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Mapping residual transmission for malaria elimination

  1. Robert C Reiner  Is a corresponding author
  2. Arnaud Le Manach
  3. Simon Kunene
  4. Nyasatu Ntshalintshali
  5. Michelle S Hsiang
  6. T Alex Perkins
  7. Bryan Greenhouse
  8. Andrew J Tatem
  9. Justin M Cohen
  10. David L Smith
  1. National Institutes of Health, United States
  2. Clinton Health Access Initiative, United States
  3. National Malaria Control Program, Swaziland
  4. University of Texas Southwestern Medical Center, United States
  5. University of California, San Francisco, United States
Research Article
  • Cited 35
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Cite this article as: eLife 2015;4:e09520 doi: 10.7554/eLife.09520

Abstract

Eliminating malaria from a defined region involves draining the endemic parasite reservoir and minimizing local malaria transmission around imported malaria infections1. In the last phases of malaria elimination, as universal interventions reap diminishing marginal returns, national resources must become increasingly devoted to identifying where residual transmission is occurring. The needs for accurate measures of progress and practical advice about how to allocate scarce resources require new analytical methods to quantify fine-grained heterogeneity in malaria risk. Using routine national surveillance data from Swaziland (a sub-Saharan country on the verge of elimination), we estimated individual reproductive numbers. Fine-grained maps of reproductive numbers and local malaria importation rates were combined to show `malariogenic potential,' a first for malaria elimination. As countries approach elimination, these individual-based measures of transmission risk provide meaningful metrics for planning programmatic responses and prioritizing areas where interventions will contribute most to malaria elimination.

Article and author information

Author details

  1. Robert C Reiner

    Fogarty International Center, National Institutes of Health, Bethesda, United States
    For correspondence
    rcreiner@indiana.edu
    Competing interests
    The authors declare that no competing interests exist.
  2. Arnaud Le Manach

    Clinton Health Access Initiative, Boston, United States
    Competing interests
    The authors declare that no competing interests exist.
  3. Simon Kunene

    National Malaria Control Program, Manzini, Swaziland
    Competing interests
    The authors declare that no competing interests exist.
  4. Nyasatu Ntshalintshali

    Clinton Health Access Initiative, Boston, United States
    Competing interests
    The authors declare that no competing interests exist.
  5. Michelle S Hsiang

    Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, United States
    Competing interests
    The authors declare that no competing interests exist.
  6. T Alex Perkins

    Fogarty International Center, National Institutes of Health, Bethesda, United States
    Competing interests
    The authors declare that no competing interests exist.
  7. Bryan Greenhouse

    Department of Medicine, University of California, San Francisco, San Francisco, United States
    Competing interests
    The authors declare that no competing interests exist.
  8. Andrew J Tatem

    Fogarty International Center, National Institutes of Health, Bethesda, United States
    Competing interests
    The authors declare that no competing interests exist.
  9. Justin M Cohen

    Clinton Health Access Initiative, Boston, United States
    Competing interests
    The authors declare that no competing interests exist.
  10. David L Smith

    Fogarty International Center, National Institutes of Health, Bethesda, United States
    Competing interests
    The authors declare that no competing interests exist.

Reviewing Editor

  1. Mark Jit, London School of Hygiene & Tropical Medicine, and Public Health England, United Kingdom

Publication history

  1. Received: June 18, 2015
  2. Accepted: November 26, 2015
  3. Accepted Manuscript published: December 29, 2015 (version 1)
  4. Version of Record published: January 27, 2016 (version 2)

Copyright

© 2015, Reiner et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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