, Atlanta, GA, United States
  • j Carter Center, Atlanta, GA, United States
  • k Carter Center, Atlanta, GA, United States

Abstract

Background Mobile populations present unique challenges to malaria control and elimination efforts. Each year, a large number of individuals travel to northwest Amhara Region, Ethiopia to seek seasonal employment on large-scale farms. Agricultural areas typically report the heaviest malaria burden within Amhara thereby placing migrants at high risk of infection. Yet little is known about these seasonal migrants and their malaria-related risk factors. Methods and Findings In July 2013, a venue-based survey of 605 migrant laborers 18 years or older was conducted in two districts of North Gondar zone, Amhara. The study population was predominantly male (97.7%) and young (mean age 22.8 years). Plasmodium prevalence by rapid diagnostic test (RDT) was 12.0%; One quarter (28.3%) of individuals were anemic (hemoglobin <13 g/dl). Nearly all participants (95.6%) originated from within Amhara Region, with half (51.6%) coming from within North Gondar zone. Around half (51.2%) slept in temporary shelters, while 20.5% regularly slept outside. Only 11.9% of participants had access to a long lasting insecticidal net (LLIN). Reported net use the previous night was 8.8% overall but 74.6% among those with LLIN access. Nearly one-third (30.1%) reported having fever within the past two weeks, of whom 31.3% sought care. Cost and distance were the main reported barriers to seeking care. LLIN access (odds ratio [OR] = 0.30, P = 0.04) and malaria knowledge (OR = 0.50, P = 0.02) were significantly associated with reduced Plasmodium infection among migrants, with a similar but non-significant trend observed for reported net use the previous night (OR = 0.16, P = 0.14). onclusions High prevalence of malaria and anemia were observed among a young population that originated from relatively proximate areas. Low access to care and low IRS and LLIN coverage likely place migrant workers at significant risk of malaria in this area and their return home may facilitate parasite transport to other areas. Strategies specifically tailored to migrant farm workers are needed to support malaria control and elimination activities in Ethiopia. © 2015 Schicker et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Author Keywords

[No Keywords available]

Index Keywords

pathogen load hemoglobin blood level complication agricultural worker sex ratio human middle aged statistics and numerical data Malaria Aged geographic distribution nonhuman Farmers Cross-Sectional Studies attitude to illness Young Adult migrant worker cross-sectional study Humans anemia male female risk factor malaria rapid test Plasmodium prevalence Article Ethiopia help seeking behavior major clinical study adult fever migration infection risk health care access parasite prevalence utilization hemoglobin emergency shelter bed net Transients and Migrants Insecticide-Treated Bednets insecticide treated net health care disparity health survey
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84957080031&doi=10.1371%2fjournal.pone.0143829&partnerID=40&md5=1bcf1a5cf487602df2823788cc2424b7
DOI: 10.1371/journal.pone.0143829
ISSN: 19326203
Cited by: 16
Original Language: English