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Infection Importation: Malaria Elimination on Bioko Island

The article by Bradley et al. (2015) titled, “Infection importation: a key challenge to malaria elimination on Bioko Island, Equatorial Guinea” focusing on the importation of malaria will be analyzed. This study was based on the fact that the importation of pathogens had been listed as one of the factors predisposing the general public to infectious diseases, including malaria. Resultantly, the authors wanted to demonstrate the impact of the importation of Plasmodium falciparum in Equatorial Guinea, involving both travelers and those who had never traveled to the Bioko Island. Data collection involved performing malaria indicator surveys between the years 2013 and 2014 to establish the existing relationship between the prevalence of malaria and the movement of people between Equatorial Guinea and Bioko Island. The passengers leaving the mainland and those entering the mainland in Bioko Island were screened for malaria.

The findings of the study revealed that malaria infection was more common among people who had gone to the island within the last two months prior to the study than those who had not visited the island. It was also discovered that the children who lived in areas with the highest proportion of travelers between the two areas were also at an increased risk of contracting malaria compared to the children living in areas with the least number of travelers. Finally, it was established that the risk of malaria was higher among boat passengers entering the mainland compared to those leaving the mainland. The findings of this study are directed to travelers between the mainland and Bioko Island as the primary audience. However, the results are of greater importance to the residents of areas with a high traveling rating, as well as the relevant authorities responsible for combating infectious diseases.

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The relevance of this study finding is mainly based on the research strength. The authors provided sufficient background information for the study, thereby giving justification for their work. It was necessary for the importation of this pathogen between the mainland and the Island to be described because pathogen importation had been shown to contribute to increased rates of infection. It also poses a challenge to strategies aimed at controlling pathogenic infections (Dolgin, 2010). The site selected for the study was also proper. Bioko Island provides a good breeding ground for mosquitoes because of being surrounded by water (Martens & Hall, 2000). As such, the rate of malaria on the island may be high. Measuring the rate of exposure of persons traveling to and from this Island was sufficient to demonstrate malaria importation and its effects. The period and the nature of participants screened were ideal for the type of study. The major limitation of this study was the lack of comparison with similar studies done in different places. Moreover, the researchers did not provide a picture of what happened between the mainland to the mainland and island to island importation.

The study provides important findings that are strongly related to the health problem of interest. It provides an excellent model of disease importation from areas where the disease prevalence is high to regions with low prevalence, and the resulting impact on the entire population, whether travelers or non-travelers. The study demonstrated that the movement of persons from infected regions can undoubtedly result in the introduction of the disease into uninfected areas. Such findings serve as a wake-up call to the authorities to strengthen screening tests for all infectious diseases at various points of entry to a country. Adequate screening can prevent the spread of infections and make it easier to control infectious diseases.


Bradley, J., Monti, F., Rehman, A. M., Schwabe, C… & Vargas, D. et al. (2015). Infection importation: a key challenge to malaria elimination on Bioko Island, Equatorial Guinea. Malaria Journal, 14, 46.

Dolgin, E. (2010). Targeting hotspots of transmission promises to reduce malaria. Nature Medicine, 16(10), 1055.

Martens, P., & Hall, L. (2000). Malaria on the move: human population movement and malaria transmission. Emerging Infectious Diseases, 6, 103–139.