[Plasmodium falciparum travels by train from Ethiopia to Djibouti]

To investigate the role of the Djibouti-Ethiopian railway as a potential vehicle for inter-regional spread of malaria vectors and malaria parasites, we performed a double-sided study, both entomological and parasitological, during November 1989, at the frontier post of Guelile where the trains from Ethiopia enter the Republic of Djibouti. No malaria-transmitting mosquitoes were collected either from the daily passenger train or from the weekly vegetables train. One hundred and five passengers entering Djibouti by train from Ethiopia had a thick film examined for malaria parasites. Five smears were positive for Plasmodium falciparum, among them two showed gametocytes. We conclude that the railway may be an effective route for the propagation of the human malaria parasite between Ethiopia and Djibouti. Indeed, passengers infected abroad could import plasmodia into Djibouti and thus become the index cases for local malaria outbreaks, in case the climatic and entomological prerequisites essential for sustaining malaria transmission are present.