Abstract
In central Senegal, malaria incidence declined in response to scaling-up of control measures from 2000 to 2010 and has since remained stable, making elimination unlikely in the short term. Additional control measures are needed to reduce transmission. We simulated chemoprophylaxis interventions targeting malaria hotspots using a metapopulation mathematical model, based on a differential-equation framework and incorporating human mobility. The model was fitted to weekly malaria incidence from 45 villages. Three approaches for selecting intervention targets were compared: (a) villages with malaria cases during the low transmission season of the previous year; (b) villages with highest incidence during the high transmission season of the previous year; (c) villages with highest connectivity with adjacent populations. Our results showed that intervention strategies targeting hotspots would be effective in reducing malaria incidence in both targeted and untargeted areas. Regardless of the intervention strategy used, pre-elimination (1–5 cases per 1000 per year) would not be reached without simultaneously increasing vector control by more than 10%. A cornerstone of malaria control and elimination is the effective targeting of strategic locations. Mathematical tools help to identify those locations and estimate the impact in silico.
Highlights
Malaria remains a major health burden, with a global annual incidence of 228 million new cases and 405,000 deaths in 2018, most of which have occurred in sub-SaharanAfrica [1]
This is primarily due to universal coverage of long-lasting insecticide-treated bednets (LLIN) [2], improved access to diagnosis (Rapid Diagnostic Tests rapid diagnostic test (RDT)) and prompt treatment of malaria with
This study aims to understand the impact of spatially targeted malaria interventions, considering human mobility and using a metapopulation mathematical model based on a susceptible-exposed-infected-recovered (SEIR) framework, with 45 spatially separated villages that interact with each other via moving individuals
Summary
Malaria remains a major health burden, with a global annual incidence of 228 million new cases and 405,000 deaths in 2018, most of which have occurred in sub-SaharanAfrica [1]. In line with the situation in Senegal nationwide, malaria incidence has declined in the Mbour area since the 2000s, due to scaling-up of malaria control. This is primarily due to universal coverage of long-lasting insecticide-treated bednets (LLIN) [2], improved access to diagnosis (Rapid Diagnostic Tests RDT) and prompt treatment of malaria with. Senegal is still in the control phase of the malaria program, according to the World Health Organization (WHO) classification (more than 5 cases per 1000 inhabitants per year), but the country has been committed to achieving the objectives of pre-elimination by 2020 [5].
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