Identifying Plasmodium falciparum transmission patterns through parasite prevalence and entomological inoculation rate

Background:Monitoring malaria transmission is a critical component of efforts to achieve targets for elimination and eradication. Two commonly monitored metrics of transmission intensity are parasite prevalence (PR) and the entomological inoculation rate (EIR). Comparing the spatial and temporal var...

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Published in:eLife 2021-10, Vol.10
Main Authors: Amoah, Benjamin, McCann, Robert S, Kabaghe, Alinune N, Mburu, Monicah, Chipeta, Michael G, Moraga, Paula, Gowelo, Steven, Tizifa, Tinashe, van den Berg, Henk, Mzilahowa, Themba, Takken, Willem, van Vugt, Michele, Phiri, Kamija S, Diggle, Peter J, Terlouw, Dianne J, Giorgi, Emanuele
Format: Article
Language:English
Subjects:
Disease hot spots
disease mapping
Disease transmission
entomological inoculation rate
Epidemiology
Epidemiology and Global Health
Estimates
Inoculation
Insecticides
Intervention
Malaria
Mathematical models
model-based geostatistics
Mosquitoes
parasite prevalence
Parasites
Plasmodium falciparum
Statistical analysis
Temporal variations
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Summary:Background:Monitoring malaria transmission is a critical component of efforts to achieve targets for elimination and eradication. Two commonly monitored metrics of transmission intensity are parasite prevalence (PR) and the entomological inoculation rate (EIR). Comparing the spatial and temporal variations in the PR and EIR of a given geographical region and modelling the relationship between the two metrics may provide a fuller picture of the malaria epidemiology of the region to inform control activities.Methods:Using geostatistical methods, we compare the spatial and temporal patterns of Plasmodium falciparum EIR and PR using data collected over 38 months in a rural area of Malawi. We then quantify the relationship between EIR and PR by using empirical and mechanistic statistical models.Results:Hotspots identified through the EIR and PR partly overlapped during high transmission seasons but not during low transmission seasons. The estimated relationship showed a 1-month delayed effect of EIR on PR such that at lower levels of EIR, increases in EIR are associated with rapid rise in PR, whereas at higher levels of EIR, changes in EIR do not translate into notable changes in PR.Conclusions:Our study emphasises the need for integrated malaria control strategies that combine vector and human host managements monitored by both entomological and parasitaemia indices.Funding:This work was supported by Stichting Dioraphte grant number 13050800.
ISSN:2050-084X
2050-084X
DOI:10.7554/eLife.65682