Reducing Plasmodium falciparum malaria transmission in Africa: a model-based evaluation of intervention strategies.

<h4>Background</h4>Over the past decade malaria intervention coverage has been scaled up across Africa. However, it remains unclear what overall reduction in transmission is achievable using currently available tools.<h4>Methods and findings</h4>We developed an individual-bas...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Jamie T Griffin, T Deirdre Hollingsworth, Lucy C Okell, Thomas S Churcher, Michael White, Wes Hinsley, Teun Bousema, Chris J Drakeley, Neil M Ferguson, María-Gloria Basáñez, Azra C Ghani
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2010
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/5bfbfb41a3a24fd9a3879f6aae06da0a
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:5bfbfb41a3a24fd9a3879f6aae06da0a
record_format	dspace
spelling	oai:doaj.org-article:5bfbfb41a3a24fd9a3879f6aae06da0a2021-12-02T19:55:50ZReducing Plasmodium falciparum malaria transmission in Africa: a model-based evaluation of intervention strategies.1549-12771549-167610.1371/journal.pmed.1000324https://doaj.org/article/5bfbfb41a3a24fd9a3879f6aae06da0a2010-08-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20711482/?tool=EBIhttps://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>Over the past decade malaria intervention coverage has been scaled up across Africa. However, it remains unclear what overall reduction in transmission is achievable using currently available tools.<h4>Methods and findings</h4>We developed an individual-based simulation model for Plasmodium falciparum transmission in an African context incorporating the three major vector species (Anopheles gambiae s.s., An. arabiensis, and An. funestus) with parameters obtained by fitting to parasite prevalence data from 34 transmission settings across Africa. We incorporated the effect of the switch to artemisinin-combination therapy (ACT) and increasing coverage of long-lasting insecticide treated nets (LLINs) from the year 2000 onwards. We then explored the impact on transmission of continued roll-out of LLINs, additional rounds of indoor residual spraying (IRS), mass screening and treatment (MSAT), and a future RTS,S/AS01 vaccine in six representative settings with varying transmission intensity (as summarized by the annual entomological inoculation rate, EIR: 1 setting with low, 3 with moderate, and 2 with high EIRs), vector-species combinations, and patterns of seasonality. In all settings we considered a realistic target of 80% coverage of interventions. In the low-transmission setting (EIR approximately 3 ibppy [infectious bites per person per year]), LLINs have the potential to reduce malaria transmission to low levels (<1% parasite prevalence in all age-groups) provided usage levels are high and sustained. In two of the moderate-transmission settings (EIR approximately 43 and 81 ibppy), additional rounds of IRS with DDT coupled with MSAT could drive parasite prevalence below a 1% threshold. However, in the third (EIR = 46) with An. arabiensis prevailing, these interventions are insufficient to reach this threshold. In both high-transmission settings (EIR approximately 586 and 675 ibppy), either unrealistically high coverage levels (>90%) or novel tools and/or substantial social improvements will be required, although considerable reductions in prevalence can be achieved with existing tools and realistic coverage levels.<h4>Conclusions</h4>Interventions using current tools can result in major reductions in P. falciparum malaria transmission and the associated disease burden in Africa. Reduction to the 1% parasite prevalence threshold is possible in low- to moderate-transmission settings when vectors are primarily endophilic (indoor-resting), provided a comprehensive and sustained intervention program is achieved through roll-out of interventions. In high-transmission settings and those in which vectors are mainly exophilic (outdoor-resting), additional new tools that target exophagic (outdoor-biting), exophilic, and partly zoophagic mosquitoes will be required.Jamie T GriffinT Deirdre HollingsworthLucy C OkellThomas S ChurcherMichael WhiteWes HinsleyTeun BousemaChris J DrakeleyNeil M FergusonMaría-Gloria BasáñezAzra C GhaniPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 7, Iss 8 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Jamie T Griffin T Deirdre Hollingsworth Lucy C Okell Thomas S Churcher Michael White Wes Hinsley Teun Bousema Chris J Drakeley Neil M Ferguson María-Gloria Basáñez Azra C Ghani Reducing Plasmodium falciparum malaria transmission in Africa: a model-based evaluation of intervention strategies.
