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Trop. Med. Infect. Dis. 2017, 2(1), 4; doi:10.3390/tropicalmed2010004

Assessing the Risk Factors Associated with Malaria in the Highlands of Ethiopia: What Do We Need to Know?

School of Public Health, University of Sydney, Sydney, NSW 2006, Australia
Department of Medical Entomology, NSW Health Pathology, Westmead Hospital, Westmead, NSW 2145, Australia
Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW 2006, Australia
Author to whom correspondence should be addressed.
Academic Editor: John Frean
Received: 7 December 2016 / Revised: 23 February 2017 / Accepted: 25 February 2017 / Published: 1 March 2017
View Full-Text   |   Download PDF [261 KB, uploaded 1 March 2017]


Malaria has been Ethiopia’s predominant communicable disease for decades. Following the catastrophic malaria outbreak in 2003–2004, the Federal Ministry of Health (FMoH) took drastic public health actions to lower the burden of malaria. The FMoH achieved significant declines in malaria mortality and incidence, and recently declared its objective to achieve malaria elimination in low malaria transmission areas of Ethiopia by 2020. However, while the overall malaria prevalence has decreased, unpredictable outbreaks increasingly occur irregularly in regions previously considered “malaria-free”. Such outbreaks have disastrous consequences on populations of these regions as they have no immunity against malaria. The Amhara Region accounts for 31% of Ethiopia’s malaria burden and is targeted for malaria elimination by the FMoH. Amhara’s epidemiological surveillance system faces many challenges to detect in a timely manner the unpredictable and irregular malaria outbreaks that occur in areas of otherwise low transmission. Despite the evidence of a shift in malaria transmission patterns, Amhara’s malaria control interventions remain constrained to areas that are historically known to have stable malaria transmission. This paper discusses the influence of temperature and precipitation variability, entomological parameters, and human population mobility on malaria transmission patterns across the Amhara Region, and in particular, in areas of unstable transmission. We argue that malaria epidemiological surveillance systems can be improved by accounting for population movements in addition to environmental and entomological factors. However, to date, no study has statistically analyzed the interplay of population dynamics on environmental and entomological drivers of malaria transmission. View Full-Text
Keywords: malaria; transmission; epidemic; outbreak; surveillance; climate; Anopheles; population mobility malaria; transmission; epidemic; outbreak; surveillance; climate; Anopheles; population mobility
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Vajda, É.A.; Webb, C.E. Assessing the Risk Factors Associated with Malaria in the Highlands of Ethiopia: What Do We Need to Know? Trop. Med. Infect. Dis. 2017, 2, 4.

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Trop. Med. Infect. Dis. EISSN 2414-6366 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
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