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Meredith HR, Wesolowski A, Okoth D, Maraga L, Ambani G, Chepkwony T, Abel L, Kipkoech J, Lokoel G, Esimit D, Lokemer S, Maragia J, Prudhomme O’Meara W, Obala AA. Characterizing mobility patterns and malaria risk factors in semi-nomadic populations of Northern Kenya. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002750. [PMID: 38478562 PMCID: PMC10936864 DOI: 10.1371/journal.pgph.0002750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/12/2024] [Indexed: 03/17/2024]
Abstract
While many studies have characterized mobility patterns and disease dynamics of settled populations, few have focused on more mobile populations. Highly mobile groups are often at higher disease risk due to their regular movement that may increase the variability of their environments, reduce their access to health care, and limit the number of intervention strategies suitable for their lifestyles. Quantifying the movements and their associated disease risks will be key to developing interventions more suitable for mobile populations. Turkana, Kenya is an ideal setting to characterize these relationships. While the vast, semi-arid county has a large mobile population (>60%) and was recently shown to have endemic malaria, the relationship between mobility and malaria risk in this region has not yet been defined. Here, we worked with 250 semi-nomadic households from four communities in Central Turkana to 1) characterize mobility patterns of travelers and 2) test the hypothesis that semi-nomadic individuals are at greater risk of malaria exposure when migrating with their herds than when staying at their semi-permanent settlements. Participants provided medical and travel histories, demographics, and a dried blood spot for malaria testing before and after the travel period. Further, a subset of travelers was given GPS loggers to document their routes. Four travel patterns emerged from the logger data, Long Term, Transient, Day trip, and Static, with only Long Term and Transient trips being associated with malaria cases detected in individuals who carried GPS devices. After completing their trips, travelers had a higher prevalence of malaria than those who remained at the household (9.2% vs 4.4%), regardless of gender and age. These findings highlight the need to develop intervention strategies amenable to mobile lifestyles that can ultimately help prevent the transmission of malaria.
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Affiliation(s)
- Hannah R. Meredith
- Duke Global Health Institute, Durham, North Carolina, United States of America
| | - Amy Wesolowski
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Dennis Okoth
- Department of Health Services and Sanitation, Lodwar, Turkana County, Kenya
| | - Linda Maraga
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | - George Ambani
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | | | - Lucy Abel
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | - Joseph Kipkoech
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | - Gilchrist Lokoel
- Department of Health Services and Sanitation, Lodwar, Turkana County, Kenya
| | - Daniel Esimit
- Department of Health Services and Sanitation, Lodwar, Turkana County, Kenya
| | - Samuel Lokemer
- Department of Health Services and Sanitation, Lodwar, Turkana County, Kenya
| | - James Maragia
- Department of Health Services and Sanitation, Lodwar, Turkana County, Kenya
| | - Wendy Prudhomme O’Meara
- Duke Global Health Institute, Durham, North Carolina, United States of America
- School of Public Health, Moi University College of Health Sciences, Eldoret, Kenya
- School of Medicine, Duke University, Durham, North Carolina, United States of America
| | - Andrew A. Obala
- School of Medicine, Moi University College of Health Sciences, Eldoret, Kenya
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Meredith HR, Wesolowski A, Okoth D, Maraga L, Ambani G, Chepkwony T, Abel L, Kipkoech J, Lokoel G, Esimit D, Lokemer S, Maragia J, O’Meara WP, Obala AA. Characterizing mobility patterns and malaria risk factors in semi-nomadic populations of Northern Kenya. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.06.23299617. [PMID: 38106223 PMCID: PMC10723563 DOI: 10.1101/2023.12.06.23299617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
While many studies have characterized mobility patterns and disease dynamics of individuals from settled populations, few have focused on more mobile populations. Highly mobile groups are often at higher disease risk due to their regular movement that may increase the variability of their environments, reduce their access to health care, and limit the number of intervention strategies suitable for their lifestyles. Quantifying the movements and their associated disease risks will be key to developing intervention strategies more suitable for mobile populations. Here, we worked with four semi-nomadic communities in Central Turkana, Kenya to 1) characterize mobility patterns of travelers from semi-nomadic communities and 2) test the hypothesis that semi-nomadic individuals are at greater risk of exposure to malaria during seasonal migrations than when staying at their semi-permanent settlements. From March-October, 2021, we conducted a study in semi-nomadic households (n=250) where some members traveled with their herd while others remained at the semi-permanent settlement. Participants provided medical and travel histories, demographics, and a dried blood spot for malaria testing before and after the travel period. Further, a subset of travelers was given GPS loggers to document their routes. Four travel patterns emerged from the logger data, Long Term, Transient, Day trip, and Static, with only Long Term and Transient trips being associated with malaria cases detected in individuals who carried GPS devices. After completing their trips, travelers had a higher prevalence of malaria than those who remained at the household (9.2% vs 4.4%), regardless of gender, age group, and catchment area. These findings highlight the need to develop intervention strategies amenable to mobile lifestyles that can ultimately help prevent the transmission of malaria.
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Affiliation(s)
| | - Amy Wesolowski
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Dennis Okoth
- Department of Health Services and Sanitation, Turkana County, Kenya
| | - Linda Maraga
- Academic Model Providing Access to Healthcare, Eldoret, Uasin Gishu, Kenya
| | - George Ambani
- Academic Model Providing Access to Healthcare, Eldoret, Uasin Gishu, Kenya
| | - Tabitha Chepkwony
- Academic Model Providing Access to Healthcare, Eldoret, Uasin Gishu, Kenya
| | - Lucy Abel
- Academic Model Providing Access to Healthcare, Eldoret, Uasin Gishu, Kenya
| | - Joseph Kipkoech
- Academic Model Providing Access to Healthcare, Eldoret, Uasin Gishu, Kenya
| | - Gilchrist Lokoel
- Department of Health Services and Sanitation, Turkana County, Kenya
| | - Daniel Esimit
- Department of Health Services and Sanitation, Turkana County, Kenya
| | - Samuel Lokemer
- Department of Health Services and Sanitation, Turkana County, Kenya
| | - James Maragia
- Department of Health Services and Sanitation, Turkana County, Kenya
| | - Wendy Prudhomme O’Meara
- Duke Global Health Institute, Durham, North Carolina, USA
- School of Public Health, Moi University College of Health Sciences, Eldoret, Uasin Gishu, Kenya
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Andrew A. Obala
- School of Medicine, Moi University College of Health Sciences, Eldoret, Uasin Gishu, Kenya
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