description	<h4>Background</h4>Over the past decade malaria intervention coverage has been scaled up across Africa. However, it remains unclear what overall reduction in transmission is achievable using currently available tools.<h4>Methods and findings</h4>We developed an individual-based simulation model for Plasmodium falciparum transmission in an African context incorporating the three major vector species (Anopheles gambiae s.s., An. arabiensis, and An. funestus) with parameters obtained by fitting to parasite prevalence data from 34 transmission settings across Africa. We incorporated the effect of the switch to artemisinin-combination therapy (ACT) and increasing coverage of long-lasting insecticide treated nets (LLINs) from the year 2000 onwards. We then explored the impact on transmission of continued roll-out of LLINs, additional rounds of indoor residual spraying (IRS), mass screening and treatment (MSAT), and a future RTS,S/AS01 vaccine in six representative settings with varying transmission intensity (as summarized by the annual entomological inoculation rate, EIR: 1 setting with low, 3 with moderate, and 2 with high EIRs), vector-species combinations, and patterns of seasonality. In all settings we considered a realistic target of 80% coverage of interventions. In the low-transmission setting (EIR approximately 3 ibppy [infectious bites per person per year]), LLINs have the potential to reduce malaria transmission to low levels (<1% parasite prevalence in all age-groups) provided usage levels are high and sustained. In two of the moderate-transmission settings (EIR approximately 43 and 81 ibppy), additional rounds of IRS with DDT coupled with MSAT could drive parasite prevalence below a 1% threshold. However, in the third (EIR = 46) with An. arabiensis prevailing, these interventions are insufficient to reach this threshold. In both high-transmission settings (EIR approximately 586 and 675 ibppy), either unrealistically high coverage levels (>90%) or novel tools and/or substantial social improvements will be required, although considerable reductions in prevalence can be achieved with existing tools and realistic coverage levels.<h4>Conclusions</h4>Interventions using current tools can result in major reductions in P. falciparum malaria transmission and the associated disease burden in Africa. Reduction to the 1% parasite prevalence threshold is possible in low- to moderate-transmission settings when vectors are primarily endophilic (indoor-resting), provided a comprehensive and sustained intervention program is achieved through roll-out of interventions. In high-transmission settings and those in which vectors are mainly exophilic (outdoor-resting), additional new tools that target exophagic (outdoor-biting), exophilic, and partly zoophagic mosquitoes will be required.
format	article
author	Jamie T Griffin T Deirdre Hollingsworth Lucy C Okell Thomas S Churcher Michael White Wes Hinsley Teun Bousema Chris J Drakeley Neil M Ferguson María-Gloria Basáñez Azra C Ghani
author_facet	Jamie T Griffin T Deirdre Hollingsworth Lucy C Okell Thomas S Churcher Michael White Wes Hinsley Teun Bousema Chris J Drakeley Neil M Ferguson María-Gloria Basáñez Azra C Ghani
author_sort	Jamie T Griffin
title	Reducing Plasmodium falciparum malaria transmission in Africa: a model-based evaluation of intervention strategies.
title_short	Reducing Plasmodium falciparum malaria transmission in Africa: a model-based evaluation of intervention strategies.
title_full	Reducing Plasmodium falciparum malaria transmission in Africa: a model-based evaluation of intervention strategies.
title_fullStr	Reducing Plasmodium falciparum malaria transmission in Africa: a model-based evaluation of intervention strategies.
title_full_unstemmed	Reducing Plasmodium falciparum malaria transmission in Africa: a model-based evaluation of intervention strategies.
title_sort	reducing plasmodium falciparum malaria transmission in africa: a model-based evaluation of intervention strategies.
publisher	Public Library of Science (PLoS)
publishDate	2010
url	https://doaj.org/article/5bfbfb41a3a24fd9a3879f6aae06da0a
work_keys_str_mv	AT jamietgriffin reducingplasmodiumfalciparummalariatransmissioninafricaamodelbasedevaluationofinterventionstrategies AT tdeirdrehollingsworth reducingplasmodiumfalciparummalariatransmissioninafricaamodelbasedevaluationofinterventionstrategies AT lucycokell reducingplasmodiumfalciparummalariatransmissioninafricaamodelbasedevaluationofinterventionstrategies AT thomasschurcher reducingplasmodiumfalciparummalariatransmissioninafricaamodelbasedevaluationofinterventionstrategies AT michaelwhite reducingplasmodiumfalciparummalariatransmissioninafricaamodelbasedevaluationofinterventionstrategies AT weshinsley reducingplasmodiumfalciparummalariatransmissioninafricaamodelbasedevaluationofinterventionstrategies AT teunbousema reducingplasmodiumfalciparummalariatransmissioninafricaamodelbasedevaluationofinterventionstrategies AT chrisjdrakeley reducingplasmodiumfalciparummalariatransmissioninafricaamodelbasedevaluationofinterventionstrategies AT neilmferguson reducingplasmodiumfalciparummalariatransmissioninafricaamodelbasedevaluationofinterventionstrategies AT mariagloriabasanez reducingplasmodiumfalciparummalariatransmissioninafricaamodelbasedevaluationofinterventionstrategies AT azracghani reducingplasmodiumfalciparummalariatransmissioninafricaamodelbasedevaluationofinterventionstrategies
_version_	1718375840933216256

Reducing Plasmodium falciparum malaria transmission in Africa: a model-based evaluation of intervention strategies.

Ejemplares similares