Abstract
BackgroundThe expansion of global travel has resulted in the importation of African Anopheles mosquitoes, giving rise to cases of local malaria transmission. Here, cases of 'airport malaria' are used to quantify, using a combination of global climate and air traffic volume, where and when are the greatest risks of a Plasmodium falciparum-carrying mosquito being importated by air. This prioritises areas at risk of further airport malaria and possible importation or reemergence of the disease.MethodsMonthly data on climate at the World's major airports were combined with air traffic information and African malaria seasonality maps to identify, month-by-month, those existing and future air routes at greatest risk of African malaria-carrying mosquito importation and temporary establishment.ResultsThe location and timing of recorded airport malaria cases proved predictable using a combination of climate and air traffic data. Extending the analysis beyond the current air network architecture enabled identification of the airports and months with greatest climatic similarity to P. falciparum endemic regions of Africa within their principal transmission seasons, and therefore at risk should new aviation routes become operational.ConclusionWith the growth of long haul air travel from Africa, the identification of the seasonality and routes of mosquito importation is important in guiding effective aircraft disinsection and vector control. The recent and continued addition of air routes from Africa to more climatically similar regions than Europe will increase movement risks. The approach outlined here is capable of identifying when and where these risks are greatest.
Highlights
The expansion of global travel has resulted in the importation of African Anopheles mosquitoes, giving rise to cases of local malaria transmission
Recent studies suggest that, where used, routine disinsection is proving effective in reducing airport malaria risk [16], the number of countries implementing such procedures is in decline [17,18]
We describe an exploratory approach which makes use of this information derived from airport malaria cases to quantify, in terms of global climate and air traffic, which airports have the greatest risks of local P. falciparum malaria transmission through importation from subSaharan Africa of infected mosquitoes
Summary
The expansion of global travel has resulted in the importation of African Anopheles mosquitoes, giving rise to cases of local malaria transmission. Cases of 'airport malaria' are used to quantify, using a combination of global climate and air traffic volume, where and when are the greatest risks of a Plasmodium falciparum-carrying mosquito being importated by air. An example of the effects of such importations are the many cases of autochthonous (locally-acquired) malaria, which are principally clustered around international airports: so called "airport malaria" [14,15]. These occur primarily through the transport of infected Anopheles mosquitoes that can survive for long enough after arrival to transmit malaria [14]. Recent studies suggest that, where used, routine disinsection is proving effective in reducing airport malaria risk [16], the number of countries implementing such procedures is in decline [17,18]
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